What’s New

Dr. Sukhvinder Kalsi-Ryan will be presenting this abstract:

GRASSP Version 2: A comprehensive SCI upper limb outcome measure

S Kalsi-Ryan, U Albisser, M Fehlings, A Curt, M Verrier, C Fellinghauer, IM Velstra

Toronto Rehabilitation Institute, UHN, University of Toronto, Canada; University Hospital Balgrist Zurich, Switzerland; Toronto Western Hospital, UHN, Canada; Swiss Paraplegic Centre Nottwil, Clinical Trial Unit, Switzerland

The GRASSP Version 1 (GV1) was made available to the SCI community in 2010. Uptake and interest in the measure has been significant. GV1 consists of 5 subtests GRASSP Strength (GR-Str), Sensation (GR-Sens), Prehension Ability (GR-pa) and Prehension Performance (GR-pp). It has excellent psychometric properties, is sensitive to small changes in impairment and function, however, an abbreviated version to further enhance uptake was of interest to the field.

Objective: To reduce the length of GRASSP and improve applicability.

Methods: Cumulative end-user feedback from Europe and Canada was collected and archived. The sum mean score of GR-Str (isotonic testing) was compared to the upper extremity motor score (UEMS). Rasch analysis was conducted to determine redundancy of items within GRASSP. All data gathered were synthesized. Consequential modifications were derived and applied to GV1.

Results: Based on end-user feedback:

  • language throughout the manual was refined to clarify subtest/item definitions and instructions to reduce variability of interpretation among assessors.
  • Paired t-test confirmed no significant difference between sumscores of GR-Str and UEMS. Rasch analysis confirmed response thresholds to be disordered, for GR-sens, and GR-pp permitting a smaller set of items to be selected.


  • GR-Str, Isotonic Manual Muscle Testing (MMT) to isometric MMT.
  • GR-Sens, Reduction of 6 test locations to 3 per hand.
  • GR-pp, Reduction of 6 items to 4 items.
  • Instruction manual revised for improved objectivity and standardization.

Conclusions: GRASSP was modified to improve objectivity, reduce assessment time, and improve usability. GV2 was launched in spring of 2017.

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