Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review.
Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review.
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DOI：
10.1371/journal.pone.0154792
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Lindberg PG
中科院分区：
文献类型：
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作者：
Santisteban L;Térémetz M;Bleton JP;Baron JC;Maier MA;Lindberg PG
确定在中风研究中最常用的上肢结果测量方法可能有助于提高科学家和临床医生之间的共识。在本研究中，我们旨在确定卒中后干预研究中最常用的上肢结果测量，并描述ICF所涵盖的领域，测量方法如何组合，以及它们的使用在地理和时间上的变化。根据PRISMA指南检索Pubmed、CinHAL和PeDRO数据库，检索中风上肢干预研究，共纳入477项研究。在研究中发现了48种不同的结果测量方法。在超过5%的研究中，只有15项结果测量被使用。Fugl-Meyer测试（FMT）是最常用的测量方法（在36%的研究中）。常用的测量方法在不同程度上涵盖了身体功能和活动的ICF域。大多数研究（72%）结合了多种结果测量：FMT通常与运动活动日志（MAL）、Wolf运动功能测试和动作研究臂测试结合，但很少与运动评估量表或九孔钉测试结合。手工灵巧的关键组成部分，如选择性手指运动很少被测量。在过去的12年里，FMT和运动学评估的使用频率有所增加，而其他测量，如MAL和捷成泰勒手测试显示，随着时间的推移，使用频率有所下降。各国之间的使用差异很大，表明国际共识较低。结果显示，不同研究中使用的结果测量方法存在很大差异。然而，越来越多的研究使用FMT，这是一种具有良好心理测量特性的神经学测试。为了进行彻底的评估，FMT需要与功能性措施相结合。这些发现表明，需要制定策略，就卒中后上肢功能的适当结局措施达成国际共识。
Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke.