Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands.
BMC Neurol. 2012 Apr 12;12:21. doi: 10.1186/1471-2377-12-21.
Loss of arm-hand performance due to a hemiparesis as a result of stroke or cerebral palsy (CP), leads to large problems in daily life of these patients. Assessment of arm-hand performance is important in both clinical practice and research. To gain more insight in e.g. effectiveness of common therapies for different patient populations with similar clinical characteristics, consensus regarding the choice and use of outcome measures is paramount. To guide this choice, an overview of available instruments is necessary. The aim of this systematic review is to identify, evaluate and categorize instruments, reported to be valid and reliable, assessing arm-hand performance at the ICF activity level in patients with stroke or cerebral palsy.
A systematic literature search was performed to identify articles containing instruments assessing arm-hand skilled performance in patients with stroke or cerebral palsy. Instruments were identified and divided into the categories capacity, perceived performance and actual performance. A second search was performed to obtain information on their content and psychometrics.
Regarding capacity, perceived performance and actual performance, 18, 9 and 3 instruments were included respectively. Only 3 of all included instruments were used and tested in both patient populations. The content of the instruments differed widely regarding the ICF levels measured, assessment of the amount of use versus the quality of use, the inclusion of unimanual and/or bimanual tasks and the inclusion of basic and/or extended tasks.
Although many instruments assess capacity and perceived performance, a dearth exists of instruments assessing actual performance. In addition, instruments appropriate for more than one patient population are sparse. For actual performance, new instruments have to be developed, with specific focus on the usability in different patient populations and the assessment of quality of use as well as amount of use. Also, consensus about the choice and use of instruments within and across populations is needed.
由于中风或脑瘫导致的偏瘫而丧失手臂和手部功能，会给这些患者的日常生活带来极大的问题。手臂和手部功能的评估在临床实践和研究中都很重要。为了更深入地了解具有相似临床特征的不同患者群体中常见疗法的效果，就必须就选择和使用结果测量工具达成共识。为了指导这种选择，需要对现有工具进行概述。本系统评价的目的是确定、评估和分类报告为有效和可靠的工具，以评估中风或脑瘫患者在国际功能、残疾和健康分类（ICF）活动水平上的手臂和手部性能。
进行了系统的文献检索，以确定包含评估中风或脑瘫患者手臂和手部熟练表现的工具的文章。确定了这些工具，并将它们分为能力、感知表现和实际表现三个类别。然后进行了第二次搜索，以获取有关其内容和心理测量学的信息。
关于能力、感知表现和实际表现，分别纳入了 18、9 和 3 个工具。所有纳入的工具中，只有 3 个工具在这两种患者群体中被使用和测试过。这些工具的内容在测量的 ICF 水平、对使用量与使用质量的评估、对单手和/或双手任务的纳入以及对基本和/或扩展任务的纳入方面差异很大。
虽然有许多工具评估能力和感知表现，但缺乏评估实际表现的工具。此外，适用于多种患者群体的工具也很少。对于实际表现，需要开发新的工具，特别关注不同患者群体的可用性，以及对使用质量和使用量的评估。此外，还需要在人群内部和跨人群之间就工具的选择和使用达成共识。
