Responsiveness and Concurrent Validity of the Revised Capabilities of Upper Extremity-questionnaire (CUE-Q) in Patients with Acute Tetraplegia

Study Design: This is a longitudinal convenience sample.

Objective: The objective of this study was to evaluate the responsiveness of the revised Capabilities of Upper Extremity-Questionnaire (CUE-Q), in which the item responses were reduced from seven to five levels, relative to the upper extremity motor score (UEMS) and to the self-care subscale of Functional Independence Measure (FIMsc).

Methods: A total of 46 subjects with acute traumatic tetraplegia, 19 motor complete, 27 motor incomplete, completed the revised CUE-Q, UEMS and FIMsc at admission and discharge from rehabilitation.

Results: Subjects were mostly male (n=42) and Caucasian (n=27). The mean age was 44±21 years. Predominant etiologies were falls (n=18) and motor vehicle accidents (n=17). During rehabilitation, mean CUE-Q scores increased from 49.8±30.8 to 73.7±36.3, UEMS increased from 19.6±11.9 to 26.3±13.4, and FIMsc increased from 9.8±5.1 to 21.5±9.7. At admission and discharge, CUE scores had excellent to good Spearman correlations (rs) with UEMS (rs=0.89, 0.70) and FIMsc (rs=0.73, 0.80), but change scores had little to moderate correlations (CUE-UEMS, rs=0.07; CUE-FIMsc, rs=0.51), suggesting that the CUE, UEMS and FIM measure related but different constructs. Effect size of the change score was 0.92 for CUE-Q, 0.87 for UEMS and 1.38 for FIMsc. This compares to an effect size of 0.73 for the original 7-level response CUE-Q.

Conclusion: The simplified response set of the CUE-Q maintains the responsiveness of the original version, whereas it increases the ease of use for the patient.