Grasp and Release Test (GRT)

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Tool Description

  • Designed to assess hand neuro-prosthesis in individuals with C5-C6 SCIs, but has also been used to assess hand function prior to and following tendon transfers in people with C6-7 level injuries.
  • Assesses the ability to pick up, move, and release six objects of varying sizes, weights and textures using a palmar or lateral grasp. Each object was chosen to represent one or more objects routinely manipulated for activities of daily living (ADL) that represented a range of difficulties.

ICF Domain:

Activity – subcategory: Mobility.

Number of Items:

6

Brief Instructions for Administration & Scoring

Administration:

  • Clinician-administered; standardized performance test.
  • Specific instructions are provided for establishing the start position and for recording a successful completion of the task (see the ‘How-to use’ page of this tool).
  • A pretrial practice test for each object is permitted and practice continues until a successful completion is achieved.
  • This test takes approximately 20 minutes to administer.

Equipment:

  • peg
  • paperweight
  • fork
  • block
  • can
  • videotape

Scoring:

  • Subjects are scored on their ability to successfully move each of the objects; the number of times the subject is able to move each object in 30 seconds is recorded.
  • Each hand is tested and scored separately.

Interpretability

MCID: not established for SCI
SEM: not established for SCI
MDC: not established for SCI

  • A summed score is calculated by adding the item scores.
  • If a person fails to move an item, they score zero for that particular item.
  • Single item scores may be used.
  • Normative data has not been established for the SCI population.

Languages:

n/a

Training Required:

None formally required.

Availability:

See the ‘How-to use’ page of this tool.

Clinical Considerations

  • This is a standardized test of hand function that would be appropriate for a limited sub-sample of individuals with SCI.
  • Completion of the tool may vary depending on the individual’s abilities. For example, subjects with paralysis of the finger and/or thumb flexor muscles are generally unable to hold the fork or paperweight between the thumb and index finger so floor effects are possible.
  • Currently only assessed for use in young adults and adolescents.

Measurement Property Summary

# of studies reporting psychometric properties: 3

Reliability:

  • Test-retest reliability is High for all 6 items (ICC=0.87-1.00).

[Wuolle et al. 1994, Mulcahey et al. 2004]

Validity:

  • Correlations between the 12-month Functional Independence Measure (FIM) and the peg, block, paperweight and total number of GRT items were not statistically significant.
  • Statistically significant and Moderate to High correlations were found between the 12-month FIM and the fork item (r=0.624), the can item (r=0.700) and the videotape item (r=0.503).

[Wuolle et al. 1994, Mulcahey et al. 2004]

Responsiveness:

No values were reported for the responsiveness of the GRT for the SCI population.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the GRT for the SCI population.

Reviewer

Dr. Janice Eng, Kyle Diab

Date Last Updated:

Dec 1, 2016

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Download Worksheet:

Worksheet Document

Video

n/a

Scoring

Scored by mean # of successful completions and mean # of failures performed in 30 seconds, for each object over several trials (3-5 trials reported).

A summed completion score is calculated by adding the mean item completion scores. If a person fails to move an item, they score zero for that particular item. If a subject moves the item N times, the score is N. Single item scores may be reported.

  • Participants are scored on their ability to successfully move each of the objects; the number of times the subject is able to move each object in 30 seconds is recorded.
  • Each hand is tested and scored separately.

Equipment Needed

  • Peg
  • Paperweight
  • Fork
  • Block
  • Can
  • Videotape

GRT:

Harvey LA, Batty J, Jones R, Crosbie J. Hand function of C6 and C7 tetraplegics 1-16 years following injury. Spinal Cord 2001;39:37-43.
http://www.ncbi.nlm.nih.gov/pubmed/11224013

Mulcahey MJ, Smith BT, Betz RR. Psychometric rigor of the Grasp and Release Test for measuring functional limitation of persons with tetraplegia: a preliminary analysis. J Spinal Cord Med 2004; 27:41-6.
http://www.ncbi.nlm.nih.gov/pubmed/15156936

Post MW, Van lieshout G, Seelen HA, Snoek GJ, Ijzerman MJ, Pons C. 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. 2006;44(12):763-71.
http://www.ncbi.nlm.nih.gov/pubmed/16773040

Stroh Wuolle K, Van Doren CL, Thorpe GB, Keith MW, Peckham PH. Development of Quantitative Hand Grasp and Release Test for Patients with Tetraplegia using a Hand Neuroprosthesis. The Journal of Hand Surgery: 1994;19:209-18.
http://www.ncbi.nlm.nih.gov/pubmed/8201183

Taylor P, Esnouf J, Hobby J. The functional impact of the Freehand System on tetraplegic hand function. Clinical results. Spinal Cord 2002;11:550-6.
http://www.ncbi.nlm.nih.gov/pubmed/12411963

Wuolle KS, Van doren CL, Thrope GB, Keith MW, Peckham PH. Development of a quantitative hand grasp and release test for patients with tetraplegia using a hand neuroprosthesis. J Hand Surg Am. 1994;19(2):209-18.
http://www.ncbi.nlm.nih.gov/pubmed/8201183