1 Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, VU University Medical Center Amsterdam, The Netherlands; and Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, USA.
2 School of Allied Health, La Trobe University, Melbourne, Australia; and Department of Occupational Therapy, Alfred Health, Melbourne, Australia.
Neurorehabil Neural Repair. 2017 Sep;31(9):784-792. doi: 10.1177/1545968317732662.
Finding, testing and demonstrating efficacy of new treatments for stroke recovery is a multifaceted challenge. We believe that to advance the field, neurorehabilitation trials need a conceptually rigorous starting framework. An essential first step is to agree on definitions of sensorimotor recovery and on measures consistent with these definitions. Such standardization would allow pooling of participant data across studies and institutions aiding meta-analyses of completed trials, more detailed exploration of recovery profiles of our patients and the generation of new hypotheses. Here, we present the results of a consensus meeting about measurement standards and patient characteristics that we suggest should be collected in all future stroke recovery trials. Recommendations are made considering time post stroke and are aligned with the international classification of functioning and disability. A strong case is made for addition of kinematic and kinetic movement quantification. Further work is being undertaken by our group to form consensus on clinical predictors and pre-stroke clinical data that should be collected, as well as recommendations for additional outcome measurement tools. To improve stroke recovery trials, we urge the research community to consider adopting our recommendations in their trial design.
寻找、测试和证明新的中风康复治疗方法的疗效是一个多方面的挑战。我们认为,为了推动该领域的发展,神经康复试验需要一个概念严谨的起始框架。至关重要的第一步是就感觉运动恢复的定义以及与这些定义一致的措施达成一致。这种标准化将允许在研究和机构之间汇集参与者数据,辅助已完成试验的荟萃分析,更详细地探索我们患者的恢复情况,并产生新的假设。在这里,我们提出了关于测量标准和我们建议应在所有未来中风康复试验中收集的患者特征的共识会议的结果。建议考虑到中风后的时间,并与国际功能和残疾分类相一致。强烈建议增加运动学和动力学运动量化。我们小组正在进一步开展工作,就应收集的临床预测因素和中风前临床数据以及其他结果测量工具的建议达成共识。为了改善中风康复试验,我们敦促研究界在其试验设计中考虑采用我们的建议。