Madroñero-Miguel Beatriz, Cuesta-García César
Occupational Therapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain.
Occupational Thinks Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Aravaca, Madrid, Spain.
Br J Occup Ther. 2023 Sep;86(9):648-658. doi: 10.1177/03080226231175574. Epub 2023 Jun 6.
There is a lack of explicit tool recommendations for upper limb (UL) assessment in stroke, occupational therapists are frequently underrepresented in consensus studies, and the frequency of use of tools is highly variable between countries. The objective was to generate national occupational therapy consensus recommendations on UL assessment tools in stroke, and to classify the tools that achieve consensus according to the International Classification of Functioning, Disability and Health (ICF) components.
Three-round e-Delphi study of national scope. Occupational therapists working in Spain with training and experience in neurorehabilitation were recruited. Rounds were based on the completion of questionnaires on UL stroke assessment tools. Consensus was reached when ⩾75% of experts gave a ⩾7 rating on a nine-point Likert scale.
A total of 29 occupational therapists comprised the expert panel. Twenty-three (17.8%) assessment tools achieved consensus and were classified according to the ICF components of body functions and structures (7), activities (11), participation (3) and other (2).
The expert panel recommended 23 outcome measures for UL recovery in stroke, representing all ICF components. The consensus recommendations are intended to assist occupational therapists in their clinical decision-making process, and to reduce the heterogeneity of research tools.
目前缺乏针对中风患者上肢评估的明确工具推荐,职业治疗师在共识研究中的代表性往往不足,而且不同国家工具的使用频率差异很大。目的是就中风患者上肢评估工具制定国家职业治疗共识推荐,并根据国际功能、残疾和健康分类(ICF)组件对达成共识的工具进行分类。
开展了三轮全国范围的电子德尔菲研究。招募了在西班牙从事神经康复工作且有相关培训和经验的职业治疗师。各轮基于关于上肢中风评估工具的问卷填写。当≥75%的专家在九点李克特量表上给出≥7的评分时,即达成共识。
共有29名职业治疗师组成专家小组。23种(17.8%)评估工具达成共识,并根据ICF的身体功能和结构(7种)、活动(11种)、参与(3种)及其他(2种)组件进行了分类。
专家小组推荐了23种中风患者上肢恢复的结局指标,涵盖了ICF的所有组件。这些共识推荐旨在协助职业治疗师进行临床决策,并减少研究工具的异质性。