{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:48:12Z","timestamp":1776826092688,"version":"3.51.2"},"reference-count":60,"publisher":"American Spinal Injury Association","issue":"Supplement1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"\n Objectives:<\/jats:title>\n To examine associations between 3 standardized upper extremity (UE) measures\u2014the Capabilities of Upper Extremity Test (CUE-T), Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP), and the International Standards for Neurological Classification of Spinal Cord Injury Upper Extremity Motor Score (ISNCSCI-UEMS)\u2014and functional independence at discharge, measured by the Continuity Assessment Record and Evaluation (CARE) Tool, and their predictive value for discharge outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This was a secondary analysis of a randomized controlled trial in cervical spinal cord injury (SCI) conducted at an inpatient rehabilitation facility specializing in SCI. Participants were 75 adults with traumatic cervical SCI (C1-C8, AIS B-D) within 5 months post injury undergoing inpatient rehabilitation. Baseline UE measures (CUE-T, GRASSP total and subscales, UEMS) were administered early during rehabilitation. CARE tool total and self-care scores were extracted from records at baseline and discharge. Pearson correlations and linear regression models assessed relationships between UE measures and CARE outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Baseline CARE total and self-care scores showed moderate to strong correlations with CUE-T (\n r<\/jats:italic>\n = 0.72, 0.57), GRASSP total (\n r<\/jats:italic>\n = 0.75, 0.60), and GRASSP prehension performance (\n r<\/jats:italic>\n = 0.76, -0.59), respectively. CUE-T demonstrated the strongest predictive value for self-care outcomes at discharge (\n r<\/jats:italic>\n = 0.62). Each 1-unit increase in CUE-T predicted a 0.75-unit increase in CARE total and 0.33-unit increase in CARE self-care.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This study supports the convergent validity of the CARE tool with established UE outcome measures in SCI rehabilitation. Baseline CUE-T scores show the strongest predictive value for self-care independence at inpatient rehabilitation discharge.<\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci25-00127","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:17:19Z","timestamp":1776824239000},"page":"14-23","source":"Crossref","is-referenced-by-count":0,"title":["Upper Extremity Measures in Spinal Cord Injury: Convergent Validity and Prediction of Functional Independence"],"prefix":"10.46292","volume":"32","author":[{"given":"Candace","family":"Tefertiller","sequence":"first","affiliation":[{"name":"Craig Hospital, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitch","family":"Sevigny","sequence":"additional","affiliation":[{"name":"Craig Hospital, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bria","family":"Mellick","sequence":"additional","affiliation":[{"name":"Craig Hospital, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitlyn","family":"Hays","sequence":"additional","affiliation":[{"name":"Craig Hospital, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Busch","sequence":"additional","affiliation":[{"name":"Craig Hospital, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.J.","family":"Tuchscherer","sequence":"additional","affiliation":[{"name":"Craig Hospital, Denver, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"25425","reference":[{"issue":"10","key":"b1","series-title":"J Neurotrauma","first-page":"1371","article-title":"Targeting recovery: Priorities of the spinal cord-injured population","volume":"21","author":"Anderson KD","year":"2004","unstructured":"Anderson KD. Targeting recovery: Priorities of the spinal cord-injured population. J Neurotrauma. 2004;21(10):1371-1383. doi:10.1089\/neu.2004.21.1371."},{"issue":"8","key":"b2","series-title":"J Neurotrauma","first-page":"1548","article-title":"The health and life priorities of individuals with spinal cord injury: A systematic review","volume":"29","author":"Simpson LA","year":"2012","unstructured":"Simpson LA, Eng JJ, Hsieh JT, Wolfe DL, Spinal Cord Injury Rehabilitation Evidence Scire Research Team. The health and life priorities of individuals with spinal cord injury: A systematic review. J Neurotrauma. 2012;29(8):1548-1555. doi:10.1089\/neu.2011.2226."},{"issue":"1","key":"b3","series-title":"Phys Med Rehabil Clin N Am","first-page":"139","article-title":"Recovery insights following spinal cord injury: A consumer's perspective","volume":"36","author":"Ferber GA","year":"2025","unstructured":"Ferber GA, Anderson KD. Recovery insights following spinal cord injury: A consumer's perspective. Phys Med Rehabil Clin N Am. 2025;36(1):139-154. doi:10.1016\/j.pmr.2024.08.002."},{"issue":"3","key":"b4","series-title":"J Neurosurg Spine","first-page":"355","article-title":"Association of upper-limb neurological recovery with functional outcomes in high cervical spinal cord injury","volume":"39","author":"Javeed S","year":"2023","unstructured":"Javeed S, Greenberg JK, Zhang JK, et al. Association of upper-limb neurological recovery with functional outcomes in high cervical spinal cord injury. J Neurosurg Spine. 2023;39(3):355-362. doi:10.3171\/2023.4.SPINE2382."},{"issue":"9-10","key":"b5","series-title":"J Neurotrauma","first-page":"1211","article-title":"Impact of upper limb motor recovery on functional independence after traumatic low cervical spinal cord injury","volume":"41","author":"Javeed S","year":"2024","unstructured":"Javeed S, Zhang JK, Greenberg JK, et al. Impact of upper limb motor recovery on functional independence after traumatic low cervical spinal cord injury. J Neurotrauma. 2024;41(9-10):1211-1222. doi:10.1089\/neu.2023.0140."},{"issue":"7","key":"b6","series-title":"J Hand Surg Am","first-page":"621 e1","article-title":"Evaluation of functional independence in cervical spinal cord injury: Implications for surgery to restore upper limb function","volume":"46","author":"Dengler J","year":"2021","unstructured":"Dengler J, Mehra M, Steeves JD, Department of Defense Group, European Multicenter Study of Spinal Cord Injury Group, Fox IK. Evaluation of functional independence in cervical spinal cord injury: Implications for surgery to restore upper limb function. J Hand Surg Am. 2021;46(7):621 e1-621 e17. doi:10.1016\/j.jhsa.2020.10.036."},{"issue":"6","key":"b7","series-title":"Arch Phys Med Rehabil","first-page":"1061","article-title":"A postacute care function process quality measure for the collection of standardized self-care and mobility data: Development, implementation, and quality measure scores","volume":"103","author":"Deutsch A","year":"2022","unstructured":"Deutsch A, Palmer L, McMullen T, et al. A postacute care function process quality measure for the collection of standardized self-care and mobility data: Development, implementation, and quality measure scores. Arch Phys Med Rehabil. 2022;103(6):1061-1069. doi:10.1016\/j.apmr.2022.01.148."},{"issue":"6","key":"b8","series-title":"Arch Phys Med Rehabil","first-page":"1070","article-title":"Inpatient rehabilitation facility patients\u2019 functional abilities and validity testing of the standardized self-care and mobility data elements","volume":"103","author":"Deutsch A","year":"2022","unstructured":"Deutsch A, Palmer L, Vaughan M, Schwartz C, McMullen T. Inpatient rehabilitation facility patients\u2019 functional abilities and validity testing of the standardized self-care and mobility data elements. Arch Phys Med Rehabil. 2022;103(6):1070-1084 e3. doi:10.1016\/j.apmr.2022.01.147."},{"issue":"6","key":"b9","series-title":"Arch Phys Med Rehabil","first-page":"1096","article-title":"Change in mobility quality measure for inpatient rehabilitation facilities: Exclusion criteria and the risk adjustment model","volume":"103","author":"Vaughan M","year":"2022","unstructured":"Vaughan M, Deutsch A, McMullen T, Palmer L, Kwon S, Ingber MJ. Change in mobility quality measure for inpatient rehabilitation facilities: Exclusion criteria and the risk adjustment model. Arch Phys Med Rehabil. 2022;103(6):1096-1104. doi:10.1016\/j.apmr.2022.03.001."},{"issue":"6","key":"b10","series-title":"Arch Phys Med Rehabil","first-page":"1105","article-title":"Inpatient rehabilitation facility change in self-care and change in mobility quality measures: Development and reliability and validity testing","volume":"103","author":"Deutsch A","year":"2022","unstructured":"Deutsch A, Palmer L, Vaughan M, et al. 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Physiother Can. 2011;63(4):474-489. doi:10.3138\/ptc.2009-46."},{"issue":"1 Suppl","key":"b12","series-title":"J Neurosurg Spine","first-page":"65","article-title":"Development of the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP): Reviewing measurement specific to the upper limb in tetraplegia","volume":"17","author":"Kalsi-Ryan S","year":"2012","unstructured":"Kalsi-Ryan S, Curt A, Verrier MC, Fehlings MG. Development of the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP): Reviewing measurement specific to the upper limb in tetraplegia. 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Distribution-based estimates of clinically significant changes in the International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores. Eur J Phys Rehabil Med. 2013;49(3):373-384."},{"issue":"5","key":"b15","series-title":"J Am Med Dir Assoc","first-page":"723","article-title":"Reliability and validity of the inpatient rehabilitation facility discharge mobility and self-care quality measures","volume":"24","author":"Deutsch A","year":"2023","unstructured":"Deutsch A, Palmer L, Vaughan M, et al. Reliability and validity of the inpatient rehabilitation facility discharge mobility and self-care quality measures. J Am Med Dir Assoc. 2023;24(5):723-728 e4. doi:10.1016\/j.jamda.2023.03.015."},{"issue":"3","key":"b16","series-title":"Top Spinal Cord Inj Rehabil","first-page":"227","article-title":"Comparison of responsiveness and minimal clinically important difference of the Capabilities of Upper Extremity Test (CUE-T) and the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP)","volume":"24","author":"Marino RJ","year":"2018","unstructured":"Marino RJ, Sinko R, Bryden A, et al. Comparison of responsiveness and minimal clinically important difference of the Capabilities of Upper Extremity Test (CUE-T) and the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP). Top Spinal Cord Inj Rehabil. 2018;24(3):227-238. doi:10.1310\/sci2403-227."},{"issue":"4","key":"b17","series-title":"J Spinal Cord Med","first-page":"498","article-title":"Reliability and validity of the capabilities of upper extremity test (CUE-T) in subjects with chronic spinal cord injury","volume":"38","author":"Marino RJ","year":"2015","unstructured":"Marino RJ, Kern SB, Leiby B, Schmidt-Read M, Mulcahey MJ. Reliability and validity of the capabilities of upper extremity test (CUE-T) in subjects with chronic spinal cord injury. J Spinal Cord Med. 2015;38(4):498-504. doi:10.1179\/2045772314Y.0000000272."},{"issue":"5","key":"b18","series-title":"J Neurotrauma","first-page":"905","article-title":"The Graded Redefined Assessment of Strength Sensibility and Prehension: Reliability and validity","volume":"29","author":"Kalsi-Ryan S","year":"2012","unstructured":"Kalsi-Ryan S, Beaton D, Curt A, et al. 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Phys Ther. 2024;104(2). doi:10.1093\/ptj\/pzad183."},{"issue":"5","key":"b26","series-title":"Neurorehabil Neural Repair","first-page":"413","article-title":"Upper extremity function in persons with tetraplegia: Relationships between strength, capacity, and the spinal cord independence measure","volume":"23","author":"Rudhe C","year":"2009","unstructured":"Rudhe C, van Hedel HJ. Upper extremity function in persons with tetraplegia: Relationships between strength, capacity, and the spinal cord independence measure. Neurorehabil Neural Repair. 2009;23(5):413-421. doi:10.1177\/1545968308331143."},{"issue":"9","key":"b27","series-title":"Spinal Cord","first-page":"507","article-title":"Classification of upper-limb dysfunction severity and prediction of independence in activities of daily living after cervical spinal-cord injury","volume":"62","author":"Jimbo K","year":"2024","unstructured":"Jimbo K, Miyata K, Yuine H, et al. 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Arch Phys Med Rehabil. 2011;92(3):361-8. doi:10.1016\/j.apmr.2010.07.241."},{"issue":"2","key":"b29","series-title":"J Spinal Cord Med","first-page":"166","article-title":"Reliability and repeatability of the motor and sensory examination of the International Standards for Neurological Classification of Spinal Cord Injury","volume":"31","author":"Marino RJ","year":"2008","unstructured":"Marino RJ, Jones L, Kirshblum S, Tal J, Dasgupta A. Reliability and repeatability of the motor and sensory examination of the International Standards for Neurological Classification of Spinal Cord Injury. J Spinal Cord Med. 2008;31(2):166-170."},{"issue":"1","key":"b30","series-title":"Sci Rep","first-page":"3148","article-title":"Independence and upper extremity functioning after spinal cord injury: A cross-sectional study","volume":"13","author":"Lili L","year":"2023","unstructured":"Lili L, Sunnerhagen KS, Rekand T, Alt Murphy M. Independence and upper extremity functioning after spinal cord injury: A cross-sectional study. Sci Rep. 2023;13(1):3148. doi:10.1038\/s41598-023-29986-y."},{"issue":"10","key":"b1","series-title":"J Neurotrauma","first-page":"1371","article-title":"Targeting recovery: Priorities of the spinal cord-injured population","volume":"21","author":"Anderson KD","year":"2004","unstructured":"Anderson KD. Targeting recovery: Priorities of the spinal cord-injured population. J Neurotrauma. 2004;21(10):1371-1383. doi:10.1089\/neu.2004.21.1371."},{"issue":"8","key":"b2","series-title":"J Neurotrauma","first-page":"1548","article-title":"The health and life priorities of individuals with spinal cord injury: A systematic review","volume":"29","author":"Simpson LA","year":"2012","unstructured":"Simpson LA, Eng JJ, Hsieh JT, Wolfe DL, Spinal Cord Injury Rehabilitation Evidence Scire Research Team. The health and life priorities of individuals with spinal cord injury: A systematic review. J Neurotrauma. 2012;29(8):1548-1555. doi:10.1089\/neu.2011.2226."},{"issue":"1","key":"b3","series-title":"Phys Med Rehabil Clin N Am","first-page":"139","article-title":"Recovery insights following spinal cord injury: A consumer's perspective","volume":"36","author":"Ferber GA","year":"2025","unstructured":"Ferber GA, Anderson KD. Recovery insights following spinal cord injury: A consumer's perspective. Phys Med Rehabil Clin N Am. 2025;36(1):139-154. doi:10.1016\/j.pmr.2024.08.002."},{"issue":"3","key":"b4","series-title":"J Neurosurg Spine","first-page":"355","article-title":"Association of upper-limb neurological recovery with functional outcomes in high cervical spinal cord injury","volume":"39","author":"Javeed S","year":"2023","unstructured":"Javeed S, Greenberg JK, Zhang JK, et al. Association of upper-limb neurological recovery with functional outcomes in high cervical spinal cord injury. J Neurosurg Spine. 2023;39(3):355-362. doi:10.3171\/2023.4.SPINE2382."},{"issue":"9-10","key":"b5","series-title":"J Neurotrauma","first-page":"1211","article-title":"Impact of upper limb motor recovery on functional independence after traumatic low cervical spinal cord injury","volume":"41","author":"Javeed S","year":"2024","unstructured":"Javeed S, Zhang JK, Greenberg JK, et al. Impact of upper limb motor recovery on functional independence after traumatic low cervical spinal cord injury. J Neurotrauma. 2024;41(9-10):1211-1222. doi:10.1089\/neu.2023.0140."},{"issue":"7","key":"b6","series-title":"J Hand Surg Am","first-page":"621 e1","article-title":"Evaluation of functional independence in cervical spinal cord injury: Implications for surgery to restore upper limb function","volume":"46","author":"Dengler J","year":"2021","unstructured":"Dengler J, Mehra M, Steeves JD, Department of Defense Group, European Multicenter Study of Spinal Cord Injury Group, Fox IK. Evaluation of functional independence in cervical spinal cord injury: Implications for surgery to restore upper limb function. J Hand Surg Am. 2021;46(7):621 e1-621 e17. doi:10.1016\/j.jhsa.2020.10.036."},{"issue":"6","key":"b7","series-title":"Arch Phys Med Rehabil","first-page":"1061","article-title":"A postacute care function process quality measure for the collection of standardized self-care and mobility data: Development, implementation, and quality measure scores","volume":"103","author":"Deutsch A","year":"2022","unstructured":"Deutsch A, Palmer L, McMullen T, et al. A postacute care function process quality measure for the collection of standardized self-care and mobility data: Development, implementation, and quality measure scores. 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Inpatient rehabilitation facility change in self-care and change in mobility quality measures: Development and reliability and validity testing. Arch Phys Med Rehabil. 2022;103(6):1105-1112. doi:10.1016\/j.apmr.2021.12.031."},{"issue":"4","key":"b11","series-title":"Physiother Can","first-page":"474","article-title":"A synthesis of best evidence for the restoration of upper-extremity function in people with tetraplegia","volume":"63","author":"Kalsi-Ryan S","year":"2011","unstructured":"Kalsi-Ryan S, Verrier MC. A synthesis of best evidence for the restoration of upper-extremity function in people with tetraplegia. 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J Neurosurg Spine. 2012;17(1 Suppl):65-76. doi:10.3171\/2012.6.AOSPINE1258."},{"issue":"12","key":"b13","series-title":"Arch Phys Med Rehabil","first-page":"1512","article-title":"The Capabilities of Upper Extremity instrument: Reliability and validity of a measure of functional limitation in tetraplegia","volume":"79","author":"Marino RJ","year":"1998","unstructured":"Marino RJ, Shea JA, Stineman MG. The Capabilities of Upper Extremity instrument: Reliability and validity of a measure of functional limitation in tetraplegia. Arch Phys Med Rehabil. 1998;79(12):1512-1521."},{"issue":"3","key":"b14","series-title":"Eur J Phys Rehabil Med","first-page":"373","article-title":"Distribution-based estimates of clinically significant changes in the International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores","volume":"49","author":"Scivoletto G","year":"2013","unstructured":"Scivoletto G, Tamburella F, Laurenza L, Molinari M. Distribution-based estimates of clinically significant changes in the International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores. Eur J Phys Rehabil Med. 2013;49(3):373-384."},{"issue":"5","key":"b15","series-title":"J Am Med Dir Assoc","first-page":"723","article-title":"Reliability and validity of the inpatient rehabilitation facility discharge mobility and self-care quality measures","volume":"24","author":"Deutsch A","year":"2023","unstructured":"Deutsch A, Palmer L, Vaughan M, et al. Reliability and validity of the inpatient rehabilitation facility discharge mobility and self-care quality measures. 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