Table 1.
Systematic reviews | Practice guidelines | Expert consensus | CAULIN recommendation |
---|---|---|---|
OM for body functions | |||
Recommendation: Strong evidence for FMA-UE; Some evidence for MI-arm, CMSA, STREAM, kinematics |
Recommendation: No specific set of OM was recommended, although the FMA-UE were most frequently recommended in the included stroke guidelines; Note: psychometric properties of many OM are not established (e.g. spasticity) |
Recommendation: No consensus was reached on specific OM Recommended for clinicians and researchers: A defined core set including validated clinical OM but also less establish OM with potential for special circumstances and for research; technology-generated measures (e.g. kinematics and wearables) Recommended for use in research: Quality of movement execution, neurophysiological (EMG, TMS), neuroimaging Recommendations for clinicians: Effort and amount of assistance (e.g. in robotics) |
FMA-UE is the most often recommended OM of UL impairment and has strong psychometric properties Some evidence to use kinematics (to measure movement quality) Some evidence to use MI-arm, CMSA, STREAM |
OM for activity | |||
Recommendation: Strong evidence: ARAT, BBT, CAHAI, WMFT (activity capacity); Some evidence: FAT, MAS, NHPT; Generally recommended: Body-worn sensors to measure activity in daily life (limited evidence on psychometrics) |
Recommendation: No specific set of OM was recommended, although ARAT, NHPT, FIM, BI are most frequently recommended in the stroke guidelines Generally recommended: Body-worn sensors to measure activity in daily life and monitor adherence to exercise programs |
Recommendation: No consensus was reached on specific OM Recommended for clinicians and researchers: A defined core set of established validated clinical OM Recommended for researchers: Body-worn sensors to monitor activity performance |
ARAT is the most often recommended OM of UL activity capacity and has strong psychometric properties BBT, CAHAI, WMFT have strong psychometric properties Some evidence to use FAT, MAS, NHPT (of which NHPT recommended twice) FIM and BI are most often recommended generic ADL instruments (out of scope for UL-specific OM) Measures of actual arm use (body-worn sensors) should be considered |
PROM | |||
Recommendation: Strong evidence: ABILHAND | Recommendation: Patient–reported outcomes should be used along with objective OM | Recommendation: Self-reported measures should be used |
Patient–reported outcomes should be used along with objective OM ABILHAND has strong psychometric properties |
Goal-oriented OM | |||
Recommendation: Not applicable (goal-oriented instruments were not included) | Recommendation: Goal attainment OM to link assessment to goal setting and to motivate patients should be used along with objective OM | Recommendation: Personalized goal attainment measures should be used |
Goal attainment OM should be used along with objective OM No specific OM can be recommended |
FMA-UE, Fugl-Meyer Assessment, Upper Extremity part; MI-arm, Motricity Index, arm part; CMSA, Chedoke-McMaster Stroke Assessment; STREAM, Stroke Rehabilitation Assessment Movement; OM, outcome measure(s); EMG, electromyography; TMS, trans-cranial magnetic stimulation; ARAT, Action Research Arm Test; BBT, Box and Block Test; CAHAI, Chedoke Arm Hand Activity Inventory; WMFT, Wolf Motor Function Test; FAT, Frenchay Arm Test; MAS, Motor Assessment Scale; NHPT, Nine Hole Peg Test; FIM, Functional Independence Measure; BI, Barthel Index; UL, upper limb; PROM, patient-reported outcome measures