Development of a Remote Version of the Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP): Validity and Reliability

Neurorehabil Neural Repair, 2023 · DOI: 10.1177/15459683231162830 · Published: January 1, 2023

Spinal Cord Injury Rehabilitation Telehealth & Digital Health

Simple Explanation

The study created a remote version of the GRASSP assessment (rGRASSP) for upper extremity function in individuals with tetraplegia to address the growing need for telemedicine. The rGRASSP includes the same three domains as the original version (Strength, Sensibility, and Prehension), but modifications were made to the subtests to allow for remote testing. The study found that the rGRASSP demonstrated strong concurrent validity and inter-rater reliability, indicating that it is a reliable tool for remote assessment of upper extremity function in individuals with tetraplegia.

Study Duration

Not specified

Participants

61 individuals with tetraplegia

Evidence Level

Not specified

Key Findings

1
The remote GRASSP demonstrated excellent concurrent validity with the original GRASSP (left hand ICC = .96, right ICC = .96).
2
Inter-rater reliability for rGRASSP total score was high (ICC = .99), and remained high for all 4 domains.
3
The remote GRASSP shows strong concurrent validity and inter-rater reliability, providing a psychometrically sound remote assessment for the upper extremity in individuals with tetraplegia.

Research Summary

This study demonstrated that the rGRASSP is a valid and reliable measure for GRASSP, and therefore provides a solution to the barriers that exist in comprehensive remote assessment of the upper extremity function in the SCI patients. The rGRASSP demonstrated robust psychometric properties against the GRASSP V1.0, highlighting the value of a virtual assessment that can garner statistically comparable results to the “gold standard” primary outcome measurement in clinical trials for the SCI population. Our study demonstrates that the rGRASSP is a reliable adjuvant and/or alternative to GRASSP V1.0 for remote assessment of hand function in individuals with SCI.

Practical Implications

Remote Assessment

rGRASSP enables remote assessment of hand function, especially valuable during pandemics or when in-clinic visits are limited.

Clinical Trials

The rGRASSP enhances clinical and research evaluation of neurological recovery and hand function in individuals with tetraplegia.

Accessibility

The affordability and accessibility of the rGRASSP make it a viable option for assessing and monitoring hand function in various settings.

Study Limitations

1
One important limitation is the use of a home assessor.
2
A second limitation is that our study was limited to chronic SCI population as our inclusion criteria required study participants to be at least 6 months post injury.
3
performing the in-person GRASSP before the remote version may have familiarized participants with the assessment procedures, potentially confounding the results of the remote assessment.

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