The Upper Extremity Measurement Scale (UEMS) is an assessment instrument that was developed by Kennedy Krieger Institute (USA) to quantify upper extremity function and fine-motor/visual motor skills, as they relate to activities of daily living and school-related tasks following acquired or traumatic brain injury during inpatient rehabilitation.

It is used with children as young as 2 years of age through young adulthood, post-brain injury.


The UEMS was developed for serial administration to track recovery and assess outcome during inpatient rehabilitation. It has adequate reliability and discriminant validity; construct validity was moderately to highly correlated with Wee-FIM total, self-care, mobility, and cognition scores.

Target Users 

  • Occupational Therapists

Key Goals 

  1. Assess upper extremity motor function at admission to assist with treatment planning/goal setting
  2. Track recovery over inpatient rehabilitation
  3. Assess upper extremity motor function at discharge

How the Tool is Used

The UEMS includes 7 items that address fine motor skills in bilateral upper extremities, and an additional 6 items that address a range of fine-motor/visual motor skills including ability to reach, grasp, release and other fine-motor skills as well as school-related tasks such as efficiency of touch screen technology access and scissoring skills. Quality of movement is also assessed. UEMS administration time is between 20 and 30 minutes. Items scores range from 1 to 5; the total score ranges from 20 (floor) to 100 (ceiling). UEMS items are rated based on clinical observation and performance on specific tasks, or self/family report can be used if direct observation cannot be completed.

Key Outcomes 

  • Improves understanding of the upper extremity and fine motor profile of children with brain injury, at all levels of functioning, throughout inpatient rehabilitation to assist in initial goal setting
  • Allows for systematic, detailed tracking of upper extremity and fine motor recovery during inpatient rehabilitation by comparing each child to that child’s own functioning earlier in admission. This informs ongoing treatment planning and evaluates interventions on the basis of early trajectory of recovery
  • Early scores predict later outcomes to allow for better prognostication and to inform discharge planning
  • Use by inpatient treatment team members promotes clarity and consistency in description of fine motor deficits which facilitate communication among team members, patients, and families and facilitate interdisciplinary team process
  • Enhances program evaluation; used in conjunction with other benchmarks to ensure a facility’s brain injury population is making adequate progress during admission


  1. Dunkleberger K, Slomine BS, Salorio C et al. The Upper Extremity Measurement Scale. Poster Presentation at the 2nd Federal Traumatic Brain Injury Interagency Conference, Bethesda, MD, March, 2006