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

Stephanie Voss; Andrea Adighibe; Emily Sanders; David Aaby; Rachel Kravitt; Gina Clark; Kelly Breen; Alexander Barry; Gail F. Forrest; Steve C. Kirshblum; Monica A. Perez; Sukhvinder Kalsi-Ryan; Masha Kocherginsky; William Zev Rymer; Milap S. Sandhu

doi:10.1177/15459683231162830

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

Stephanie Voss, Andrea Adighibe, Emily Sanders, David Aaby, Rachel Kravitt, Gina Clark, Kelly Breen, Alexander Barry, Gail F. Forrest, Steve C. Kirshblum, Monica A. Perez, Sukhvinder Kalsi-Ryan, Masha Kocherginsky, William Zev Rymer, Milap S. Sandhu^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background: The Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP V1.0) was developed in 2010 as a 3-domain assessment for upper extremity function after tetraplegia (domains: Strength, Sensibility, and Prehension). A remote version (rGRASSP) was created in response to the growing needs of the field of Telemedicine. Objective: The purpose of this study was to assess the psychometric properties of rGRASSP, establishing concurrent validity and inter-rater reliability. Methods: Individuals with tetraplegia (n = 61) completed 2 visits: 1 in-person and 1 remote. The first visit was completed in-person to administer the GRASSP, and the second visit was conducted remotely to administer the rGRASSP. The rGRASSP was scored both by the administrator of the rGRASSP (Examiner 1), and a second assessor (Examiner 2) to establish inter-rater reliability. Agreement between the in-person and remote GRASSP evaluations was assessed using the intraclass correlation coefficient (ICC) and Bland–Altman agreement plots. Results: The remote GRASSP demonstrated excellent concurrent validity with the GRASSP (left hand intraclass correlation coefficient (ICC) =.96, right ICC =.96). Concurrent validity for the domains was excellent for strength (left ICC =.96, right ICC =.95), prehension ability (left ICC =.94, right ICC =.95), and prehension performance (left ICC =.92, right ICC =.93), and moderate for sensibility (left ICC =.59, right ICC =.68). Inter-rater reliability for rGRASSP total score was high (ICC =.99), and remained high for all 4 domains. Bland–Altman plots and limits of agreements support these findings. Conclusions: The rGRASSP shows strong concurrent validity and inter-rater reliability, providing a psychometrically sound remote assessment for the upper extremity in individuals with tetraplegia.

Original language	English (US)
Pages (from-to)	83-93
Number of pages	11
Journal	Neurorehabilitation and Neural Repair
Volume	37
Issue number	2-3
DOIs	https://doi.org/10.1177/15459683231162830
State	Published - Feb 1 2023

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was generously supported by the Craig H. Neilsen Foundation Infrastructure Grant to Shirley Ryan AbilityLab, National Institute on Disability, Independent Living, and Rehabilitation Research (Midwest Regional SCI Model System grant - 90SI5009, and SCI multi-site grant - 90SIM0001), NINDS R35NS122336, and VA Grants (IO1RX003715, IO1RX002474, IORX002848).

Keywords

physical functional performance
psychometrics
quadriplegia
rehabilitation
spinal cord injuries
telemedicine
upper extremity
virtual rehabilitation

ASJC Scopus subject areas

Clinical Neurology
Neurology
Rehabilitation

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10.1177/15459683231162830

Cite this

Voss, S., Adighibe, A., Sanders, E., Aaby, D., Kravitt, R., Clark, G., Breen, K., Barry, A., Forrest, G. F., Kirshblum, S. C., Perez, M. A., Kalsi-Ryan, S., Kocherginsky, M., Rymer, W. Z., & Sandhu, M. S. (2023). Development of a Remote Version of the Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP): Validity and Reliability. Neurorehabilitation and Neural Repair, 37(2-3), 83-93. https://doi.org/10.1177/15459683231162830

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

abstract = "Background: The Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP V1.0) was developed in 2010 as a 3-domain assessment for upper extremity function after tetraplegia (domains: Strength, Sensibility, and Prehension). A remote version (rGRASSP) was created in response to the growing needs of the field of Telemedicine. Objective: The purpose of this study was to assess the psychometric properties of rGRASSP, establishing concurrent validity and inter-rater reliability. Methods: Individuals with tetraplegia (n = 61) completed 2 visits: 1 in-person and 1 remote. The first visit was completed in-person to administer the GRASSP, and the second visit was conducted remotely to administer the rGRASSP. The rGRASSP was scored both by the administrator of the rGRASSP (Examiner 1), and a second assessor (Examiner 2) to establish inter-rater reliability. Agreement between the in-person and remote GRASSP evaluations was assessed using the intraclass correlation coefficient (ICC) and Bland–Altman agreement plots. Results: The remote GRASSP demonstrated excellent concurrent validity with the GRASSP (left hand intraclass correlation coefficient (ICC) =.96, right ICC =.96). Concurrent validity for the domains was excellent for strength (left ICC =.96, right ICC =.95), prehension ability (left ICC =.94, right ICC =.95), and prehension performance (left ICC =.92, right ICC =.93), and moderate for sensibility (left ICC =.59, right ICC =.68). Inter-rater reliability for rGRASSP total score was high (ICC =.99), and remained high for all 4 domains. Bland–Altman plots and limits of agreements support these findings. Conclusions: The rGRASSP shows strong concurrent validity and inter-rater reliability, providing a psychometrically sound remote assessment for the upper extremity in individuals with tetraplegia.",

keywords = "physical functional performance, psychometrics, quadriplegia, rehabilitation, spinal cord injuries, telemedicine, upper extremity, virtual rehabilitation",

author = "Stephanie Voss and Andrea Adighibe and Emily Sanders and David Aaby and Rachel Kravitt and Gina Clark and Kelly Breen and Alexander Barry and Forrest, {Gail F.} and Kirshblum, {Steve C.} and Perez, {Monica A.} and Sukhvinder Kalsi-Ryan and Masha Kocherginsky and Rymer, {William Zev} and Sandhu, {Milap S.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2023",

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day = "1",

doi = "10.1177/15459683231162830",

language = "English (US)",

volume = "37",

pages = "83--93",

journal = "Neurorehabilitation and Neural Repair",

issn = "1545-9683",

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number = "2-3",

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Voss, S, Adighibe, A, Sanders, E, Aaby, D, Kravitt, R, Clark, G, Breen, K, Barry, A, Forrest, GF, Kirshblum, SC, Perez, MA, Kalsi-Ryan, S, Kocherginsky, M , Rymer, WZ & Sandhu, MS 2023, 'Development of a Remote Version of the Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP): Validity and Reliability', Neurorehabilitation and Neural Repair, vol. 37, no. 2-3, pp. 83-93. https://doi.org/10.1177/15459683231162830

TY - JOUR

T1 - Development of a Remote Version of the Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP)

T2 - Validity and Reliability

AU - Voss, Stephanie

AU - Adighibe, Andrea

AU - Sanders, Emily

AU - Aaby, David

AU - Kravitt, Rachel

AU - Clark, Gina

AU - Breen, Kelly

AU - Barry, Alexander

AU - Forrest, Gail F.

AU - Kirshblum, Steve C.

AU - Perez, Monica A.

AU - Kalsi-Ryan, Sukhvinder

AU - Kocherginsky, Masha

AU - Rymer, William Zev

AU - Sandhu, Milap S.

N1 - Publisher Copyright: © The Author(s) 2023.

PY - 2023/2/1

Y1 - 2023/2/1

N2 - Background: The Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP V1.0) was developed in 2010 as a 3-domain assessment for upper extremity function after tetraplegia (domains: Strength, Sensibility, and Prehension). A remote version (rGRASSP) was created in response to the growing needs of the field of Telemedicine. Objective: The purpose of this study was to assess the psychometric properties of rGRASSP, establishing concurrent validity and inter-rater reliability. Methods: Individuals with tetraplegia (n = 61) completed 2 visits: 1 in-person and 1 remote. The first visit was completed in-person to administer the GRASSP, and the second visit was conducted remotely to administer the rGRASSP. The rGRASSP was scored both by the administrator of the rGRASSP (Examiner 1), and a second assessor (Examiner 2) to establish inter-rater reliability. Agreement between the in-person and remote GRASSP evaluations was assessed using the intraclass correlation coefficient (ICC) and Bland–Altman agreement plots. Results: The remote GRASSP demonstrated excellent concurrent validity with the GRASSP (left hand intraclass correlation coefficient (ICC) =.96, right ICC =.96). Concurrent validity for the domains was excellent for strength (left ICC =.96, right ICC =.95), prehension ability (left ICC =.94, right ICC =.95), and prehension performance (left ICC =.92, right ICC =.93), and moderate for sensibility (left ICC =.59, right ICC =.68). Inter-rater reliability for rGRASSP total score was high (ICC =.99), and remained high for all 4 domains. Bland–Altman plots and limits of agreements support these findings. Conclusions: The rGRASSP shows strong concurrent validity and inter-rater reliability, providing a psychometrically sound remote assessment for the upper extremity in individuals with tetraplegia.

AB - Background: The Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP V1.0) was developed in 2010 as a 3-domain assessment for upper extremity function after tetraplegia (domains: Strength, Sensibility, and Prehension). A remote version (rGRASSP) was created in response to the growing needs of the field of Telemedicine. Objective: The purpose of this study was to assess the psychometric properties of rGRASSP, establishing concurrent validity and inter-rater reliability. Methods: Individuals with tetraplegia (n = 61) completed 2 visits: 1 in-person and 1 remote. The first visit was completed in-person to administer the GRASSP, and the second visit was conducted remotely to administer the rGRASSP. The rGRASSP was scored both by the administrator of the rGRASSP (Examiner 1), and a second assessor (Examiner 2) to establish inter-rater reliability. Agreement between the in-person and remote GRASSP evaluations was assessed using the intraclass correlation coefficient (ICC) and Bland–Altman agreement plots. Results: The remote GRASSP demonstrated excellent concurrent validity with the GRASSP (left hand intraclass correlation coefficient (ICC) =.96, right ICC =.96). Concurrent validity for the domains was excellent for strength (left ICC =.96, right ICC =.95), prehension ability (left ICC =.94, right ICC =.95), and prehension performance (left ICC =.92, right ICC =.93), and moderate for sensibility (left ICC =.59, right ICC =.68). Inter-rater reliability for rGRASSP total score was high (ICC =.99), and remained high for all 4 domains. Bland–Altman plots and limits of agreements support these findings. Conclusions: The rGRASSP shows strong concurrent validity and inter-rater reliability, providing a psychometrically sound remote assessment for the upper extremity in individuals with tetraplegia.

KW - physical functional performance

KW - psychometrics

KW - quadriplegia

KW - rehabilitation

KW - spinal cord injuries

KW - telemedicine

KW - upper extremity

KW - virtual rehabilitation

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U2 - 10.1177/15459683231162830

DO - 10.1177/15459683231162830

M3 - Article

C2 - 36987396

AN - SCOPUS:85152169898

SN - 1545-9683

VL - 37

SP - 83

EP - 93

JO - Neurorehabilitation and Neural Repair

JF - Neurorehabilitation and Neural Repair

IS - 2-3

ER -

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

Abstract

Funding

Keywords

ASJC Scopus subject areas

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