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Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis

A better understanding of motor recovery after stroke requires large-scale, longitudinal trials applying suitable assessments. Currently, there is an abundance of upper limb assessments used to quantify recovery. How well various assessments can describe upper limb function change over 1 year remain...

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Autores principales: Wolf, Silke, Gerloff, Christian, Backhaus, Winifried
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222610/
https://www.ncbi.nlm.nih.gov/pubmed/34177780
http://dx.doi.org/10.3389/fneur.2021.675255
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author Wolf, Silke
Gerloff, Christian
Backhaus, Winifried
author_facet Wolf, Silke
Gerloff, Christian
Backhaus, Winifried
author_sort Wolf, Silke
collection PubMed
description A better understanding of motor recovery after stroke requires large-scale, longitudinal trials applying suitable assessments. Currently, there is an abundance of upper limb assessments used to quantify recovery. How well various assessments can describe upper limb function change over 1 year remains uncertain. A uniform and feasible standard would be beneficial to increase future studies' comparability on stroke recovery. This review describes which assessments are common in large-scale, longitudinal stroke trials and how these quantify the change in upper limb function from stroke onset up to 1 year. A systematic search for well-powered stroke studies identified upper limb assessments classifying motor recovery during the initial year after a stroke. A metaregression investigated the association between assessments and motor recovery within 1 year after stroke. Scores from nine common assessments and 4,433 patients were combined and transformed into a standardized recovery score. A mixed-effects model on recovery scores over time confirmed significant differences between assessments (P < 0.001), with improvement following the weeks after stroke present when measuring recovery using the Action Research Arm Test (β = 0.013), Box and Block test (β = 0.011), Fugl–Meyer Assessment (β = 0.007), or grip force test (β = 0.023). A last-observation-carried-forward analysis also highlighted the peg test (β = 0.017) and Rivermead Assessment (β = 0.011) as additional, valuable long-term outcome measures. Recovery patterns and, thus, trial outcomes are dependent on the assessment implemented. Future research should include multiple common assessments and continue data collection for a full year after stroke to facilitate the consensus process on assessments measuring upper limb recovery.
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spelling pubmed-82226102021-06-25 Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis Wolf, Silke Gerloff, Christian Backhaus, Winifried Front Neurol Neurology A better understanding of motor recovery after stroke requires large-scale, longitudinal trials applying suitable assessments. Currently, there is an abundance of upper limb assessments used to quantify recovery. How well various assessments can describe upper limb function change over 1 year remains uncertain. A uniform and feasible standard would be beneficial to increase future studies' comparability on stroke recovery. This review describes which assessments are common in large-scale, longitudinal stroke trials and how these quantify the change in upper limb function from stroke onset up to 1 year. A systematic search for well-powered stroke studies identified upper limb assessments classifying motor recovery during the initial year after a stroke. A metaregression investigated the association between assessments and motor recovery within 1 year after stroke. Scores from nine common assessments and 4,433 patients were combined and transformed into a standardized recovery score. A mixed-effects model on recovery scores over time confirmed significant differences between assessments (P < 0.001), with improvement following the weeks after stroke present when measuring recovery using the Action Research Arm Test (β = 0.013), Box and Block test (β = 0.011), Fugl–Meyer Assessment (β = 0.007), or grip force test (β = 0.023). A last-observation-carried-forward analysis also highlighted the peg test (β = 0.017) and Rivermead Assessment (β = 0.011) as additional, valuable long-term outcome measures. Recovery patterns and, thus, trial outcomes are dependent on the assessment implemented. Future research should include multiple common assessments and continue data collection for a full year after stroke to facilitate the consensus process on assessments measuring upper limb recovery. Frontiers Media S.A. 2021-06-10 /pmc/articles/PMC8222610/ /pubmed/34177780 http://dx.doi.org/10.3389/fneur.2021.675255 Text en Copyright © 2021 Wolf, Gerloff and Backhaus. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Wolf, Silke
Gerloff, Christian
Backhaus, Winifried
Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis
title Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis
title_full Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis
title_fullStr Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis
title_full_unstemmed Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis
title_short Predictive Value of Upper Extremity Outcome Measures After Stroke—A Systematic Review and Metaregression Analysis
title_sort predictive value of upper extremity outcome measures after stroke—a systematic review and metaregression analysis
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222610/
https://www.ncbi.nlm.nih.gov/pubmed/34177780
http://dx.doi.org/10.3389/fneur.2021.675255
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