Is the Downs and Black scale a better tool to appraise the quality of the studies using virtual rehabilitation for post-stroke upper limb rehabilitation?

Subramanian, Sandeep; Caramba, Sheena M; Hernandez, Oscar L; Morgan, Quenton T; Cross, Mackenzie K; Hirschhauser, Cole S

doi:10.1109/icvr46560.2019.8994724

Cited by 10 publications

(9 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared to the PEDro scale, we used the Downs and Black checklist as it is useful to assess the quality of both randomized and non-randomized study designs and the total scores of both assessments are highly correlated in studies involving individuals with brain injuries. 27,28 The Downs and Black checklist has been previously used to appraise quality of published studies for UL rehabilitation. 29,30 Study quality assessment scores on the checklist were rated as “excellent” (score 24-28), “good” (score 19-23), “fair” (score 14-18), or “poor” (score ≤ 13).…”

Section: Methodsmentioning

confidence: 99%

“…Compared to the PEDro scale, we used the Downs and Black checklist as it is useful to assess the quality of both randomized and non-randomized study designs and the total scores of both assessments are highly correlated in studies involving individuals with brain injuries. 27,28 The Downs and Black checklist has been previously used to . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Section: Data Abstraction and Analysismentioning

confidence: 99%

See 1 more Smart Citation

Upper Limb Motor Improvement after TBI: Systematic Review of Interventions

Subramanian

Fountain

Hood

et al. 2020

Preprint

View full text Add to dashboard Cite

Traumatic Brain Injury (TBI) is a leading cause of adult morbidity and mortality. Individuals sustaining a TBI have impairments in both cognitive and motor domains. Motor improvements post-TBI are attributable to adaptive neuroplasticity and motor learning. Majority of the studies focus on remediation of balance and mobility impairments. There is limited understanding on the use of interventions for upper limb (UL) motor improvements in this population. We examined the evidence regarding the effectiveness of different interventions to augment UL motor improvement after a TBI. We systematically reviewed the literature published in English from 1990-2020. The modified Down’s and Black checklist helped assess study quality (total score:28). Studies were classified as excellent:24-28, good:19-23, fair:14-18 and poor:≤13 in quality. Effect sizes helped quantify intervention effectiveness. Twenty-three studies were retrieved. Study quality was excellent (n=1), good (n=4) or fair (n=19). Interventions used included strategies to decrease spasticity [Botulinum toxin provision (n=2), serial casting, soft splinting, tizanidine and acupuncture (n=1 each)], constraint induced movement therapy (n=4), virtual reality gaming (n=5), noninvasive stimulation (n=3), arm motor ability training (n=1), stem-cell transplant (n=1); task-oriented training (n=2) and augmented feedback (n=1). Motor impairment outcomes included Fugl-Meyer Assessment, Modified Ashworth Scale and kinematic outcomes (error and movement straightness). Activity limitation outcomes included Wolf Motor Function Test and Motor Activity Log. Effect sizes for majority of the interventions ranged from medium (0.5-0.79) to large (≥0.8). Only ten studies included retention testing. Results suggest that using these interventions can reduce UL motor impairment and improve activity performance after a TBI.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Compared to the PEDro scale, we used the Downs and Black checklist as it is useful to assess the quality of both randomized and non-randomized study designs and the total scores of both assessments are highly correlated in studies involving individuals with brain injuries. 27,28 The Downs and Black checklist has been previously used to . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Section: Data Abstraction and Analysismentioning

confidence: 99%

Upper Limb Motor Improvement after TBI: Systematic Review of Interventions

Subramanian

Fountain

Hood

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The total scores of this assessment and PEDro scale are highly correlated in studies involving post-stroke participants. 48 According to available guidelines, 49 we classified the scores as "excellent" (score 24-28), "good" (score [19][20][21][22][23], "fair" (score 14-18), or "poor" (score ≤ 13). The quality of each study was independently evaluated by RTM, CR and KMS, with discrepancies, if any, resolved by SKS and CLL.…”

Section: Study Quality Assessmentmentioning

confidence: 99%

Genetic Polymorphisms and Post-Stroke Upper Limb Motor Improvement – A Systematic Review and Meta-Analysis

Subramanian,

Morgan,

Rasmusson

et al. 2023

Preprint

View full text Add to dashboard Cite

BackgroundPost-stroke upper limb (UL) motor improvement is associated with adaptive neuroplasticity and motor learning. Both intervention-related (including provision of intensive, variable, and task-specific practice) and individual-specific factors (including the presence of genetic polymorphisms) influence improvement. In individuals with stroke, most commonly, polymorphisms are found in Brain Derived Neurotrophic Factor (BDNF), Apolipoprotein (APOE) and catechol-O-methyltransferase (COMT). These involve a replacement of cystine by arginine (APOEε4) or one or two valines by methionine (BDNF: val66met, COMT: val158met). However, the implications of these polymorphisms on post-stroke UL motor improvement specifically have not yet been elucidated.ObjectiveExamine the influence of genetic polymorphism on post-stroke UL motor improvement.DesignSystematic Review and Meta-AnalysisMethodsWe conducted a systematic search of the published literature in English language of using standard methodology. The modified Downs and Black checklist helped assess study quality. We compared change in UL motor impairment and activity scores between individuals with and without the polymorphisms. Meta-analyses helped assess change in motor impairment scores based upon a minimum of two studies per time point. Effect sizes (ES) were quantified based upon the Rehabilitation Treatment Specification System as follows: small (0.08–0.18), medium (0.19–0.40) and large (≥0.41).ResultsWe retrieved 10 (four good and six fair quality) studies. Compared to those with BDNF val66met polymorphism, meta-analyses revealed lower motor impairment scores (large ES) in those without the polymorphism at intervention completion (0.5, 95% CI: 0.11-0.88) and at retention (0.58, 95% CI: 0.06-1.11). Presence of CoMT val158met polymorphism had similar results, with higher levels of improvement in impairment (large ES ≥1.5) and activity scores (large ES ranging from 0.5-0.76) in those without the polymorphism. Presence of APOEε4 form did not influence UL motor improvement.ConclusionBDNF val66met and COMT val158met polymorphisms negatively influence UL motor improvement in impairment and activity scores.Registrationhttps://osf.io/wk9cf/

show abstract

“…The total scores of this assessment and PEDro scale are highly correlated in studies involving individuals with brain injuries. 31,32 Scores on the modified Downs and Black checklist were rated as "excellent" (score 24-28), "good" (score [19][20][21][22][23], "fair" (score 14-18), or "poor" (score ≤13). 33 The quality of each study was independently evaluated by AFH and MKF, with discrepancies, if any, resolved by SKS.…”

Section: Data Abstraction and Analysismentioning

confidence: 99%

Upper Limb Motor Improvement after Traumatic Brain Injury: Systematic Review of Interventions

Subramanian

Fountain

Hood

et al. 2021

Neurorehabil Neural Repair

View full text Add to dashboard Cite

Background Traumatic brain injury (TBI) is a leading cause of adult morbidity and mortality. Individuals with TBI have impairments in both cognitive and motor domains. Motor improvements post-TBI are attributable to adaptive neuroplasticity and motor learning. Majority of the studies focus on remediation of balance and mobility issues. There is limited understanding on the use of interventions for upper limb (UL) motor improvements in this population. Objective We examined the evidence regarding the effectiveness of different interventions to augment UL motor improvement after a TBI. Methods We systematically examined the evidence published in English from 1990–2020. The modified Downs and Black checklist helped assess study quality (total score: 28). Studies were classified as excellent: 24–28, good: 19–23, fair: 14–18, and poor: ≤13 in quality. Effect sizes helped quantify intervention effectiveness. Results Twenty-three studies were retrieved. Study quality was excellent (n = 1), good (n = 5) or fair (n = 17). Interventions used included strategies to decrease muscle tone (n = 6), constraint induced movement therapy (n = 4), virtual reality gaming (n = 5), non-invasive stimulation (n = 3), arm motor ability training (n = 1), stem cell transplant (n = 1), task-oriented training (n = 2), and feedback provision (n = 1). Motor impairment outcomes included Fugl-Meyer Assessment, Modified Ashworth Scale, and kinematic outcomes (error and movement straightness). Activity limitation outcomes included Wolf Motor Function Test and Motor Activity Log (MAL). Effect sizes for majority of the interventions ranged from medium (.5-.79) to large (≥.8). Only ten studies included retention testing. Conclusion There is preliminary evidence that using some interventions may enhance UL motor improvement after a TBI. Answers to emergent questions can help select the most appropriate interventions in this population.

show abstract

Is the Downs and Black scale a better tool to appraise the quality of the studies using virtual rehabilitation for post-stroke upper limb rehabilitation?

Cited by 10 publications

References 9 publications

Upper Limb Motor Improvement after TBI: Systematic Review of Interventions

Upper Limb Motor Improvement after TBI: Systematic Review of Interventions

Genetic Polymorphisms and Post-Stroke Upper Limb Motor Improvement – A Systematic Review and Meta-Analysis

Upper Limb Motor Improvement after Traumatic Brain Injury: Systematic Review of Interventions

Contact Info

Product

Resources

About