Background
Method
Search strategy
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systematic reviews published in peer-reviewed journals,
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involving participants with stroke and/or hemiparesis due to stroke,
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reporting a clear objective to identify outcome measures specific for the upper extremity and/or include measures with a specific separate subsection for the upper extremity,
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report on and/or evaluate the psychometric properties of the outcome measures,
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participants older than 18 years,
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publication year 2004 or later (up to February 2014)
Quality assessment and data extraction
Results
Description of included reviews
Author year
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Primary objective or research question
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Literature search and data extraction process
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Requirements of the measurement properties for the outcome measures in primary studies
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Comprehensive search (>2 databases, strategy)/number of papers included
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Clear inclusion/exclusion criteria
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Duplicate search
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Duplicate data extraction
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Reference provided
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Values reported
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Standard and/or criteria
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Ashford 2008 [22] | Identify valid and reliable OM (real-life function) | Yes/84 | Yes | Yes | Yes | Yes | Level | Standard & criteria |
Baker 2011 [21] | Selection strategy and identification of scientifically sound UE OM suitable for robot trials | Yes/230 | Yes | - | - | Yes | Partly | Standard |
Connell 2012 [31] | Review psychometrics and clinical utility of UE OM | Yes/NR | Yes | Yes | Yes | Yes | Yes | Standard & criteria |
Croarkin 2004 [32] | Review and evaluate psychometrics of UE motor function tests | Yes/170 | Yes | Yes | - | Yes | Yes | Standard & criteria |
Gebruers 2010 [30] | Assess psychometrics and clinical applicability of accelerometry measures | Yes/25 | Yes | Yes | - | Yes | yes | No |
Hillier 2010 [23] | Develop and evaluate a process of OM selection for community settings | Yes/300 | Yes | - | 20% | No | No | Standard |
Lemmens 2012 [33] | Identify, evaluate, categorize valid and reliable activity level UE OM | Yes/747 | Yes | Yes | - | Yes | No | No |
Platz 2005 [34] | Review evidence of psychometric properties of OM for spasticity | Yes/110 | Yes | Yes | Yes | Yes | Partly | No |
Simpson 2013 [35] | Review the responsiveness of OM for UE recovery | Yes/68 | Yes | - | - | Yes | Yes | No |
Sivan 2011 [14] | Classify, evaluate UE OM used in robot-assisted trials | Yes/28 | Yes | Yes | Yes | Yes | Level | Standard & criteria |
Tse 2013 [36] | Identify, evaluate the psychometrics of participation OM | Yes/119 | Yes | - | - | Yes | Yes | Standard & criteria |
Van Peppen 2007 [37] | Develop clinical practice guideline for physiotherapy (OM, intervention, prognosis) | Yes/32 | Yes | Yes | Yes | Yes | Yes | Standard & criteria |
Velstra 2011 [38] | Review reliability, responsiveness and content validity of UE OM | Yes/44 | Yes | Yes | - | Yes | No | Not reported |
Author year
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ICF level (special interest)
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Target population
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OM for UE and stroke (number)
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List of included OM for UE
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Recommended or met the criteria of psychometrics
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Number
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OM
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Standard or criteria used
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Ashford 2008 [22] | Activity (real-life functioning) | stroke, brain injury | 6 | MAL (12,14, 26, 28 items), ABILHAND, Leeds Adult Spasticity Impact Scale | 1 |
ABILHAND
| Met 9 of 11 criteria |
Baker 2011 [21] | Body function and activity (robot-assisted trials) | stroke | 25 | ARAT, CAHAI, 10s test, AMAT, WMFT, FMA, MSS, MAS, DeSouza, RMA, STREAM, MESUPE, MI, NHPT, FAT, Sodring Motor Evaluation Test, Sollerman, MCA, MMAC, BBT, Functional Test; Patient-reported: DHI, MAL, ABILHAND, UMAQS | 3 Additional scales (2) | CAHAI, STREAM, ABILHAND Additional (FMA, ARAT) | MOT and FDA standards; psychometrics provided for CAHAI, STREAM, ABILHAND |
Connell 2012 [31] | Body function and activity (clinical utility) | neurologic conditions | 11 | BBT, NHPT, ARAT, ABILHAND, MAL (14,26), RMA, MSS, Sollerman, Simplified STREAM, Fitts Reaching test | 2 |
BBT, ARAT
| Clinical utility criteria of ≥8; criteria of validity, intra/inter-rater reliability, ability to detect change |
Croarkin 2004 [32] | Body function and functional limitation (no disability scales) | stroke | 9 | ARAT, CMSA, FMA, MMAC, MAS, MCA, MI, NHPT, RMA | 6 |
NHPT, FMA, MI, CMSA, ARAT, MAS
| Met 2 of 3 criteria: validity, inter-rater, test-retest reliability; psychometrics provided |
Gebruers 2010 [30]* | Activity (accelerometry) | stroke | NA | Accelerometry | NA | NA | No specific criteria; psychometrics provided |
Hillier 2010 [23] | ICF (clinical use) | stroke | 7 | Manual muscle testing, Tardieu Scale, WMFT, Grip strength, CAHAI, Hand Active Sensation Test, NHPT | 2 |
CAHAI
| Standards described for reliability, validity, responsiveness, utility; psychometrics not provided |
Lemmens 2012 [33]* | Activity | stroke, CP | 17 | AMAT, CAHAI, FAT, TEMPA, ARAT, JHFT, MESUPE, WMFT, ABILHAND, MAL, DHI, UBDS, Actual amount of use, Functional test, MFT, Hand Function Survey, Accelerometry | 9 | AMAT, CAHAI, FAT, UBDS, ARAT, JHFT, WMFT, DHI, MAL-26 | No specific criteria; reference provided for validity, reliability, responsiveness; psychometrics not provided |
Platz 2005 [34]* | Body function (spasticity) | stroke, MS, SCI and CP with spasticity | 11 | Ashworth Scale (original, modified, velocity corrected), Muscle Tone Scale, Modified Tardieu Scale, VAS for tone, Tone assessment Scale, ROM (goniometer, estimation), Finger curl test, Tendon reflex scale | 0 | - | No specific criteria; psychometrics not provided |
Simpson 2013 [35]* | Activity (responsiveness) | stroke | 14 | ABILHAND, AMAT, ARAT, Accelerometry, CAHAI, DHI, FAT, Functional Test, Hand Function Survey, JHFT, MAL, SIS, TEMPA, WMFT | 5 | ABILHAND, ARAT, MAL, SIS, WMFT | No specific criteria; MCID values provided |
Sivan 2011 [14] | ICF (robot-assisted trials) | Stroke | 17 | FMA, MSS, CMSA, Ashworth Scale, MRC, Kinematics, Grip strength, NHPT, BBT, ARAT, WMFT, CAHAI, AMAT, RMA (arm), FAT, MAS, ABILHAND | 5 |
FMA, Kinematics, ARAT, WMFT, ABILHAND
| Criteria high/excellent/moderate for validity, reliability, responsiveness provided |
Tse 2013 [36] | Participation | stroke | 1 | SIS | 0 |
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| Criteria for reliability, internal consistency, validity |
van Peppen 2007 [37] | ICF (clinical utility for physiotherapy practice) | stroke | 10 | Core set: MI, FAT; Optional: ROM, Numeric Pain Rating Scale, Nottingham Sensory Assessment, Modified Ashworth Scale, FMA, Hand volumeter, ARAT, NHPT | 2 |
MI, FAT (core set)
| Level of evidence at least 2 (psychometric properties, clinical utility, ICF) |
Velstra 2011 [38]* | ICF (reliability, responsiveness) | stroke, tetraplegia, peripheral or reumathology conditions | 8 | Ashworth Scale, ARAT, MAL, WMFT, JHFT, FMA, Muscle strength, ROM | 2 | ARAT, MAL | No specific criteria; grading very good/good for reliability, internal consistency and responsiveness provided; psychometrics not provided |
Assessment of the methodological quality
Extracted outcome measures
FMA
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MI-arm
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CMSA
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STREAM
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Kinematics
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References
| [32] | [32] | [14] | [21] | [14] | ||
Psychometric properties
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Content validity | + | NA | |||||
Internal consistency | *** | + | NA | ||||
Construct validity | + | *** | *** | + | ** | ||
Concurrent validity | + | *** | + | + | + | ||
Floor/ceiling effect | ** | NR | NR | ||||
Intra-rater, test-retest reliability | + | *** | + | NR | + | *** | |
Inter-rater reliability | + | *** | + | + | *** | + | |
Responsiveness | ** | * | NR | *** | |||
MCID, points | 7p | NR | NR | ||||
MDC/SDD, points | 12p | ||||||
Clinical utility
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Time to administer, minutes | 20 | 10-15 | 60 | varies | |||
Administration burden | ** | * | ** |
BBT
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ARAT
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CAHAI
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WMFT
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ABILHAND
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FAT
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MAS
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NHPT
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References
| [31] | [14] | [14] | [37] | [14] | [32] | [14] | [32] | [14] | ||||||
Psychometric properties
| |||||||||||||||
Content validity | + | + | NA | ||||||||||||
Internal consistency | *** | + | *** | + | NA | ||||||||||
Construct validity | *** | + | ** | + | *** | *** | + | ** | NR | + | *** | + | *** | ||
Concurrent validity | + | + | + | *** | + | + | + | + | |||||||
Floor/ceiling effect | NR | * | NR | * | * | * | NR | NR | |||||||
Intra-rater/test-retest reliability | + | *** | + | *** | + | NR | *** | + | + | *** | *** | + | |||
Inter-rater reliability | + | *** | + | *** | + | *** | *** | + | *** | *** | + | *** | + | *** | |
Responsiveness | NR | ** | + | *** | ** | + | ** | * | NR | NR | |||||
MCID, points, seconds | 6 blocks | 6p | 6.3p | 12p | 0.26-0.35 logitsa,d | NR | 32.8 s | ||||||||
12-17pc | 0.14-1.2pa,b,c | ||||||||||||||
MDC/SDD/SRD | + | + | 1.3p | 32.8 s | |||||||||||
Clinical utility
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Time to administer, minutes | 2 | 10 | 25 | 10-12 | ≥10 | 5-10 | 20-30 | 2 | |||||||
Administration burden | *** | ** | ** | ** | ** | *** | ** | *** |
Review
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Criteria of psychometrics or clinical utility provided by the authors of the reviews
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Ashford [22] | Content validity, internal consistency, construct validity, test-retest reliability, agreement, responsiveness, interpretability: adequate design, method and results (Chronbach’s α: adequate 0.7-0.9, ICC: > 0.70); minimal clinically important difference presented, floor/ceiling effect ≤ 15%, time to administer < 10 min, administration burden: easy to sum up the items |
Baker [21] | Psychometric testing have been performed |
Connell [31] | Clinical utility criteria of ≥ 8points (time to administer and interpret ≤ 30 min, cost ≤ ₤ 100, simple equipment, portability), reliability/validity (kappa, correlation coefficients, ICC/r: strong ≥ 0.80, moderate 0.6-0.8, weak 0.4-0.6), ability to detect change (measurement error, standardized response mean, standardized error of measurement, limits of agreement, minimal detectable change) |
Croarkin [32] | Significant correlations (p < 0.05) for test-retest, inter-rater reliability and validity (convergent, concurrent): level of evidence 1 = meets all 3 psychometrics criteria, level 2 = meets 2 of 3 criteria |
Hillier [23] | Sound psychometrics: content and construct validity, reliability, sensitivity to change, utility (interpretability, acceptability, relevance) |
Simpson [35] | MCID values calculated (related to effect size 0.2, anchor-based method using clinical scale, global rating, percentage of recovery) |
Sivan [14] | Test-retest reliability (ICC/kappa: high/excellent ≥ 0.75, moderate 0.40-0.74, poor <0.40); internal consistency (Chronbach’s α: high/excellent > 0.80, adequate 0.70-0.79, low < 0.70); validity (correlation coefficient: excellent r > 0.60, adequate 0.30-0.59, poor <0.30), area under the curve: excellent > 0.90, adequate 0.70-0.89, poor < 0.70); responsiveness (effect size: large > 0.8, moderate 0.5-0.79, small <0.50; other adequate responsiveness methods, MCID value); floor/ceiling effect (excellent 0%, adequate < 20%, poor > 20%), respondent burden: (time, acceptance: excellent < 15 min, adequate: longer time, lower acceptability; poor: lengthy, acceptability problem); administrative burden (excellent: scoring by hand, easy to interpret, adequate: computer scoring, obscure interpretation; poor: costly, complex scoring/interpretation) |
Tse [36] | Inter-rater, test-retest reliability (kappa/r/ICC > 0.75), internal consistency (Chronbach’s α > 0.80), content validity, construct validity (adequate method, r ≥ 0.60) |
van Peppen [37] | Valid for stroke, test-retest reliability and concurrent validity (ICC/r ≥ 0.70), responsiveness (high/low), time to administer ≤ 15 min, test-protocol available: level of evidence 1 = meets all 6 criteria, level 2 = meets 5 of 6 criteria |
Velstra [38] | Reliability (correlation coefficient, kappa, Chronbach’s α, ICC): very good or good/moderate; Responsiveness (effect size, standardized response mean): moderate or large |