Responsiveness of kinematic and clinical measures of upper-limb motor function after stroke: A systematic review and meta-analysis
Résumé
Background: Kinematic analysis and clinical outcome measures with established responsiveness contribute to the quantified assessment of upper-limb function post-stroke, the selection of interventions and the differentiation of motor recovery patterns. Objective: This systematic review and meta-analysis aimed to report trends in use and compare the responsiveness of kinematic and clinical measures in studies measuring the effectiveness of constraint-induced movement, trunk restraint and bilateral arm therapies for upper-limb function after stroke. Methods: In this systematic review, randomised controlled trials implementing kinematic analysis and clinical outcome measures to evaluate the effects of therapies in post-stroke adults were eligible. We searched 8 electronic databases (MEDLINE, EMBASE, Web of Science, Scopus, CINAHL, CENTRAL, OTseeker and Pedro). Risk of bias was assessed according to the Cochrane Risk of Bias domains. A meta-analysis was conducted for repeated design measures of pre-and post-test data providing estimated standardised mean differences (SMDs). Results: We included reports of 12 studies (191 participants) reporting kinematic smoothness, movement duration and efficiency, trunk and shoulder range of motion, control strategy and velocity variables in conjunction with assessment by Motor Activity Log, Fugl-Meyer Assessment and Wolf Motor Function Test. Responsiveness was higher (i.e., non-overlap of 95% confidence intervals [CIs]) for Motor Activity Log score (SMD for amount of use 1.0, 95% CI 0.75-1.25, P < 0.001; SMD for quality of movement 0.96, 95% CI 0.72-1.20, P < 0.001) than movement efficiency, trunk and shoulder range of motion, control strategy and peak velocity. Conclusion: These results are consistent with current literature supporting the use of combined kinematic and clinical measures for comprehensive and accurate evaluation of upper-limb function post-stroke. Future research should include other design trials and rehabilitation types to confirm these findings, focusing on subgroup analysis of type of rehabilitation intervention and functional levels.
Mots clés
3D motion analysis
Hemiparesis
Kinematics
Outcome measure
Psychometrics
Upper extremity.
hemiparesis
upper extremity
kinematics
3D motion analysis
outcome measure
psychometrics KINO
Kinematic Motion Analysis Outcome Measures
MAL
Motor Activity Log
PICOS
Population-Interventions-Comparator-Outcomes-Study design(s)
ROM
Range of Motion
TRT
Trunk Restraint Therapy
UL
Upper Limb
WMFT
Wolf Motor Function Test KINO
Wolf Motor Function Test
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Villepinte_2020_preproofAccepted.pdf (767.15 Ko)
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Villepinte_2021-mmc1.pdf (630.6 Ko)
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