• 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


  • 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



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


  • 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.



Training Required

Does not require advanced training.


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


  • 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


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

(Wuolle et al. 1994, Mulcahey et al. 2004)


  • 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)


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.


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.

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.

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.

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.

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.

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.