Preliminary evaluation of the reliability and validity of the 3D printed Toronto Rehabilitation Institute-Hand Function Test in individuals with spinal cord injury

Figures & data

Table 1 Participant demographics.

Participant ID	Sex	Age	Level of injury	AIS	FIM-Self Care				SCIM-Self Care
					Baseline	Midpoint	D	F	Baseline	Midpoint	D	F
Sub-acute group
AAOF	M	66	C4	C	6	N	18	N	0	N	9	N
AAOG	F	72	C4	C	16	23	26	N	5	10	13	N
AAOH	M	37	C4	B	6	6	6	N	0	0	0	N
AAOI	M	58	C4	D	15	32	35	N	2	16	16	N
AAOJ	F	26	C5	B	8	8	N	N	2	2	N	N
Chronic group
AAOA	M	31	C4	B	6	6	6	6	0	N	0	0
AAOB	M	53	C4	C	7	9	10	10	1	2	2	2
AAOC	F	31	C4	C	7	7	7	N	1	1	1	N

Note: M, male; F, Female; AIS, American Spinal Injury Association Impairment Scale; FIM, Functional Independence Measure; SCIM, Spinal Cord Independence Measure; D, Discharge; F, Follow-up; N, Not available.

Table 2 3D Toronto Rehabilitation Institute – Hand Function Test scores.

		Sub-acute group										Chronic group
Participant ID		AAOF		AAOG		AAOH		AAOI		AAOJ		AAOA		AAOB		AAOC
		L	R	L	R	L	R	L	R	L	R	L	R	L	R	L	R
TRI-HFT
Object manipulation	B	10	28	56	24	0	10	0	65	16	16	0	0	10	50	30	0
	M	N	N	68	26	10	18	50	70	N	N	0	0	10	58	30	0
	D	60	67	68	40	10	24	60	70	20	21	0	0	10	58	42	0
	F	N	N	N	N	N	N	N	N	N	N	0	0	10	54	N	N
Rectangular blocks	B	17	38	50	18	0	9	0	52	18	18	0	0	9	38	22	0
	M	N	N	63	22	9	22	50	63	N	N	0	0	9	54	22	0
	D	54	54	63	28	9	18	54	63	18	18	0	0	9	54	40	0
	F	N	N	N	N	N	N	N	N	N	N	0	0	9	54	N	N
Instrumented cylinder	B	0	0	2	0	0	0	0	12.5	0	0	0	0	0	8	0	0
	M	N	N	5	1	0	0	0	19	N	N	0	0	0	8	0	0
	D	4	15	9	0	0	0	6	25	0	0	0	0	0	6	2	0
	F	N	N	N	N	N	N	N	N	N	N	0	0	0	10	N	N
Credit card	B	0	0	1	0	0	0	0	11	0	0	0	0	21	22	0	0
	M	N	N	4	0	0	0	6	38	N	N	0	0	0	25	0	0
	D	4	14	10	0	0	0	24	50	0	0	0	0	7	42	2	0
	F	N	N	N	N	N	N	N	N	N	N	0	0	0	24	N	N
Bar	B	0	0	15	0	0	0	0	39	0	0	0	0	0	0	0	0
	M	N	N	30	0	0	0	0	60	N	N	0	0	0	25	0	0
	D	20	48	47	0	0	0	35	60	0	0	0	0	0	17	0	0
	F	N	N	N	N	N	N	N	N	N	N	0	0	0	38	N	N

Note: L, left hand; R, right hand; B, baseline; M, midpoint; D, discharge; F, six month follow up; N, not available.

Table 3 Graded redefined assessment of strength, sensibility and prehension scores.

		Sub-acute group										Chronic group
Participant ID		AAOF		AAOG		AAOH		AAOI		AAOJ		AAOA		AAOB		AAOC
		L	R	L	R	L	R	L	R	L	R	L	R	L	R	L	R
GRASSP
Strength	B	11	18	28	17	4	5	13	42	13	10	5	2	20	39	23	5
	M	N	N	43	28	9	10	31	49	N	N	5	3	22	40	26	6
	D	30	40	45	31	12	12	38	50	15	12	5	3	22	40	32	8
	F	N	N	N	N	N	N	N	N	N	N	5	3	22	41	N	N
Sensitivity	B	7	10	21	23	4	4	8	7	8	7	0	0	9	4	3	18
	M	N	N	22	24	5	3	12	11	N	N	0	0	13	3	8	15
	D	11	8	24	24	11	7	21	16	7	7	0	0	6	2	9	21
	F	N	N	N	N	N	N	N	N	N	N	0	0	12	5	N	N
Prehension ability	B	1	4	6	2	0	0	0	9	0	0	0	0	4	10	2	0
	M	N	N	11	5	0	0	9	12	N	N	0	0	4	12	2	0
	D	6	9	12	6	0	0	9	12	1	1	0	0	3	12	9	0
	F	N	N	N	N	N	N	N	N	N	N	0	0	3	12	N	N
Prehension performance	B	0	1	16	3	0	0	0	17	2	0	0	0	3	12	6	0
	M	N	N	22	6	0	0	11	27	N	N	0	0	3	15	5	0
	D	11	21	23	8	0	2	15	26	4	0	0	0	4	14	8	0
	F	N	N	N	N	N	N	N	N	N	N	0	0	3	13	N	N

Note: L, left hand; R, right hand; B, baseline; M, midpoint; D, discharge; F, six month follow up; N, not available.

Figure 1 (a) Inter-rater Reliability of the 10-object manipulation component of the 3D TRI-HFT in sub-acute SCI. (b) Intra-rater Reliability of the 10-object manipulation component of the 3D TRI-HFT in sub-acute SCI.

Table 4 Concurrent and criterion validity of the 3D TRI-HFT.

Outcome Measure	3D TRI-HFT Object Manipulation	3D TRI-HFT Rectangular Blocks	3D TRI-HFT Instrumented Cylinder	3D TRI-HFT Instrumented Credit Card	3D TRI-HFT Bar
SUB-ACUTE STUDY
FIM-SC	0.770**	0.760**	0.669**	0.705**	0.636**
SCIM-SC	0.769**	0.758**	0.656**	0.700**	0.625**
GRASSP
Strength	0.946**	0.918**	0.846**	0.774**	0.837**
Sensation	0.523	0.512	0.346	0.235	0.280
Qualitative Prehension	0.951**	0.941**	0.843**	0.800**	0.841**
Quantitative Prehension	0.974**	0.938**	0.889**	0.804**	0.885**
CHRONIC STUDY
FIM-SC	0.756**	0.759**	0.481	0.608**	0.527
SCIM-SC	0.725**	0.726**	0.464	0.578**	0.540
GRASSP
Strength	0.936**	0.938**	0.737**	0.731**	0.601**
Sensation	0.274	0.284	0.053	0.123	−0.035
Qualitative Prehension	0.965**	0.965**	0.779**	0.851**	0.635**
Quantitative Prehension	0.997**	0.995**	0.775**	0.807**	0.633**

Note: FIM-SC, Functional Independence Measure Selfcare sub-score; SCIM-SC, Spinal Cord Independence Measure Selfcare sub-score; GRASSP, Graded Redefined Assessment of Strength, Sensibility and Prehension; 3D TRI-HFT, 3D printed Toronto Rehabilitation Institute-Hand Function Test. *Correlation is significant at the 0.05 level (2 tailed); ** Correlation is significant at the 0.01 level (2 tailed).

Figure 2 (a) Criterion Validity of the 3D TRI-HFT 10-object manipulation component with the GRASSP Quantitative Prehension component in sub-acute SCI. (b) Criterion Validity of the 3D TRI-HFT 10-object manipulation component with the GRASSP Quantitative Prehension component in chronic SCI.

Table 5 Time taken (in minutes) to complete the 3D TRI-HFT* for B/L upper extremities for all study participants.

Participant ID	AAOF	AAOG	AAOH	AAOI	AAOJ	AAOA	AAOB	AAOC
Time point
Baseline	14:43	11:38	2:06	11:08	5:25	3:13	18:31	6:21
Mid-point	N	13:53	12:10	14:33	N	0:46	16:55	13:51
Discharge	19:07	11:41	11:52	13:33	13:25	0:04	19:00	12:27
Follow-up	N	N	N	N	N	0:40	18:08	N

*Tasks that were video recorded and timed include 10 object manipulation, 9 rectangular blocks and the bar test for B/L upper extremities.

Data availability statement

The raw data of all participants is included in the manuscript.