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 and 12 others
PMID 36987396WHAT IT FOUND
Remote hand testing after chronic spinal cord injury gave scores similar to the in-person test and to scores from another examiner.
It needs a home helper for some parts, and sensation had wider disagreement.
Key findings
01The average difference between remote and in-person percentage total scores was 0.11% on the left and 1.2% on the right, with agreement within about ±12% points.
02Another examiner scoring the same remote session agreed very closely with the examiner who originally scored it for total scores on both sides.
03The sensibility domain had much wider disagreement between in-person and remote testing, with some ranges beyond 30%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
A home helper was needed for several domains, and some participants did not have one available. Home helpers had no formal training before the remote session. The study included only chronic spinal cord injury, so it does not show how the remote test performs soon after injury. The in-person test was done before the remote test, which may have taught participants the procedure and affected the remote scores. Sensibility testing used cotton swabs instead of the standard monofilaments, and it showed wider disagreement. Kit shipping, sanitizing, assembly, and return require planning, and transportation barriers can make return difficult.
Declared interests
The article is tagged as NIH and U.S. government non-PHS funded. The study team partnered with the original GRASSP design team, Neural Outcomes Consulting Inc., and the standardized kits were purchased from that company. The authors declared no potential conflicts of interest.
The easy way to misread this
Do not treat the remote version as fully equivalent to in-person testing for every patient. It required a home helper for some domains, and the light touch part showed much wider disagreement than the other parts.