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Evaluation of upper extremity neurorehabilitation using technology: A European Delphi consensus study within the EU COST Action Network on Robotics for Neurorehabilitation

Evaluation of upper extremity neurorehabilitation using technology: A European Delphi consensus study within the EU COST Action Network on Robotics for Neurorehabilitation
Evaluation of upper extremity neurorehabilitation using technology: A European Delphi consensus study within the EU COST Action Network on Robotics for Neurorehabilitation
Background
The need for cost-effective neurorehabilitation is driving investment into technologies for patient assessment and treatment. Translation of these technologies into clinical practice is limited by a paucity of evidence for cost-effectiveness. Methodological issues, including lack of agreement on assessment methods, limit the value of meta-analyses of trials. In this paper we report the consensus reached on assessment protocols and outcome measures for evaluation of the upper extremity in neurorehabilitation using technology. The outcomes of this research will be part of the development of European guidelines.

Methods
A rigorous, systematic and comprehensive modified Delphi study incorporated questions and statements generation, design and piloting of consensus questionnaire and five consensus experts groups consisting of clinicians, clinical researchers, non-clinical researchers, and engineers, all with working experience of neurological assessments or technologies. For data analysis, two major groups were created: i) clinicians (e.g., practicing therapists and medical doctors) and ii) researchers (clinical and non-clinical researchers (e.g. movement scientists, technology developers and engineers).

Results
Fifteen questions or statements were identified during an initial ideas generation round, following which the questionnaire was designed and piloted. Subsequently, questions and statements went through five consensus rounds over 20 months in four European countries. Two hundred eight participants: 60 clinicians (29 %), 35 clinical researchers (17 %), 77 non-clinical researchers (37 %) and 35 engineers (17 %) contributed. At each round questions and statements were added and others removed. Consensus (≥69 %) was obtained for 22 statements on i) the perceived importance of recommendations; ii) the purpose of measurement; iii) use of a minimum set of measures; iv) minimum number, timing and duration of assessments; v) use of technology-generated assessments and the restriction of clinical assessments to validated outcome measures except in certain circumstances for research.

Conclusions
Consensus was reached by a large international multidisciplinary expert panel on measures and protocols for assessment of the upper limb in research and clinical practice. Our results will inform the development of best practice for upper extremity assessment using technologies, and the formulation of evidence-based guidelines for the evaluation of upper extremity neurorehabilitation
1743-0003
1-25
Hughes, A.M.
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Barbosa Boucas, Sofia
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Burridge, J.H.
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Alt Murphy, M.
76870056-4495-44ac-97cf-69067e496405
Buurke, J.
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Feys, P.
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Klamroth-Marganska, V.
abb99deb-3cd8-43c2-97bc-5c86bfdf8e35
Lamers, I.
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Prange-Lasonder, G.
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Timmermans, A.
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Keller, T.
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Hughes, A.M.
11239f51-de47-4445-9a0d-5b82ddc11dea
Barbosa Boucas, Sofia
0ce17fb0-8489-4a30-a739-fdce52ad6f3a
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64
Alt Murphy, M.
76870056-4495-44ac-97cf-69067e496405
Buurke, J.
63d20b94-58e6-42cd-a201-9d2f4b24e77e
Feys, P.
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Klamroth-Marganska, V.
abb99deb-3cd8-43c2-97bc-5c86bfdf8e35
Lamers, I.
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Prange-Lasonder, G.
bf46682f-4002-4892-ab20-f42cb175da02
Timmermans, A.
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Keller, T.
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Hughes, A.M., Barbosa Boucas, Sofia, Burridge, J.H., Alt Murphy, M., Buurke, J., Feys, P., Klamroth-Marganska, V., Lamers, I., Prange-Lasonder, G., Timmermans, A. and Keller, T. (2016) Evaluation of upper extremity neurorehabilitation using technology: A European Delphi consensus study within the EU COST Action Network on Robotics for Neurorehabilitation. Journal of NeuroEngineering and Rehabilitation, 13 (1), 1-25, [86]. (doi:10.1186/s12984-016-0192-z).

Record type: Article

Abstract

Background
The need for cost-effective neurorehabilitation is driving investment into technologies for patient assessment and treatment. Translation of these technologies into clinical practice is limited by a paucity of evidence for cost-effectiveness. Methodological issues, including lack of agreement on assessment methods, limit the value of meta-analyses of trials. In this paper we report the consensus reached on assessment protocols and outcome measures for evaluation of the upper extremity in neurorehabilitation using technology. The outcomes of this research will be part of the development of European guidelines.

Methods
A rigorous, systematic and comprehensive modified Delphi study incorporated questions and statements generation, design and piloting of consensus questionnaire and five consensus experts groups consisting of clinicians, clinical researchers, non-clinical researchers, and engineers, all with working experience of neurological assessments or technologies. For data analysis, two major groups were created: i) clinicians (e.g., practicing therapists and medical doctors) and ii) researchers (clinical and non-clinical researchers (e.g. movement scientists, technology developers and engineers).

Results
Fifteen questions or statements were identified during an initial ideas generation round, following which the questionnaire was designed and piloted. Subsequently, questions and statements went through five consensus rounds over 20 months in four European countries. Two hundred eight participants: 60 clinicians (29 %), 35 clinical researchers (17 %), 77 non-clinical researchers (37 %) and 35 engineers (17 %) contributed. At each round questions and statements were added and others removed. Consensus (≥69 %) was obtained for 22 statements on i) the perceived importance of recommendations; ii) the purpose of measurement; iii) use of a minimum set of measures; iv) minimum number, timing and duration of assessments; v) use of technology-generated assessments and the restriction of clinical assessments to validated outcome measures except in certain circumstances for research.

Conclusions
Consensus was reached by a large international multidisciplinary expert panel on measures and protocols for assessment of the upper limb in research and clinical practice. Our results will inform the development of best practice for upper extremity assessment using technologies, and the formulation of evidence-based guidelines for the evaluation of upper extremity neurorehabilitation

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Accepted/In Press date: 1 September 2016
e-pub ahead of print date: 23 September 2016
Published date: December 2016
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 400531
URI: http://eprints.soton.ac.uk/id/eprint/400531
ISSN: 1743-0003
PURE UUID: 99b87cc7-6354-462c-b84a-2415f9bde228
ORCID for A.M. Hughes: ORCID iD orcid.org/0000-0002-3958-8206
ORCID for J.H. Burridge: ORCID iD orcid.org/0000-0003-3497-6725

Catalogue record

Date deposited: 20 Sep 2016 12:08
Last modified: 15 Mar 2024 05:54

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Contributors

Author: A.M. Hughes ORCID iD
Author: Sofia Barbosa Boucas
Author: J.H. Burridge ORCID iD
Author: M. Alt Murphy
Author: J. Buurke
Author: P. Feys
Author: V. Klamroth-Marganska
Author: I. Lamers
Author: G. Prange-Lasonder
Author: A. Timmermans
Author: T. Keller

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