Evaluation of the Capabilities of Upper Extremity Test (CUE-T) in Children With Tetraplegia

The Capabilities of Upper Extremity Test (CUE-T) is a spinal cord injury (SCI)-specific instrument based on the CUE Questionnaire (CUE-Q). To evaluate the psychometric properties of CUE-T in children with cervical SCI and determine the lowest age appropriate for test administration. In this repeated measures multicenter study, 39 youths, mean age 12.3 years and mean time post injury 5.14 years, completed two administrations of the CUE-T. Test-retest reliability, internal consistency, and known groups validity were measured. Concurrent and discriminant validity were measured against previously validated measures: CUE-Q, Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP), Spinal Cord Independence Measure (SCIM) III, SCIM III-Self Care (SCIM-SC), and SCIM-Mobility. The CUE-T scores demonstrated strong test-retest reliability (ICC ≥ 0.95), strong internal consistency (α ≥ 0.90), and acceptable individual item agreement (κ ≥ 0.49). The hand subscale had better scores ( < .05) for the motor incomplete versus complete known groups, and the arm, hand, and side subscales had better scores ( < .05) for higher versus lower strength groups. The CUE-T had strong concurrent validity with the CUE-Q ( = 0.85-0.87), GRASSP ( = 0.78-0.90), and SCIM-SC ( = 0.70) and moderate-to-weak correlation with the total SCIM ( = 0.65) and SCIM-Mobility ( = 0.51). Children older than 6 years with mature grasp patterns were able to complete the CUE-T. The CUE-T scores are reliable and valid for use in children with cervical SCI older than 6 years of age.