Outcome measures and motion capture systems for assessing lower limb orthosis-based interventions after stroke: a systematic review

Abstract

To review and categorize, according to the International Classification of Functioning, the outcome measures, and motion capture systems for studying the evidence-based practice of orthotic-based interventions in post-stroke gait rehabilitation. Methods: An electronic literature search was conducted up to February 2018 in Web of Science, Scopus, MEDLINE, and Physiotherapy Evidence Database. Randomized trials measuring activity, impairment, or participation outcome measures for studying the evidence-based practice of orthoses in gait rehabilitation after an acute or chronic stroke were identified. The studies were assessed through the Cochrane risk-of-bias tool by three authors. Information about stroke's stage, assessment protocol (goal, timing, and motion capture system), orthosis configuration, and outcome measures were extracted. Results: Eighteen randomized trials, including 387 post-stroke adults, mostly in the chronic stage, were selected. They assessed 39 outcomes, mainly activity outcome measures such as spatiotemporal (72.2%), kinematic (44.4%), and functional (33.3%) outcomes. Gait speed was the primary outcome in most studies. Participation (22.2%) and impairment (16.7%) outcome measures were less explored. Mostly, non-portable motion capture systems were employed opposing the freely-use of the wearable orthosis. The detection bias risk and the shortage of baseline and follow-up outcome measures affected the studies' assessment quality.Conclusionsː Studies showed heterogeneity in selecting outcomes and timings for assessment. There is evidence for assessing the evidence of orthosis-based gait rehabilitation after stroke through activity outcome measures, primarily the gait speed, recorded by non-wearable motion capture systems. A unified methodology considering wearable sensors for tracking baseline and follow-up measures is needed.

Clinical outcome measures to evaluate the effects of orthotic management post-stroke: a systematic review

“…In examining the aggregated data, the preponderance of outcome measures identified in this review was related to measuring aspects of mobility, coded within the activity domain of the ICF. This finding is consistent with previous reviews related to outcome measures in stroke rehabilitation, which have also identified measures within the activity domain as being most prevalent [11,33]. Previous studies, however, only classified measures in relation to major ICF categories and did not consider second-level classifications which provide considerably more detail.…”

“…In the only other review of outcome measures assessing lowerlimb orthotic management of stroke Figueiredo et al [33] reported the most commonly used outcome measures as being; temporospatial measures (e.g., gait speed, step length, and cadence), kinematics (e.g., range of motion) and functional measures (e.g., TUG, BBS, and 10MWT). Given that the present study excluded laboratory-based measures that were not considered to be readily accessible in the clinical environment, results were slightly different to those of Figueiredo et al however, similarities were observed in relation to functional measures with the most frequently used measures being the 10MWT, TUG, and 6MWT.…”

“…In the only review with a specific focus on lower-limb orthotic management of stroke, Figueiredo et al [14] reviewed outcome measures and motion capture systems which had been used in randomised trials evaluating orthotic interventions for gait rehabilitation. 39 outcome measures were identified with gait speed, step length, cadence, and stride duration being the most frequently reported measures.…”

Pelvis-Toe Distance: 3-Dimensional Gait Characteristics of Functional Limb Shortening in Hemiparetic Stroke

“…In general, the gold standard for gait ability is gait speed [ 31 , 32 ]. However, gait speed has been pointed out to be insufficient to detect qualitative changes in stroke population [ 12 , 33 ].…”

Reliability and validity of the Turkish version of the satisfaction module of the Orthotics and Prosthetics Users' Survey

“…4 Various performancebased and self-reported measurements are used to evaluate the success of P&O in rehabilitation. 5,6 Although these evaluations are very informative, they do not provide information about the experience of the patient using the device in his/her daily life. Therefore, the use of standardized measures of satisfaction has been recommended.…”