Graded and Redefined Assessment of Strength, Sensibility, and Prehension

Instrument Reviewers

Initially reviewed by Cara Leone Weisbach, PT, DPT, Wendy Romney, PT, DPT, NCS, and the SCI EDGE task force of the Neurology Section of the APTA in 5/2012.

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  ANPT Outcome Measures Recommendations (EDGE)

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

Recommendations for use based on acuity level of the patient:

Acute

(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

SCI EDGE

LS

LS

R

Recommendations based on SCI AIS Classification: 

AIS A/B

AIS C/D

SCI EDGE

R

R

Recommendations for entry-level physical therapy education and use in research:

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

SCI EDGE

No

No

Yes

Not reported

Considerations

• Individuals with sensory level of C5 or above are expected to score 0 on the sensory testing of the GRASSP.
• Clinical utility is decreased secondary to cost of GRASSP kit and increased time to complete measure.
• Domains can be used individually or together.
• This battery of tests has been developed through a comprehensive four phase process examining existing measures and identifying best methods for assessing subtle and clinically meaningful changes and how sensory and motor impairments contribute to integrate function.

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Alexander, M. S., Anderson, K., et al. (2009). "Outcome measures in spinal cord injury: recent assessments and recommendations for future directions." Spinal Cord 47(8): 582-591. Find it on PubMed

Harvey, L. A., Dunlop, S. A., et al. (2011). "Early intensive hand rehabilitation after spinal cord injury (" Hands On"): a protocol for a randomised controlled trial." Trials 2011(12): 14. Find it on PubMed

Kalsi-Ryan, S., Beaton, D., et al. (2012). "The Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP)–Reliability and Validity." Journal of Neurotrauma(ja). Find it on PubMed

Kalsi-Ryan, S., Curt, A., et al. (2009). "Assessment of the Hand in Tetraplegia Using the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP)." Topics in Spinal Cord Injury Rehabilitation 14(4): 34-46.

Zariffa, J., Kapadia, N., et al. (2011). "Relationship between clinical assessments of function and measurements from an upper-limb robotic rehabilitation device in cervical spinal cord injury." Neural Systems and Rehabilitation Engineering, IEEE Transactions on(99): 1-1. Find it on PubMed

Zariffa, J., Kapadia, N., et al. (2011). "Effect of a robotic rehabilitation device on upper limb function in a sub-acute cervical spinal cord injury population." IEEE. Find it on PubMed