The GRT assesses basic unilateral hand performance with manipulating objects with and without a neuroprosthesis in individuals with C5 and C6 tetraplegia.
6 tasks
90-150 minutes
Varies based on number of objects the participant is able to manipulate; 90-150 minutes including pretest (Stroh-Woulle et al., 1994).
Adult
18 - 64
yearsInitially reviewed by Cara Weisbach PT, DPT; Wendy Romney PT, DPT, NCS, and the SCI EDGE task force of the Neurology Section of the APTA in 04/2012.
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit:
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations for use based on acuity level of the patient:
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Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post) |
Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) |
Chronic (> 6 months) |
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SCI EDGE |
NR |
NR |
NR |
Recommendations based on SCI AIS Classification:
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AIS A/B |
AIS C/D |
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SCI EDGE |
NR |
NR |
Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
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SCI EDGE |
No |
No |
Yes |
Not reported |
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C5 and C6 Tetraplegia:
(Mulcahey, Smith & Betz, 2004; n = 21 hands prior to surgical intervention; age = 7-20 years, average 6.5 days between test)
Predictive Validity
C5 and C6 Tetraplegia:
(Mulcahey, Smith, & Betz, 2004; post surgical intervention)
Convergent Validity
C6 and C7 Tetraplegia:
(Harvey, Kilgore,& Peckham, 2001; n = 47, 81 hands 1-16 years post complete or incomplete SCI)
Chronic Tetraplegia:
(Post, 2006; n = 12; mean age = 43.2 (12.7) years; mean time since injury 13.0 (11.2) years)
Tetraplegia:
(Spooren et al., 2006; n = 34 AIS A and B; n = 26 AIS C and D; Assessed at start of active rehabilitation and at discharge, mean = 288 days)
Tetraplegia:
(Spooren et al., 2006; n = 34, AIS A and B; n = 26 AIS C and D; assessed start of rehabilitation to 3 months, mean = 93 days)
Tetraplegia:
(Mulcahey, Smith, & Betz, 2004)
Hart, R. L., Kilgore, K. L., et al. (1998). "A comparison between control methods for implanted FES hand-grasp systems." IEEE Transactions on Rehabilitation Engineering 6(2): 208-218.
Harvey, L. A., Batty, J., et al. (2001). "Hand function of C6 and C7 tetraplegics 1 - 16 years following injury." Spinal Cord 39(1): 37-43.
Mulcahey, M. J., Betz, R. R., et al. (1999). "A prospective evaluation of upper extremity tendon transfers in children with cervical spinal cord injury." Journal of Pediatric Orthopedics 19(3): 319-328.
Mulcahey, M. J., Betz, R. R., et al. (1997). "Implanted functional electrical stimulation hand system in adolescents with spinal injuries: an evaluation." Archives of Physical Medicine and Rehabilitation 78(6): 597-607.
Mulcahey, M. J., Smith, B. T., et al. (2004). "Psychometric rigor of the Grasp and Release Test for measuring functional limitation of persons with tetraplegia: a preliminary analysis." Journal of Spinal Cord Medicine 27(1): 41-46.
Post, M. W., Van Lieshout, G., et al. (2006). "Measurement properties of the short version of the Van Lieshout test for arm/hand function of persons with tetraplegia after spinal cord injury." Spinal Cord 44(12): 763-771.
Spooren, A. I., Janssen-Potten, Y. J., et al. (2006). "Measuring change in arm hand skilled performance in persons with a cervical spinal cord injury: responsiveness of the Van Lieshout Test." Spinal Cord 44(12): 772-779.
Taylor, P., Esnouf, J., et al. (2002). "The functional impact of the Freehand System on tetraplegic hand function. Clinical Results." Spinal Cord 40(11): 560-566.
Wuolle, K. S., Van Doren, C. L., et al. (1994). "Development of a quantitative hand grasp and release test for patients with tetraplegia using a hand neuroprosthesis." J Hand Surg Am 19(2): 209-218.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.