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Evaluation of the graded redefined assessment of strength, sensibility and prehension (GRASSP) in children with tetraplegia

Spinal Cordvolume 56pages741749 (2018) | Download Citation


Study design

Psychometric study.


To validate the GRASSP in pediatric SCI populations and establish the lower age of test administration.


United States: Pennsylvania, Maryland, Illinois, Michigan, California, Texas.


Mean, SD and range of scores were calculated and examined for known-group differences. Test-retest reliability was measured by the intra-class correlation, concurrent validity of the GRASSP against the SCIM, SCIM-SS, and the CUE-Q was measured by the Spearman correlation.


GRASSP scores differed between participants with motor complete and incomplete injuries (p = <0.0001−0.036). Test-retest reliability was strong (ICC = 0.99). Weak correlation with the total SCIM (r = 0.33−0.66), and moderate to strong correlation with the SCIM-SC (r = 37−0.70) and CUE-Q (r = 0.40−0.84).


Results support the validity of the GRASSP and provide evidence that the scores are reliable when administered to children. The GRASSP sensory and strength subtests are recommended for children beginning at 6 years of age, and the GRASSP prehension performance/ability subtest for children beginning at 8 years of age. Normative data are needed for the performance components of the GRASSP.

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This study was funded by the Craig H Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592 (Mulcahey, PI). Becky Sinko OTD, OTR/L, Jennifer L Silvestri, MS, OTR/L, Lauren White, PT, DPT, PCS, Julie A Cagney PT, DPT, PCS, Ingrid Parry, PT, Jennifer Schottler MSPT, Kristine Higgins, PT, MS, NCS, Michelle L. Feltz, BA, and Jenny Mazurkiewicz MS, OTR/L are acknowledged for their role in data collection. Sue Duff is acknowledge for review of the manuscript.


The study was funded by the Craig H. Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award Grant #282592 (Mulcahey, PI).

Author information


  1. Thomas Jefferson University, Philadelphia, PA, USA

    • MJ Mulcahey
    • , Christina Calhoun Thielen
    • , Kathryn Dent
    • , Rebecca Sinko
    •  & John Gaughan
  2. Shriners Hospitals for Children, Philadelphia, PA, USA

    • MJ Mulcahey
  3. Kennedy Krieger Rehabilitation Institute, Baltimore, MD, USA

    • Cristina Sadowsky
    •  & Rebecca Martin
  4. Shriners Hospitals for Children, Chicago, IL, USA

    • Lawrence C. Vogel
  5. Shriners Hospitals for Children, Sacramento, CA, USA

    • Loren Davidson
  6. TIRR Herman Memorial, Houston, TX, USA

    • Heather Taylor
  7. Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA

    • Jackie Bultman


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Conflict of interest

Dr. Mulcahey receives research support from the Shriners Hospitals for Children, National Institute Neurological Disease and Stroke, The Craig H. Neilsen Foundation and The Rick Hansen Institute. She receives compensation for her role as Associate Editor for Topics in Spinal Cord Rehabilitation, royalties for the textbook “The Child and Young Adult with Spinal Cord Injury” and has received compensation as review panel chair/member for the Dept. of Defense and the Craig H. Neilsen Foundation. Dr. Vogel receives compensation for his role as Editor for Topics in Spinal Cord Injury Rehabilitation, royalties for the textbook “The Child and Young Adult with Spinal Cord Injury” and has received compensation as review panel chair/member for the Dept. of Defense. The remaining authors declare no conflict of interest.

Corresponding author

Correspondence to MJ Mulcahey.

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