Wang Sophie, Hsu C Janice, Trent Lauren, Ryan Tiffany, Kearns Nathan T, Civillico Eugene F, Kontson Kimberly L
U.S. Food and Drug Administration, Center for Devices and Radiological Health, Office of Science and Engineering Labs, Division of Biomedical Physics, Silver Spring, MD; and University of Maryland, Department of Biomedical Engineering, College Park, MD(∗).
Advanced Arm Dynamics, Redondo Beach, CA(†).
PM R. 2018 Sep;10(9):951-962.e3. doi: 10.1016/j.pmrj.2018.02.008. Epub 2018 Feb 21.
Objective performance-based outcome measures (OMs) have the potential to provide unbiased and reproducible assessments of limb function. However, very few of these performance-based OMs have been validated for upper limb (UL) prosthesis users. OMs validated in other clinical populations (eg, neurologic or musculoskeletal conditions) could be used to fill gaps in existing performance-based OMs for UL amputees. Additionally, a joint review might reveal consistent gaps across multiple clinical populations. Therefore, the objective of this review was to systematically characterize prominent measures used in both sets of clinical populations with regard to (1) location of task performance around the body, (2) possible grips employed, (3) bilateral versus unilateral task participation, and (4) details of scoring mechanisms. A systematic literature search was conducted in EMBASE, Medline, and Cumulative Index to Nursing and Allied Health electronic databases for variations of the following terms: stroke, musculoskeletal dysfunction, amputation, prosthesis, upper limb, outcome, assessments. Articles were included if they described performance-based OMs developed for disabilities of the UL. Results show most tasks were performed with 1 hand in the space directly in front of the participant. The tip, tripod, and cylindrical grips were most commonly used for the specific tasks. Few measures assessed sensation and movement quality. Overall, several limitations in OMs were identified. The solution to these limitations may be to modify and validate existing measures originally developed for other clinical populations as first steps to more aptly measure prosthesis use while more complete assessments for UL prosthesis users are being developed.
Level III.
基于客观表现的结局指标（OMs）有潜力对肢体功能提供无偏且可重复的评估。然而，这些基于表现的OMs中，很少有针对上肢（UL）假肢使用者进行过验证。在其他临床人群（如神经或肌肉骨骼疾病患者）中验证过的OMs可用于填补现有针对UL截肢者的基于表现的OMs的空白。此外，联合综述可能会揭示多个临床人群中存在的一致差距。因此，本综述的目的是系统地描述在这两组临床人群中使用的突出指标，涉及以下方面：（1）身体周围任务执行的位置，（2）可能使用的抓握方式，（3）双侧与单侧任务参与情况，以及（4）评分机制的细节。在EMBASE、Medline和护理及联合健康累积索引电子数据库中进行了系统的文献检索，以查找以下术语的变体：中风、肌肉骨骼功能障碍、截肢、假肢、上肢、结局、评估。如果文章描述了针对UL残疾开发的基于表现的OMs，则将其纳入。结果显示，大多数任务是由参与者在其正前方空间内用一只手完成的。在特定任务中，指尖抓握式、三指抓握式和圆柱状抓握式最为常用。很少有指标评估感觉和运动质量。总体而言，确定了OMs中的几个局限性。解决这些局限性的办法可能是修改并验证最初为其他临床人群开发的现有指标，作为更恰当地测量假肢使用情况的第一步，同时开发针对UL假肢使用者的更全面评估方法。
三级。
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