• Originally developed to assess basic functional modalities of the arm and hand in individuals with cervical SCI.
  • Assesses positioning and stabilization of the arms, opening and closing of the functional hand, grasping and releasing of the hands, and manipulation of the thumbs and fingers.
  • Tasks include:
    1) arch task
    2) forward reaching
    3) thumb opening
    4) finger opening
    5) grasp function of the thumb
    6) thumb strength
    7) finger strength
    8) pen grip
    9) opening a bottle
    10) lighting a match

Clinical Considerations

The VLT-SV was developed with the cervical SCI population in mind, implying appropriate item selection / challenge. During administration of the test, the patient and clinician together identify the best way to complete the task.

ICF Domain

Activity ▶ Mobility

Administration

  • Clinician-administered standardized performance test.
  • All tasks are performed while the patient is seated in their wheelchair for the “best hand” only.
  • The VLT-SV is scored on a 6-point scale, where 0 = task was not possible, and 5 = highest level of accomplishment. Individual item scores take into account the:

1) ability to complete the task;
2) behavioral quality of performance (e.g./accuracy of task completion);
3) independence in performing the task without using external support (e.g./assistance of the contra-lateral arm).

  • Administration time is usually 25-35 minutes.

Number of Items

10

Equipment

Current published literature does not provide details about standardization of the test (e.g./ table heights, distance of reaching tasks, etc.).

Scoring

A total score may be calculated by summing the scores of all 10 items.

Languages

English and Italian.

Training Required

No formal training is required. However, test administration by a skilled therapist is recommended.

Availability

The Van Lieshout Test – Short Version worksheet can be found here.

# of studies reporting psychometric properties: 2

Interpretability

  • Total scores range from 0 to 50 with higher scores indicating greater functional ability

MCID: not established
SEM: not established
MDC: not established

Typical Values

  • Mean (SD) of all 10 VLT Scores:
    Left hand = 2.6 (1.3)
    Right hand = 3.1 (1.3)

(Post et al. 2006: study 2; n=55, 46 males; tetraplegia; mean (SD) time since injury: 11.0 (8.5) years)

Reliability – High

  • Internal consistency of the VLT-SV is High for both the left hand (Cronbach’s a = 0.88) and right hand (Cronbach’s a = 0.94).
  • Inter-rater reliability is High for both the left hand (ICC = 0.98) and right hand (ICC = 0.99).
  • Test-retest reliability is High for both the left hand and right hand (ICC = 0.90)

(Post et al. 2006: study 2; n=55, 46 males; tetraplegia; mean (SD) time since injury: 11.0 (8.5) years)
(Berardi et al. 2019, n=61; 80.3% males; mean (SD) age: 47 (14.76) years; ASIA: 25A, 15B, 15C, 6D; Italian version)

Validity – Moderate to High

  • Correlation between left and right hand VLT-SV score is Moderate (Spearman’s r = 0.50)
  • Correlation between the Grasp and Release Test and VLT-SV is High for both left hand (Spearman’s r = 0.87) and right hand (Spearman’s r = 0.90).
  • Correlation between the Self Care-Functional Independence Measure and VLT-SV is High for both left hand (Spearman’s r = 0.61) and right hand (Spearman’s r = 0.69).
  • Correlation between the Transfer-Functional Independence Measure and VLT-SV is High for both left hand (Spearman’s r = 0.71) and right hand (Spearman’s r = 0.72).
  • Correlation between the ASIA Impairment Scale and VLT-SV is Moderate–High for the left hand (Spearman’s r = 0.35) and right hand (Spearman’s r = 0.69).

(Post et al. 2006: study 2; n=55, 46 males; tetraplegia; mean (SD) time since injury: 11.0 (8.5) years)
(Berardi et al. 2019, n=61; 80.3% males; mean (SD) age: 47 (14.76) years; ASIA: 25A, 15B, 15C, 6D; Italian version)

Responsiveness

There was a significant difference in VLT-SV scores across 3 measurement points (t1 = start of rehab, t2= 3 months after start of rehab, t3 = discharge).

(Spooren et al. 2006)

Floor/Ceiling Effect

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

Reviewers

Dr. Carlos L. Cano-Herrera, Elsa Sun

Date Last Updated

31 December 2024

Berardi, A., Biondillo, A., Màrquez, M.A., Santis, R.D., Fabbrini, G., Tofani, M., Valente, D., Galeoto, G.. Validation of the short version of the Van Lieshout Test in an Italian population with cervical spinal cord injuries: a cross-sectional study. Spinal Cord. 2019; 57: 339–345. https://www.nature.com/articles/s41393-018-0226-4#citeas

Franke AC, Snoek GJ, De groot S, Nene AV, Spooren AI, Post MW. Arm hand skilled performance in persons with a cervical spinal cord injury–long-term follow-up. Spinal Cord. 2013;51(2):161-4.
http://www.ncbi.nlm.nih.gov/pubmed/22986678

Post MWM, van Lieshout F, Seelen HAM, 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: 763-771
http://www.ncbi.nlm.nih.gov/pubmed/16773040

Spooren AI, Janssen-Potten YJ, Post MW, Kerckhofs E, Nene A, Seelen HA. Measuring change in arm hand skilled performance in persons with a cervical spinal cord injury: responsiveness of the Van Lieshout Test. Spinal Cord 2006; 44: 772-779.
http://www.ncbi.nlm.nih.gov/pubmed/16819555

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