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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation (CAULIN) : data synthesis from systematic reviews, clinical practice guidelines and expert consensus
Authors: Prange-Lasonder, Gerdienke B
Alt Murphy, Margit
Lamers, Ilse
Hughes, Ann-Marie
Buurke, Jaap H
Feys, Peter
Keller, Thierry
Klamroth-Marganska, Verena
Tarkka, Ina M
Timmermans, Annick
Burridge, Jane H
et. al: No
DOI: 10.1186/s12984-021-00951-y
Published in: Journal of NeuroEngineering and Rehabilitation
Volume(Issue): 18
Issue: 162
Issue Date: 8-Nov-2021
Publisher / Ed. Institution: BioMed Central
ISSN: 1743-0003
Language: English
Subjects: Assessment; Multiple sclerosis; Outcome measure; Rehabilitation; Spinal cord injury; Stroke; Therapy; Traumatic brain injury; Upper extremity; Upper limb
Subject (DDC): 616.8: Neurology, diseases of nervous system
Abstract: Background: Technology-supported rehabilitation can help alleviate the increasing need for cost-effective rehabilitation of neurological conditions, but use in clinical practice remains limited. Agreement on a core set of reliable, valid and accessible outcome measures to assess rehabilitation outcomes is needed to generate strong evidence about effectiveness of rehabilitation approaches, including technologies. This paper collates and synthesizes a core set from multiple sources; combining existing evidence, clinical practice guidelines and expert consensus into European recommendations for Clinical Assessment of Upper Limb In Neurorehabilitation (CAULIN). Methods: Data from systematic reviews, clinical practice guidelines and expert consensus (Delphi methodology) were systematically extracted and synthesized using strength of evidence rating criteria, in addition to recommendations on assessment procedures. Three sets were defined: a core set: strong evidence for validity, reliability, responsiveness and clinical utility AND recommended by at least two sources; an extended set: strong evidence OR recommended by at least two sources and a supplementary set: some evidence OR recommended by at least one of the sources. Results: In total, 12 measures (with primary focus on stroke) were included, encompassing body function and activity level of the International Classification of Functioning and Health. The core set recommended for clinical practice and research: Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT); the extended set recommended for clinical practice and/or clinical research: kinematic measures, Box and Block Test (BBT), Chedoke Arm Hand Activity Inventory (CAHAI), Wolf Motor Function Test (WMFT), Nine Hole Peg Test (NHPT) and ABILHAND; the supplementary set recommended for research or specific occasions: Motricity Index (MI); Chedoke-McMaster Stroke Assessment (CMSA), Stroke Rehabilitation Assessment Movement (STREAM), Frenchay Arm Test (FAT), Motor Assessment Scale (MAS) and body-worn movement sensors. Assessments should be conducted at pre-defined regular intervals by trained personnel. Global measures should be applied within 24 h of hospital admission and upper limb specific measures within 1 week. Conclusions: The CAULIN recommendations for outcome measures and assessment procedures provide a clear, simple, evidence-based three-level structure for upper limb assessment in neurological rehabilitation. Widespread adoption and sustained use will improve quality of clinical practice and facilitate meta-analysis, critical for the advancement of technology-supported neurorehabilitation.
Fulltext version: Published version
License (according to publishing contract): CC BY 4.0: Attribution 4.0 International
Departement: School of Health Sciences
Organisational Unit: Institute of Occupational Therapy (IER)
Appears in collections:Publikationen Gesundheit

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