Evaluation of functional outcome measures for the hemiparetic upper limb: A systematic review

Ashford, Stephen; Slade, Mike; Malaprade, F.; Turner-Stokes, Lynne

doi:10.2340/16501977-0276

Cited by 116 publications

(112 citation statements)

References 44 publications

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“…However, motor ability and the use of the UL in this context may not correspond to what the individuals really perform in their daily lives. Thus, it is important to rely on adequate instruments to assess relevant aspects of functional performance in real life contexts 9 . The effects of neurorehabilitation on the most affected UL use in the real world are largely unexamined, and deficits in the most affected UL use after neurological injuries may be underdiagnosed 8 .…”

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confidence: 99%

Motor Activity Log-Brazil: reliability and relationships with motor impairments in individuals with chronic stroke

Pereira¹,

Ovando²,

Michaelsen

et al. 2012

Arq. Neuro-Psiquiatr.

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The Motor Activity Log (MAL) assesses the spontaneous use of the most affected upper limb with the amount of use (AOU) and quality of movement (QOM) scales during daily activities in real environments in individuals with chronic stroke. Objectives: This study translated the testing manual into Portuguese and assessed the inter-rater and test-retest reliabilities of the MAL, based upon the Brazilian manual version. Methods: The inter-rater reliability was evaluated by comparing the results of two examiners, and the test-retest reliability was tested by comparing the results of two evaluations, repeated one-week apart with 30 individuals with chronic hemiparesis (55.8±15.1 years). Results: The intra-class correlation coefficients (ICCs) for the total scores were adequate for both the inter-rater (0.98 for the AOU and 0.91 for QOM) and test-retest reliabilities (0.99 for both scales). Conclusions: The results suggested that the MAL was reliable to evaluate the spontaneous use of the most affected upper limb after stroke.

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confidence: 99%

Motor Activity Log-Brazil: reliability and relationships with motor impairments in individuals with chronic stroke

Pereira¹,

Ovando²,

Michaelsen

et al. 2012

Arq. Neuro-Psiquiatr.

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“…For example, there is currently no single valid and reliable scale available that comprehensively captures the complete range of function hemiparetic upper limb. 7 Furthermore, scales that focus on the participation component of the ICF are extremely limited. 19 Finally, the use of PRO measures in stroke research is a relatively new development 31,32 and is complicated in this population by cognitive and communication difficulties that can occur in stroke survivors.…”

Section: Discussionmentioning

confidence: 99%

“…6 Systemic reviews can help to select outcome measures. For example, Ashford et al 7 reviewed measures for the hemiparetic upper limb, identified 6 scales that met their selection criteria, but concluded that currently there was no single reliable and valid measure available to capture the full range of functional tasks in the hemiparetic upper limb. This type of systematic review provides invaluable information but also raises important questions.…”

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confidence: 99%

Outcome Measurement in Stroke

Baker

Cano

Playford

2011

Stroke

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Background and Purpose-Evaluating the impact of new treatments requires the use of reliable, valid, and responsive outcome measures. However, given the wide range of instruments currently available, it is not always straightforward for healthcare professionals to select the most appropriate tool. In this review, we propose a potential approach to scale selection. Methods-In designing a new study of the impact of a robotic device in stroke rehabilitation, we developed a three-stage scale selection strategy. First, two guidance documents (Medical Outcome Trust and Food and Drug Administration PRO Guidance) were reviewed to identify key scale assessment criteria. Second, consideration was given at a theoretical level of the concepts and domains relevant to the goals our study. Third, a comprehensive literature search strategy and review were developed in conjunction with healthcare professionals and psychometricians. Identified scales were appraised regarding their psychometric properties and clinical content. Results-Forty-five measures were initially identified and appraised. From a clinical content perspective, none of the measures were considered to be sufficient on their own to capture all the important outcome domains in this study. However, 3 measures were identified that best met our review criteria: Stroke Key Words: cerebrovascular disorders Ⅲ outcomes Ⅲ rehabilitation Ⅲ scales Ⅲ upper extremity S troke is currently the single largest cause of adult disability in the United Kingdom with one third of people who have had a stroke left with long-term disability. 1 New therapies such as repetitive practice through the use of robotics 2 have the potential to enhance the recovery of neurological function post-stroke. 3 The evaluation of such treatments increasingly depends on the use of valid, reliable, and responsive outcome measures. 4,5 Therefore, selecting the right measure for the right study is essential and rests on a clear understanding of the scientific quality of the rating scales. 6 Systemic reviews can help to select outcome measures. For example, Ashford et al 7 reviewed measures for the hemiparetic upper limb, identified 6 scales that met their selection criteria, but concluded that currently there was no single reliable and valid measure available to capture the full range of functional tasks in the hemiparetic upper limb. This type of systematic review provides invaluable information but also raises important questions. For example, how well targeted are different measures to the goals of specific interventions? How do we select the best available measures for future clinical studies? What criteria should be used and why?The aim of this article is to present a scale selection strategy for evidence-based scale selection in stroke research. We describe three steps. First, we reviewed two recent psychometric guidance documents that define key scale assessment criteria. Second, we considered, at a theoretical level, clinical issues, concepts, and domains important to include in stroke outcome resear...

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“…The existing measurements usually have a quantitative approach (for example measures time to perform a movement, the number of possible repetitions of a movement, and active range of motion) without identifying whether the movement is similar to premorbid movements or whether the action occurs through compensatory movements. In addition, there is a lack of standardization of passive range of motion and movement quality of active range especially when there is a low level of arm function [7].…”

Section: Introductionmentioning

confidence: 99%

Measurement properties of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES)

Johansson

Häger

2011

Disability and Rehabilitation

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This is an accepted version of a paper published in Disability and Rehabilitation. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination.Citation for the published paper: Johansson, G., Häger, C. (2012) Methods. Forty-two stroke patients (mean age 56+12 years) were independently assessed within a 48 hours window by two raters in different pairs (total raters = 4).Results. Weighted kappa analysis indicated good to very good agreement at item level (range 0.63-0.96). The relative and absolute reliability of the total score of MESUPES (maximum 58) was high according to the intraclass correlation coefficients (ICC=0.98) and the standard error of measurement (SEM=2.68). The MDC for three levels of confidence was calculated: A score change of 8, 7 and 5 is necessary for a MDC to have confidence of 95%, 90% and 80% respectively of a genuine change. Correlation between the MESUPES and M MAS was high (r s =0.87).Conclusions. The MESUPES shows high interrater reliability, and our study provides useful estimates of MDC for different levels of certainty. Additional research to confirm concurrent validity and to examine other psychometric properties of the MESUPES such as sensitivity is needed.

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Evaluation of functional outcome measures for the hemiparetic upper limb: A systematic review

Cited by 116 publications

References 44 publications

Motor Activity Log-Brazil: reliability and relationships with motor impairments in individuals with chronic stroke

Motor Activity Log-Brazil: reliability and relationships with motor impairments in individuals with chronic stroke

Outcome Measurement in Stroke

Measurement properties of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES)

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