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Establishing the predictive validity and determining cutoff values of the capabilities of upper extremity test for predicting activities of daily living independence in cervical spinal cord injury

Spinal Cord (2026) Cite this article

Subjects

Abstract

Study design

Retrospective observational study.

Objectives

The Capabilities of the Upper Extremity Test (CUE-T) is a tool that assesses upper limb function in detail among individuals with cervical spinal cord injury (CSCI). We aimed to evaluate the predictive validity of the CUE-T for independence in activities of daily living (ADL) at discharge.

Setting

Spinal cord injury rehabilitation center in Chiba, Japan.

Methods

The cutoff value for independence in ADL (six self-care items of the spinal cord independence measure III [SCIM Ⅲ]) at the time of discharge from a rehabilitation center was calculated based on the results of the CUE-T conducted within 3 months of injury for individuals with CSCI. We defined a SCIM item score of ≤ 1 as dependence and ≥ 2 as independence. Analyses were performed using a receiver operating characteristic curve; the cutoff value was calculated using the Youden index. Bootstrapping was used for internal validation.

Results

Data were collected from 44 individuals with CSCI (median age: 59.0 [interquartile range, 50.8–67.3] years; men: 38, women: 6; American Spinal Injury Association Impairment Scale A/B: 7; C/D: 37). The cutoff values for the SCIM III self-care items ranged from 13–61 points. All area under the curves were 0.8 or greater, which was similar to the results obtained using bootstrapping.

Conclusions

The CUE-T cutoff values calculated in this study showed good predictive ability and reproducibility and were clinically useful. These results demonstrate the high predictive validity of the CUE-T.

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Fig. 1: Flow diagram of the study sample.
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Fig. 2: ROC curve for each activity.
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Data availability

The data generated and/or analyzed during this study are not publicly available owing to the lack of participant consent for public sharing. However, these data may be made available by the corresponding author upon request.

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Acknowledgements

The authors would like to express their gratitude to the staff at Chiba Rehabilitation Center for their help with data collection and other activities. We would like to thank Editage (http://www.editage.jp/) for English language editing. Some of the Graphical Abstracts included in this study were generated with the assistance of artificial intelligence (AI).

Funding

There are no funding sources to report for this study.

Author information

Authors and Affiliations

  1. Department of Rehabilitation Treatment, Chiba Rehabilitation Center, Chiba, Japan

    Kazumasa Jimbo, Kousuke Takahama, Tomohiro Yoshimura, Taichi Yasumori & Takashi Murayama

  2. Department of Rehabilitation Medicine, Chiba Rehabilitation Center, Chiba, Japan

    Naohisa Kikuchi

Authors
  1. Kazumasa Jimbo
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  2. Kousuke Takahama
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  3. Tomohiro Yoshimura
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  4. Taichi Yasumori
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  5. Takashi Murayama
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  6. Naohisa Kikuchi
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Contributions

All authors were involved in the research design and preparation of this manuscript. Kazumasa Jimbo, Kousuke Takahama, Tomohiro Yoshimura, Taichi Yasumori, Takashi Murayama, and Naohisa Kikuchi were substantially involved in data collection at the Chiba Rehabilitation Center and in creating the data collection manual. Kazumasa Jimbo, Kousuke Takahama, and Tomohiro Yoshimura were involved in the post-collection data analysis.

Corresponding author

Correspondence to Kazumasa Jimbo.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

This study was approved by the Ethical Review Committee of the Chiba Rehabilitation Center (approval no. Medical 7-8). All protocols were conducted in accordance with the principles of the Declaration of Helsinki. As this was a retrospective study, the participants provided informed consent, with opt-out options available within the hospital or on the hospital’s website. All applicable institutional and government regulations concerning the ethical use of human volunteers were followed during this study.

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Jimbo, K., Takahama, K., Yoshimura, T. et al. Establishing the predictive validity and determining cutoff values of the capabilities of upper extremity test for predicting activities of daily living independence in cervical spinal cord injury. Spinal Cord (2026). https://doi.org/10.1038/s41393-026-01221-1

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