Systematic review of outcome measures used in the evaluation of robot-assisted upper limb exercise in stroke

Abstract

Objective: To classify and evaluate outcome measures currently used in robot-assisted exercise trials (RAET) in stroke, and to determine selection criteria for outcome measures in future trials.

Methods: Outcome measures used in RAET were identified from MEDLINE, EMBASE, CINAHL, PubMed and PsychINFO databases. The scale items were categorized into International Classification of Functioning Disability and Health (ICF) domains. The psychometric properties of scale were rated using a standardized pro forma.

Results: Thirty outcome measures were identified from 28 published RAET. Commonly used ICF body function scales were: Fugl-Meyer (FM) (24 studies), Modified Ashworth Scale (13 studies), Medical Research Council (11 studies), Kinematic measures (8 studies) and Motor Status Score (6 studies); ICF activity scale was Functional Independence Measure (FIMTM) (9 studies); ICF participation, personal and environmental factors scales were rarely used. Standard-ized rating identified that FM, kinematic measures, Action Research Arm Test, Wolf Motor Function Test, FIMTM, and ABILHAND have adequate measurement properties for use in RAET.

Conclusion: Some of the currently used outcome measures seem appropriate for RAET. The use of the ICF framework enables selection of an appropriate combination of outcome measures depending on patient characteristics, such as severity of weakness and chronicity of stroke impairments.