Proud Elizabeth L, Miller Kimberly J, Bilney Belinda, Balachandran Sulakshana, McGinley Jennifer L, Morris Meg E
Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Victoria, Australia.
Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Victoria, Australia; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
Arch Phys Med Rehabil. 2015 Mar;96(3):540-551.e1. doi: 10.1016/j.apmr.2014.09.016. Epub 2014 Oct 7.
To identify measurement tools used for upper limb evaluation in people with Parkinson disease (PD), to summarize the content of each tool using the International Classification of Functioning, Disability and Health, and to examine the reliability, validity, clinical utility, and responsiveness of the measurement tools specific to this clinical group.
Two systematic searches of online databases included articles published from inception to November 2013.
Search 1 identified upper limb measures. Search 2 retrieved studies investigating the measurement properties of these tools in people with PD.
Independent reviewers screened articles and extracted data, classified measurement tool content on the basis of the International Classification of Functioning, Disability and Health content domains, and applied both the COnsensus-based Standards for the selection of health status Measurement INstruments checklist to evaluate the study's methodological quality and a second checklist by Terwee et al to assess the measurement tool's quality. A third reviewer adjudicated differences between reviewers. Information on clinical utility was also compiled.
The 18 identified measures included PD-specific scales, generic measures, and tools developed for other clinical populations; most measures evaluated impairments and/or activity limitations. Measurement properties of 10 of the 18 identified measures were evaluated in people with PD. No high-quality studies investigated validity or responsiveness. High-quality evidence supported the interrater reliability of some Unified Parkinson's Disease Rating Scale subtests, and lower quality studies provided limited evidence for the test-retest reliability of measures evaluating fine hand function and bradykinesia.
There are relatively few high-quality studies to support the measurement properties, particularly the validity and responsiveness, of tools currently used to evaluate upper limb disability and function in people with PD. Further research is needed to inform measurement tool selection and treatment evaluation in this clinical group.
确定用于评估帕金森病（PD）患者上肢功能的测量工具，使用《国际功能、残疾和健康分类》总结每种工具的内容，并考察针对该临床群体的测量工具的信度、效度、临床实用性和反应性。
对在线数据库进行两次系统检索，纳入自数据库创建至2013年11月发表的文章。
检索1确定上肢测量方法。检索2检索了调查这些工具在PD患者中测量特性的研究。
独立评审员筛选文章并提取数据，根据《国际功能、残疾和健康分类》内容领域对测量工具内容进行分类，并应用基于共识的健康状况测量工具选择标准清单来评估研究的方法学质量，以及应用Terwee等人的第二份清单来评估测量工具的质量。第三位评审员裁决评审员之间的差异。还汇编了关于临床实用性的信息。
确定的18项测量方法包括特定于PD的量表、通用测量方法以及为其他临床群体开发的工具；大多数测量方法评估损伤和/或活动受限情况。在PD患者中评估了18项确定测量方法中10项的测量特性。没有高质量研究调查效度或反应性。高质量证据支持一些统一帕金森病评定量表子测试的评分者间信度，低质量研究为评估精细手部功能和运动迟缓的测量方法的重测信度提供了有限证据。
相对较少有高质量研究支持目前用于评估PD患者上肢残疾和功能的工具的测量特性，尤其是效度和反应性。需要进一步研究为该临床群体的测量工具选择和治疗评估提供依据。
