European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation (CAULIN): data synthesis from systematic reviews, clinical practice guidelines and expert consensus

Journal of NeuroEngineering and Rehabilitation

Ina M. Tarkka¹  Margit Alt Murphy²  Verena Klamroth-Marganska³  Thierry Keller⁴  Ilse Lamers⁵  Peter Feys⁵  Annick Timmermans⁵  Jaap H. Buurke⁶  Gerdienke B. Prange-Lasonder⁶  Ann-Marie Hughes⁷  Jane H. Burridge⁷ 

[1] Faculty of Sport and Health Sciences, University of Jyväskylä;Institute of Neuroscience and Physiology, University of Gothenburg;Institute of Occupational Therapy, Zurich University of Applied Sciences;Neurorehabilitation Area at the Health Division of TECNALIA, Basque Research and Technology Alliance (BRTA);Rehabilitation Research Center (REVAL), UHasselt;Roessingh Research and Development;School of Health Sciences, University of Southampton;

关键词: Upper limb;    Upper extremity;    Assessment;    Rehabilitation;    Therapy;    Outcome measures;   

DOI  :  10.1186/s12984-021-00951-y

来源: DOAJ

【 摘 要 】

Abstract Background Technology-supported rehabilitation can help alleviate the increasing need for cost-effective rehabilitation of neurological conditions, but use in clinical practice remains limited. Agreement on a core set of reliable, valid and accessible outcome measures to assess rehabilitation outcomes is needed to generate strong evidence about effectiveness of rehabilitation approaches, including technologies. This paper collates and synthesizes a core set from multiple sources; combining existing evidence, clinical practice guidelines and expert consensus into European recommendations for Clinical Assessment of Upper Limb In Neurorehabilitation (CAULIN). Methods Data from systematic reviews, clinical practice guidelines and expert consensus (Delphi methodology) were systematically extracted and synthesized using strength of evidence rating criteria, in addition to recommendations on assessment procedures. Three sets were defined: a core set: strong evidence for validity, reliability, responsiveness and clinical utility AND recommended by at least two sources; an extended set: strong evidence OR recommended by at least two sources and a supplementary set: some evidence OR recommended by at least one of the sources. Results In total, 12 measures (with primary focus on stroke) were included, encompassing body function and activity level of the International Classification of Functioning and Health. The core set recommended for clinical practice and research: Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT); the extended set recommended for clinical practice and/or clinical research: kinematic measures, Box and Block Test (BBT), Chedoke Arm Hand Activity Inventory (CAHAI), Wolf Motor Function Test (WMFT), Nine Hole Peg Test (NHPT) and ABILHAND; the supplementary set recommended for research or specific occasions: Motricity Index (MI); Chedoke-McMaster Stroke Assessment (CMSA), Stroke Rehabilitation Assessment Movement (STREAM), Frenchay Arm Test (FAT), Motor Assessment Scale (MAS) and body-worn movement sensors. Assessments should be conducted at pre-defined regular intervals by trained personnel. Global measures should be applied within 24 h of hospital admission and upper limb specific measures within 1 week. Conclusions The CAULIN recommendations for outcome measures and assessment procedures provide a clear, simple, evidence-based three-level structure for upper limb assessment in neurological rehabilitation. Widespread adoption and sustained use will improve quality of clinical practice and facilitate meta-analysis, critical for the advancement of technology-supported neurorehabilitation.

【 授权许可】

Unknown