Standardized Measurement of Quality of Upper Limb Movement After Stroke: Consensus-Based Core Recommendations From the Second Stroke Recovery and Rehabilitation Roundtable

Abstract

The second Stroke Recovery and Rehabilitation Roundtable “metrics” task force developed consensus around the recognized need to add kinematic and kinetic movement quantification to its core recommendations for standardized measurements of sensorimotor recovery in stroke trials. Specifically, we focused on measurement of the quality of upper limb movement. We agreed that the recommended protocols for measurement should be conceptually rigorous, reliable, valid and responsive to change. The recommended measurement protocols include four performance assays (i.e. 2D planar reaching, finger individuation, grip strength, and precision grip at body function level) and one functional task (3D drinking task at activity level) that address body function and activity respectively. This document describes the criteria for assessment and makes recommendations about the type of technology that should be used for reliable and valid movement capture. Standardization of kinematic measurement protocols will allow pooling of participant data across sites, thereby increasing sample size aiding meta-analyses of published trials, more detailed exploration of recovery profiles, the generation of new research questions with testable hypotheses, and development of new treatment approaches focused on impairment. We urge the clinical and research community to consider adopting these recommendations.

A data-driven framework for selecting and validating digital health metrics: use-case in neurological sensorimotor impairments

“…Most importantly, the high variability of clinimetric properties across behavioral tasks and sensor-based metrics motivates the need for a methodology to select metrics for a specific assessment task, starting from a large set of potential metrics that should be narrowed down to a clinically relevant core set 13,21,26 . Existing approaches to select core sets of metrics commonly rely on the consensus from a group of selected experts, which can lead to bias and is often not task-dependent 21,[27][28][29][30] . Moreover, existing data-driven selection procedures (e.g., regression-based methods such as LASSO), are rarely tailored to the specific requirements of digital health metrics, where often no accurate ground truth about the targeted impairments is available [31][32][33] .…”

Upper limb kinematics during the first year after stroke: the stroke arm longitudinal study at the University of Gothenburg (SALGOT)

“…Kinematic analysis using optoelectronic systems provide precise and detailed measurements of movement performance and quality. A resent task force for stroke recovery metrics has recommended both 2D planar reaching and 3D functional reach-to-grasp task for measuring behavioral restitution of the upper limb [13]. The measurements in 3D using functional tasks are of particular interest since they provide quantifiable metrics on the quality of movement during a natural task that is well known to the performer [14,15].…”

Virtual reality training enhances gait poststroke: a systematic review and meta‐analysis

“…Recent consensus-based core recommendations from the Second Stroke Recovery and Rehabilitation Roundtable include the use of standardized kinematic and kinetic outcomes as measurements of sensorimotor recovery in stroke trials targeting upper extremity function. 123 A similar principle and further investigations would be helpful to further unveil the impact of VR interventions on poststroke locomotor recovery.…”