SHUEE Introduction

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This manual provides the examiner with an overview of the administration
and interpretation of the Shriners Hospital Upper Extremity Evaluation (SHUEE).
Evaluator training prior to clinical application of the SHUEE should include:

  •         Reading this manual
  •         Viewing the Key Interpretation video
  •         Completing the Video Proficiency test

Information regarding the assembly of a test kit has also been provided in this manual.


The SHUEE was developed in November 1996 to assess the segmental, dynamic
alignment of the involved upper extremity in clients with hemiplegic cerebral
palsy when performing functional tasks. Review of the literature revealed evaluation
tools that measured those tasks that could be completed, but no standardized methods
for documenting the manner in which the functional tasks were performed.
Such information is essential in designing interventions and documenting outcome.

The SHUEE was initially developed as a screening test to determine which clients
were appropriate candidates for BOTOX injections to the involved upper extremity.
It has subsequently been used to trend upper extremity function, select surgical interventions,
and document the effects of such interventions.

Because the shoulder is rarely addressed surgically in clients with cerebral palsy,
the SHUEE focuses on segmental analysis of elbow, forearm, wrist, thumb and fingers.
Observation of shoulder girdle is recommended, but not currently included in the SHUEE.



The SHUEE is a video-based evaluation that was designed for use with clients with hemiplegic type cerebral palsy. The SHUEE presents a descriptive profile for comparing dynamic segmental alignment of the upper extremity, pre-and post intervention. The SHUEE has a numerical score for comparing a client’s own scores to one another.

The test consists of two pages. The first page evaluates the client through standard measurements of active and passive range of motion (ROM), tone, and a history-based assessment of the performance of activities of daily living. The second page evaluates the spontaneous use of the involved extremity and the segmental alignment of the extremity while performing tasks on demand. The SHUEE is designed to evaluate both functional and spontaneous abilities, as well as to document dynamic segmental alignment when performing tasks.

The SHUEE is video-based for several reasons. This allows it to be viewed at a later date. During administration of the test, the client can complete all tasks in a dynamic fashion without starting and stopping for the evaluator to record data. The SHUEE may be evaluated by a multi-disciplinary team consisting of occupational/physical therapists, physicians, and family, resulting in a more comprehensive treatment plan. The videotaped SHUEE becomes an invaluable part of the medical record, documenting functional alignment and pre/post intervention for comparative study.


Although to date the SHUEE has only been evaluated for use with clients with hemiplegic cerebral palsy between the ages of 3 and 18 years, other potential applications exist. Further clinical testing is necessary before these other applications can be recommended.


Printable version of SHUEE manual

SHUEE Validation Study


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