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Evaluation of upper extremity function after spinal cord injury using GRASSP

Publication at Second Faculty of Medicine |
2023

Abstract

Introduction: Cervical spinal cord injury (SCI) leads, among other impairments, to dysfunction of the upper limbs. It significantly limits the ability to self-care and increases dependence on others.

Every improvement, even the smallest, can fundamentally affect the quality of life. The Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) test was created to document changes in the upper limbs in post-traumatic development.

Aim: To introduce the GRASSP to the general professional public and to evaluate the relationship between this examination and other standardized tests. Method: The study group consisted of 52 patients with acute cervical spinal cord injury hospitalized at the Spinal Cord Unit in University Hospital Motol between 2019 and 2021.

In addition to the GRASSP, standardized Spinal Cord Independence Measure (SCIM) test and upper extremity motor score were used for evaluation. GRASSP deals with four domains - muscle strength, sensitivity, grasp ability, and grasp execution.

Results: The greatest differences between the GRASSP examination at admission and discharge of patients were found in the domains of grasp ability and execution. These changes corresponded well with the self-care domain of the SCIM.

The correlation between the GRASSP and SCIM tests generally increased within the time since injury. Conclusion: GRASSP is a suitable test for evaluating even minor changes in the upper limbs in patients after cervical SCI, which can be used in both acute and chronic stages of SCI.