Purpose
The CUE measures upper extremity functional limitations in individuals with tetraplegia.
Link to Instrument
Area of Assessment
Bodily FunctionsAssessment Type
Patient Reported OutcomesCost
FreeDiagnosis/Conditions
- Spinal Cord Injury
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The CUE measures upper extremity functional limitations in individuals with tetraplegia.
32
30 minutes
Adult
18 - 64
yearsInitially reviewed by Cara Leone Weibsach PT, DPT; Wendy Romney, PT, DPT, NCS; and the SCI EDGE task force of the Neurology Section of the APTA in 3/2012.
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 months 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 | Yes | Yes | Not reported |
High internal consistency (0.96) suggests there may be redundancy in items however this can only be determined after items are assessed for sensitivity to change (Marino, Shea, Stineman, 1998) It was determined that a chest strap can be used for the item “lifting a 5lb object overhead” (Marino, Shea, Stineman 1998). Measure assesses upper limb function including proximal arm and hand function, not strictly hand function.
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Cervical SCI:
(Marino, Shea, Stineman, 1998, n = 154; mean age = 36.7; motor complete (AIS A or B) or incomplete (AIS C or D); 68% were motor complete)
Cervical SCI:
(Marino, Shea, Stineman, 1998)
Cervical SCI:
(Marino, Shea, Stineman, 1998)
CUE Scores in Participants with Cervical SCI | ||
Item | Mean (SD) | |
Right | Left | |
Arm Function | ||
Reach 1 | 4.5 (2.0) | 5.4 (2.1) |
Reach 2 | 4.6 (2.4) | 4.5 (2.5) |
Reach 3 | 3.2 (2.5) | 3.2 (2.5) |
Pull/push 1 | 5.9 (1.9) | 5.7 (2.1) |
Pull/push 2 | 5.1 (2.2) | 5.0 (2.2) |
Pull/push 3 | 5.8 (2.1) | 5.5 (2.3) |
Pull/push 4 | 4.9 (2.3) | 4.6 (2.3) |
Wrist 1 | 5.0 (2.5) | 4.8 (2.5) |
Wrist 2 | 5.2 (2.3) | 5.2 (2.3) |
Hand Function | ||
Hand 1 | 3.0 (2.3) | 3.0 (2.3) |
Hand 2 | 3.8 (2.5) | 3.7 (2.4) |
Hand 3 | 3.9 (2.5) | 3.8 (2.5) |
Hand 4 | 2.8 (2.3) | 2.7 (2.3) |
Hand 5 | 2.4 (2.0) | 2.2 (2.0) |
Hand 6 | 3.6 (2.6) | 3.5 (2.6) |
Bilateral | ||
Reach down | ||
Bilateral 1 | 4.7 (2.4) | |
Bilateral 2 | 3.8 (2.6) |
Cervical SCI:
(Marino, Shea, Stineman, 1998)
Cervical SCI:
(Marino, Shea, Stineman, 1998)
Cervical SCI:
(Marino, Shea, Stineman, 1998)
Correlations Between Motor Completeness, CUE, UEMS, and FIM Scores in Participants with SCI | ||||||
Total Sample (n = 154) | Motor Complete (n = 105) | Motor Incomplete (n = 49) | ||||
UEMS | FIM | UEMS | FIM | UEMS | FIM | |
Pearson Correlations | ||||||
CUE | 0.782 | 0.738 | 0.798 | 0.753 | 0.683 | 0.672 |
UEMS | 0.741 | 0.772 | 0.593 | |||
Spearman's Correlations | ||||||
CUE | 0.798 | 0.798 | 0.815 | 0.822 | 0.650 | 0.719 |
UEMS | 0.803 | 0.825 | 0.580 |
(none is significantly different from another at the p < 0.05 level)
Chronic Tetraplegia:
(Kalsi-Ryan et al, 2012)
Cervical SCI:
(Marino, Shea, Stineman, 1998)
Discriminant Validity
CUE Scores by Motor Level for Participants with SCI | |||
n | Mean (SD) | p* | |
Right Motor Level | < 0.001 | ||
C2-4 | 7 | 28.9 (20.2) | a |
C5 | 39 | 43.3 (21.4) | a |
C6 | 53 | 64.1 (17.2) | |
C7 | 31 | 78.3 (12.9) | b |
C8 | 13 | 92.2 (8.5) | b |
T1 | 11 | 93.9 (12.1) | b |
Left Motor Level | < 0.001 | ||
C2-4 | 6 | 19.0 (9.8) | |
C5 | 41 | 43.4 (20.9) | |
C6 | 58 | 63.9 (20.0) | c |
C7 | 27 | 75.1 (15.4) | c,e |
C8 | 14 | 91.0 (9.8) | d,e |
T1 | 8 | 100.2 (4.2) | d |
*Letters in column p indicated that mean values were not statistically significant (p < 0.05) between levels marked with the same letter.
Cervical SCI:
(Marino, Shea, Stineman, 1998)
Kalsi-Ryan, S., Beaton, D., et al. (2012). "The Graded Redefined Assessment of Strength Sensibility and Prehension: reliability and validity." J Neurotrauma 29(5): 905-914. Find it on PubMed
Marino, R. J., Shea, J. A., et al. (1998). "The Capabilities of Upper Extremity instrument: reliability and validity of a measure of functional limitation in tetraplegia." Archives of Physical Medicine and Rehabilitation 79(12): 1512-1521. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.