Standardized measurement of sensorimotor recovery in stroke trials: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable

Kwakkel, Gert; Lannin, Natasha A.; Borschmann, Karen; English, Coralie; Ali, Myzoon; Чурилов, Леонид; Saposnik, Gustavo; Winstein, Carolee J.; Wegen, Erwin E. H. van; Wolf, Steven L.; Krakauer, John W.; Bernhardt, Julie

doi:10.1177/1747493017711813

Cited by 390 publications

(422 citation statements)

References 54 publications

Supporting

Mentioning

394

Contrasting

Unclassified

Order By: Relevance

“…Yet, there were high attrition rates and bias, and variable outcomes used, which prevented metaanalysis. These issues are not isolated to RPD; the Stroke Recovery and Rehabilitation Roundtable group highlighted this as common in stroke rehabilitation trials (10,65,66). Nevertheless, several classes of RPDs should be discussed in more detail.…”

Section: Eighteen Of 28 Drug Interventions Identified In Thismentioning

confidence: 99%

Safety and efficacy of recovery-promoting drugs for motor function after stroke: A systematic review of randomized controlled trials

Firth¹,

Barker²,

Hayward³

et al. 2019

J Rehabil Med

View full text Add to dashboard Cite

LAY ABSTRACTSeveral drugs, administered in combination with rehabilitation, have been found to increase the amount of physical recovery achieved by a stroke survivor. This paper reviews the published literature to investigate which drugs have the best evidence of efficacy and safety to promote motor recovery after stroke. However, many studies investigating these drugs lack rigor and have little consistency between how trials were performed. Consequently, it is difficult to make a definitive judgement on how safe and effective these drugs are, or to compare drugs to determine superiority. To overcome this, a reporting standard must be developed for trials of these particular drugs. In addition, stricter adherence is necessary to already established reporting standards, including those that outline how parallel group randomized trials and physical interventions embedded within them are described (the Template for Intervention Description and Replication checklist and the Consolidated Standards of Reporting Trials statement, respectively).Objective: To investigate the efficacy and safety of drug interventions to promote motor recovery poststroke. Data sources: CENTRAL, CINAHL, Embase, MEDLINE, SCOPUS and Web of Science. Study selection: Published human randomized controlled trials in which the primary intervention was a drug administered to promote motor recovery poststroke, vs placebo. Data extraction: Standardized pro forma used to extract safety and efficacy data; Cochrane Collaboration risk of bias assessment tool performed to assess risk of bias.Data synthesis: Fifty randomized controlled trials from 4,779 citations were included. An overall trend of high risk of attrition (n = 27) and reporting bias (n = 36) was observed. Twenty-eight different drug interventions were investigated, 18 of which demonstrated statistically significant results favouring increased motor recovery compared with control intervention. Forty-four studies measured safety; no major safety concerns were reported. Conclusion: Candidate drug interventions promoting motor recovery post-stroke were identified, specifically selective serotonin reuptake inhibitors and levodopa; however, the high risk of bias in many trials is concerning. Drugs to improve motor function remain an important area of enquiry. Future research must focus on establishing the right drug intervention to be administered at an optimal dose and time, combined with the most effective adjuvant physical therapy to drive stroke recovery.

show abstract

Section: Eighteen Of 28 Drug Interventions Identified In Thismentioning

confidence: 99%

Safety and efficacy of recovery-promoting drugs for motor function after stroke: A systematic review of randomized controlled trials

Firth¹,

Barker²,

Hayward³

et al. 2019

J Rehabil Med

View full text Add to dashboard Cite

show abstract

“…Apart from its popularity, the robust and sensitive nature of the ARAT are indicated by its use as a criterion measure in validation studies for new, existing and/or modified assessments Blennerhassett, Avery & Carey, 2010;Edwards, Lang, Wagner, Birkenmeier & Dromerick, 2012;Page, Hade & Persch, 2015). The ARAT has also been included in clinical practice guidelines and consensus statements relevant to neurorehabilitation, stroke (Kwakkel et al, 2017;Sullivan et al, 2013) and upper limb spasticity (Sheean, Lannin, Turner-Stokes, Rawicki & Snow, 2010).…”

Section: Arat Uptakementioning

confidence: 99%

“…These movements are needed to perform many everyday tasks. For this reason, an inability to perform test items is thus proposed to be a valid indicator of upper limb activity limitation (Kwakkel et al, 2017). The ARAT has been demonstrated to be unidimensional, measuring the single construct of upper limb function related to everyday activities (Koh et al, 2006;Van der Lee, Roorda, Beckerman, Lankhorst & Bouter, 2002).…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the psychometric properties of the Action Research Arm Test in neurorehabilitation

Pike

Lannin

Wales

et al. 2018

Aus Occup Therapy J

View full text Add to dashboard Cite

Background/aim The Action Research Arm Test (ARAT) measures upper limb activity limitations in people with acquired brain injuries. Evidence relating to the use of this test in neurorehabilitation is scattered. This review identifies, rates and synthesises evidence on the original 1981 ARAT use within neurorehabilitation. Psychometric properties are reviewed, including specific examination of participants with upper limb spasticity. Methods Systematic review of published articles describing psychometric properties and/or use of the original version of the ARAT in neurorehabilitation. COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN) search strategy, reporting and methodological checklist with criterion‐based appraisal of quality criteria for good measurement properties were applied. A best evidence synthesis for each psychometric property was completed. Results In 28 included studies, participants had suffered a stroke or traumatic brain injury, with 46% >6 months post‐injury. Six studies identified participants with upper limb spasticity. Methodological quality of psychometric properties ranged from poor to excellent. Best evidence synthesis determined moderate positive evidence for using the ARAT with people without limb spasticity: intra‐rater reliability (ICC 0.71 (95% CI 0.53–0.89) to 0.99 (95% CI 0.98, 0.99)); responsiveness (ROC curve 0.72–0.88, SRM 0.89); and regarding construct validity, it is a valid measure of activity limitation. Limited evidence for psychometric properties of the ARAT were found when used with people with upper limb spasticity for construct validity and responsiveness (ES 0.55–0.78). Gaps in evidence were found for inter and test–retest reliability, measurement error, content validity, structural validity, floor and ceiling effects. Conclusions The ARAT is an appropriate measure of activity limitation post‐stroke and should be considered for use with people with TBI; evidence for people with upper limb spasticity is limited. Gaps and mixed limited to moderate evidence for psychometric properties in neurorehabilitation mean further research is required.

show abstract

“…For every stroke recovery trial, the following assessments are recommended: NIHSS to characterize baseline stroke severity, Fugl-Meyer Assessment to characterize impairment, Action Research Arm Test to characterize activity limitation, a 10-meter walk test, a self-reported questionnaire of health status (EQ-5D) for quality of life, and the modified Rankin Scale to characterize global disability. 80 If possible, kinematic and kinetic information should also be collected, which can tease apart the contribution of true motor recovery versus compensation. Some questions to think about in the context of MST include: What ICF domains does it target?, and What aspects of movement are being retrained and therefore are expected to change?…”

Section: How Do We Move Forward?mentioning

confidence: 99%

Music‐supported therapy for stroke motor recovery: theoretical and practical considerations

Chen

2018

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

Music may confer benefits for well-being and health. What is the state of knowledge and evidence for a role of music in supporting the rehabilitation of movements after stroke? In this brief perspective, I provide background context and information about stroke recovery in general, in order to spark reflection and discussion for how we think music may impact motor recovery, given the current clinical milieu.

show abstract

Standardized measurement of sensorimotor recovery in stroke trials: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable

Cited by 390 publications

References 54 publications

Safety and efficacy of recovery-promoting drugs for motor function after stroke: A systematic review of randomized controlled trials

Safety and efficacy of recovery-promoting drugs for motor function after stroke: A systematic review of randomized controlled trials

A systematic review of the psychometric properties of the Action Research Arm Test in neurorehabilitation

Music‐supported therapy for stroke motor recovery: theoretical and practical considerations

Contact Info

Product

Resources

About