Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
Int J Stroke. 2024 Feb;19(2):158-168. doi: 10.1177/17474930231205207. Epub 2023 Oct 12.
Mobility is a key priority for stroke survivors. Worldwide consensus of standardized outcome instruments for measuring mobility recovery after stroke is an essential milestone to optimize the quality of stroke rehabilitation and recovery studies and to enable data synthesis across trials.
Using a standardized methodology, which involved convening of 13 worldwide experts in the field of mobility rehabilitation, consensus was established through an defined survey-based approach followed by group discussions. The group agreed on balance- and mobility-related definitions and recommended a core set of outcome measure instruments for lower extremity motor function, balance and mobility, biomechanical metrics, and technologies for measuring quality of movement.
Selected measures included the Fugl-Meyer Motor Assessment lower extremity subscale for motor function, the Trunk Impairment Scale for sitting balance, and the Mini Balance Evaluation System Test (Mini-BESTest) and Berg Balance Scale (BBS) for standing balance. The group recommended the Functional Ambulation Category (FAC, 0-5) for walking independence, the 10-meter Walk Test (10 mWT) for walking speed, the 6-Minute Walk Test (6 MWT) for walking endurance, and the Dynamic Gait Index (DGI) for complex walking. An FAC score of less than three should be used to determine the need for an additional standing test (FAC < 3, add BBS to Mini-BESTest) or the feasibility to assess walking (FAC < 3, 10 mWT, 6 MWT, and DGI are "not testable"). In addition, recommendations are given for prioritized kinetic and kinematic metrics to be investigated that measure recovery of movement quality of standing balance and walking, as well as for assessment protocols and preferred equipment to be used.
The present recommendations of measures, metrics, technology, and protocols build on previous consensus meetings of the International Stroke Recovery and Rehabilitation Alliance to guide the research community to improve the validity and comparability between stroke recovery and rehabilitation studies as a prerequisite for building high-quality, standardized "big data" sets. Ultimately, these recommendations could lead to high-quality, participant-specific data sets to aid the progress toward precision medicine in stroke rehabilitation.
行动能力是脑卒中幸存者的关键关注点。在全球范围内，达成使用标准化工具来衡量脑卒中后行动能力恢复的共识是优化脑卒中康复研究质量和实现试验间数据综合的重要里程碑。
采用标准化方法，召集了 13 位全球移动康复领域的专家，通过定义明确的基于调查的方法达成共识，随后进行小组讨论。专家组就平衡和移动相关定义达成一致，并推荐了一套核心的下肢运动功能、平衡和移动、生物力学指标以及用于测量运动质量的技术的结果测量工具。
选定的措施包括 Fugl-Meyer 运动评估下肢子量表（Fugl-Meyer Motor Assessment lower extremity subscale）用于运动功能，躯干损伤量表（Trunk Impairment Scale）用于坐姿平衡，迷你平衡评估系统测试（Mini-BESTest）和伯格平衡量表（Berg Balance Scale）用于站立平衡。专家组建议使用功能性步行分类（Functional Ambulation Category，FAC，0-5）来衡量步行独立性，使用 10 米步行测试（10-meter Walk Test，10mWT）来衡量步行速度，使用 6 分钟步行测试（6-Minute Walk Test，6MWT）来衡量步行耐力，使用动态步态指数（Dynamic Gait Index，DGI）来衡量复杂行走。如果 FAC 评分低于 3，应使用该评分来确定是否需要进行额外的站立测试（FAC<3，添加 BBS 到 Mini-BESTest）或评估步行的可行性（FAC<3，10mWT、6MWT 和 DGI 为“不可测试”）。此外，还建议优先研究用于测量站立平衡和行走运动质量恢复的动力学和运动学指标，并给出评估协议和首选设备的建议。
本研究中的建议包括测量工具、指标、技术和方案，是对国际脑卒中康复与康复联盟（International Stroke Recovery and Rehabilitation Alliance）之前的共识会议的扩展，旨在指导研究界提高脑卒中康复研究之间的有效性和可比性，这是建立高质量、标准化“大数据”集的前提。最终，这些建议可以为参与者提供高质量的特定数据集，以帮助推进脑卒中康复的精准医学。
