- 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.
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.
ICF Domain
Activity ▶ Mobility
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.
Number of Items
6
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.
Languages
N/A
Training Required
Does not require advanced training.
Availability
Can be found here.
The file above contains instructions for administration and scoring, as well as a ready-to-use worksheet for data collection.
# of studies reporting psychometric properties: 3
Interpretability
- 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.
MCID: not established for SCI
SEM: not established for SCI
MDC: not established for SCI
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.
Reviewers
Dr. Janice Eng, Kyle Diab
Date Last Updated
1 May 2016
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
