Verification of item difficulty in the Capabilities of Upper Extremity Test using Rasch analysis for individuals with cervical spinal cord injury

The Capabilities of Upper Extremity Test (CUE-T) is a tool that can assess upper limb function in more detail for cervical spinal cord injury (CSCI). This study aimed to determine the degree of difficulty of the CUE-T subtests. This was a cross-sectional study. This study was conducted with participants from the Chiba Rehabilitation Center in Japan. A total of 176 data sets were collected from 100 individuals with CSCI (mean age: 59.2 ± 13.8 years; men: 86, women: 14). We assessed the structural validity of the CUE-T for CSCI using Rasch analysis based on the Rasch Reporting Guidelines in Rehabilitation Research framework. CUE-T. The 17 items did not conform to the assumptions of Rasch analysis, such as unidimensionality and local dependence. Therefore, the Rasch analysis was reanalyzed using 10 items, excluding the seven items that were misfit by the item goodness of fit. The most difficult item was the Push Thumb, and the easiest item was Pull. The CUE-T showed good structural validity for 10 items. Indicated the degree of difficulty was similar to the neurological perspective, therefore, it may reflect the clinical practice of upper limb function in CSCI. These results may be useful for setting the difficulty level for rehabilitation of upper limb function in CSCI and for developing better evaluation methods in the future.