REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands.
REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands; Center of Expertise, Adelante Rehabilitation Center, Valkenburg, the Netherlands.
Arch Phys Med Rehabil. 2020 May;101(5):907-916. doi: 10.1016/j.apmr.2019.11.015. Epub 2019 Dec 28.
To summarize the literature on definitions, assessment protocols, and outcome measures for motor fatigability in patients with neurologic problems and investigates the known clinimetric properties according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria.
Two databases were consulted for studies published between January 2003 and November 2018 using the terms "motor fatigability," "nervous system disease," and "upper limb."
Studies were included if they were (1) not older than 15 years; (2) written in English, German, or Dutch; (3) involved upper limbs of patients with neurologic disease; and (4) adequately described protocols using maximum voluntary contractions.
Thirty-three studies were included, describing 14 definitions, 37 assessment protocols, and 9 outcome measures. The following data were obtained: (1) author and publication year; (2) aim; (3) fatigability definition; (4) sample characteristics; (5) fatigability protocol; (8) measurement system; and (9) outcome measure.
Protocols relating to body function level of the International Classification of Functioning (ICF) were most often performed in patients with multiple sclerosis (MS) including maximal or submaximal, isometric or concentric, and eccentric contractions of variable duration. For ICF activities level, most protocols included wheelchair-related tasks. Clinimetric properties were known in 2 included protocols. Test-retest reliability in patients with MS were moderate to excellent for the static fatigue index and moderate for the dynamic fatigue index.
Based on physiology, recommendations are made for protocols and outcome measures for motor fatigability at the ICF body function level. For the ICF activities level, too little is known to make sound statements on the use of protocols in populations with neurologic disease. Clinimetric properties should be further investigated for populations with neurologic problems.
总结神经问题患者运动疲劳性的定义、评估方案和结果测量的文献，并根据共识基础的健康测量仪器选择标准（COSMIN）标准调查已知的临床计量学特性。
使用“运动疲劳性”、“神经系统疾病”和“上肢”等术语，在 2003 年 1 月至 2018 年 11 月期间，在两个数据库中检索发表的研究。
如果研究符合以下标准，则将其纳入：（1）不超过 15 年；（2）用英语、德语或荷兰语书写；（3）涉及神经系统疾病患者的上肢；（4）使用最大自主收缩充分描述方案。
共纳入 33 项研究，描述了 14 种定义、37 种评估方案和 9 种结果测量。获得以下数据：（1）作者和出版年份；（2）目的；（3）疲劳定义；（4）样本特征；（5）疲劳方案；（8）测量系统；（9）结果测量。
在多发性硬化症（MS）患者中，最常进行与国际功能、残疾和健康分类（ICF）身体功能水平相关的方案，包括最大或次最大、等长或向心、以及不同持续时间的离心收缩。对于 ICF 活动水平，大多数方案包括与轮椅相关的任务。在纳入的 2 项方案中，已知临床计量学特性。在 MS 患者中，静态疲劳指数的测试-重测信度为中度至良好，动态疲劳指数的测试-重测信度为中度。
根据生理学，建议在 ICF 身体功能水平上制定运动疲劳性的方案和结果测量。对于 ICF 活动水平，由于对神经疾病患者人群中方案的使用缺乏了解，因此无法做出合理的陈述。应进一步针对神经问题人群进行临床计量学特性的研究。
