Table 3.
Consensus statements
| Round | Question number | Statements | Agreement overall % (n) |
Agreement clinicians % (n) |
Agreement researchers % (n) |
|---|---|---|---|---|---|
| 1 | Q1. | Recommendations on an assessment framework and outcome measures for use in technology based neuro-rehabilitation are useful. | 79 (27) | 100 (3) | 77 (24) |
| 2 | Q3. | The purpose of measurement is to design therapy (initial decisions and changes in therapy programme) and to measure progress. | 86 (30) | 81 (21) | 100 (9) |
| 2 | Q6. | Technology-generated data (from a device, wearable and environmental sensors, wii, social networking, etc.) should be used by both clinicians and researchers. | 83 (29) | 81 (21) | 89 (8) |
| 3 | Q2.1. Q2.2 |
Recommendations including a minimum defined set of measures should be used by: | |||
| Clinicians | 83 (59) | 100 (12) | 80 (47) | ||
| Researchers | 87 (62) | 100 (12) | 85 (50) | ||
| 3 | Q28. | Measures that are not currently widely used or practical, but which have the potential to be useful should be included. | 92 (65) | 92 (11) | 92 (54) |
| 3 | Q18R. | Performance quality measures (Co-ordination, smoothness of movement, precision/accuracy of movement, number of errors and successes - during the performance of a task), Response to perturbations (disturbances during movement), and Compensatory (abnormal) movements should be used by researchers. | 73 (55) | 64 (7)a | 75 (48) |
| 3 | Q7C. Q7R. |
A range of kinematic measures (active ROM at a single joint, extent of workspace at multiple joints, speed of movement, etc.) should be used by: | |||
| Clinicians | 76 (54) | 75 (9) | 76 (45) | ||
| Researchers. | 83 (59) | 75 (9) | 85 (50) | ||
| 3 | Q17C. Q17R. |
A range of kinetic measures (e.g., Isometric force in a range of muscles and positions, Isokinetic force in a range of muscles and movements, endurance, Grip strength, Non-neural muscle stiffness (resistance to passive movement), and Spasticity) should be used by: | |||
| Clinicians | 53 (40)a | 79 (11) | 47 (29)a | ||
| Researchers. | 55 (56)a | 77 (10) | 52 (46)a | ||
| 3 | Q19R. | A range of EMG measures (e.g., Co-contraction, Synergies, Muscle onset time, and Inappropriate muscle activity, etc.) should be used by researchers. | 83 (59) | 91 (10) | 82 (49) |
| 3 | Q20C. | Effort during movement measure (amount of assistance required to complete task) should be used by clinicians. | 73 (48) | 67 (8) a | 74 (40) |
| 3 | Q21R. | A range of neuropsychological and other non-motor domain measures (e.g., Attention +/− when distracted, Neglect, Engagement, Reaction time, and Pain associated with movement, etc.) should be used by researchers. | 100 | N/Ab | 100 (59) |
| 3 | Q23C. Q23R. |
Non-technology based measures of Impairment should be restricted to validated outcome measures (e.g. Fugl Meyer (FM), Grip or muscle strength), except in certain circumstances (e.g., experimental research, development of new technologies or for the purposes of validation) for use of: | |||
| Clinicians | 76 (54) | 75 (9) | 76 (45) | ||
| Researchers | 71 (44) | 80 (8) | 69 (36) | ||
| 3 | Q14C. Q14R. |
Technology-based measures of Activity (e.g., Measures that can be used at home, Body-worn sensors to monitor activity, and Body-worn sensors as surrogate measures of function (e.g., the WMFT)) should be used by: | |||
| Clinicians | 53 (31)a | 50 (6)a | 54 (25)a | ||
| Researchers | 72 (39) | 70 (7) | 73 (32) | ||
| 3 | Q13C. | Non-technology based measures of Activity should be restricted to validated outcome measures such as the Action Research Arm Test (ARAT) or Wolf Motor Function Test (WMFT) for use of clinicians. | 72 (51) | 67 (8) a | 73 (43) |
| 3 | Q15R. | In research, non-technology based Measures of Participation measures should be restricted to validated outcome measures such as the Stroke Impact Scale (SIS), Short Form-36 (SF36), except in certain circumstances (e.g., experimental research, development of new technologies or for the purposes of validation). | 85 (45) | 71 (5) | 87 (40) |
| 3 | Q15C. | In clinic, non-technology based Measures of Participation measures should be restricted to validated outcome measures such as the Stroke Impact Scale (SIS), Short Form-36 (SF36). | 70 (50) | 75 (7) | 70 (41) |
| 3 | Q24R. | A range of Neurophysiology Measures (e.g., EEG, TMS/MEP, and functional neuro-imaging) should be used by researchers. | 76 (47) | 100 (9) | 72 (38) |
| 4 | Q32. | Self-reported measures (e.g. Motor Activity Log) should be used. | 91 (39) | 93 (14) | 89 (25) |
| 4 | Q34. | Personalized, goal orientated measures (e.g. COPM) should be used. | 84 (37) | 81 (13) | 86 (24) |
| 5 | Q37R. Q37C. |
Four face-to-face patient assessments should be collected for a treatment programme: Baseline (beginning of the programme), interim (during the programme), final (end of the programme), and follow-up (a set period of time after the end of the programme), other than data collected automatically by technology for: | |||
| Clinicians | 100 (24) | 75 (3) | 100 (21) | ||
| Researchers | 83 (20) | 75 (3) | 81 (17) | ||
| 5 | Q39R. Q39C. |
Assessment should take place separately from treatment by: | |||
| Clinicians | 96 (23) | 100 (4) | 90 (19) | ||
| Researchers. | 83 (20) | 75 (3) | 81 (17) | ||
| 5 | Q40R. Q40C. |
Maximum time for assessment is 3 h for: | |||
| Clinic | 92 (22) | 75 (3) | 90 (19) | ||
| Research | 83 (20) | 75 (3) | 81 (17) |
C&R indicate whether the question/statement is applicable to practice in clinic (C) or to research (R)
a: The monitoring group agreed that the statement should be accepted as having reached consensus for the following reasons: These was clear agreement from practicing clinicians, and the majority of non-clinicians and non-practicing clinicians also voted for this option or the majority of experts voted for this option (the remaining votes were spread in support of the different individual measures which are encompassed by this statement)
b: Practicing clinicians did not vote