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A review of international clinical guidelines for rehabilitation of people with neurological conditions: what recommendations are made for upper limb assessment?

A review of international clinical guidelines for rehabilitation of people with neurological conditions: what recommendations are made for upper limb assessment?
A review of international clinical guidelines for rehabilitation of people with neurological conditions: what recommendations are made for upper limb assessment?
Background: upper limb impairment is a common problem for people with neurological disabilities, affecting activity, performance, quality of life and independence. Accurate, timely assessments are required for effective rehabilitation, and development of novel interventions. International consensus on upper limb assessment is needed to make research findings be more meaningful, provide a benchmark for quality in clinical practice, more cost-effective neurorehabilitation and improved outcomes for neurological patients undergoing rehabilitation.

Aim: to conduct a systematic review, as part of the output of a European COST Action, to identify what recommendations are
made for upper limb assessment.

Methods: we systematically reviewed published guidance on measures and protocols for assessing upper limb function in
neurological rehabilitation via electronic databases from January 2007 – December 2017. Additional records were then identified through other sources. Records were selected for inclusion based on scanning of titles, abstracts and full text by two authors working independently, and a third author if there was disagreement. Records were included if they referred to ‘rehabilitation’ and ‘assessment’ or ‘measurement’. Reasons for exclusion were documented.

Results: From the initial 552 records identified (after duplicates were removed), 34 satisfied our criteria for inclusion and only six recommended specific outcome measures and /or protocols. Records were divided into National Guidelines and other practice guidelines published in peer reviewed journals. There was agreement that assessment is critical, should be conducted early and at regular intervals and that there is a need for standardised measures. Assessments should be conducted by a healthcare professional trained in using the measure and should encompass body function and structure, activity and participation.

Conclusions: we present a comprehensive, critical and original summary of current recommendations. Defining a core set of measures and agreed protocols requires international consensus between experts representing the diverse and multi-disciplinary field of neurorehabilitation including clinical researchers and practitioners, rehabilitation technology researchers and commercial developers. Current lack of guidance may hold-back progress in understanding function and recovery. Together with a Delphi consensus study and an overview of systematic reviews of outcome measures it will contribute to the development of international guidelines for upper limb assessment in neurological conditions.
1664-2295
Burridge, Jane
0110e9ea-0884-4982-a003-cb6307f38f64
Murphy, Margit Alt
8f0cc5b2-d5dc-417d-b9be-dd51ca626346
Buurke, Jaap
4295b8e8-2add-46fc-a9cf-5c4d12cee3bc
Feys, Peter
8f40b436-8c83-4d56-bbaf-85f5ebebc590
Keller, Thierry
7ec5996d-fc65-4107-88c5-50709996a52c
Klamroth-Marganska, Verena
94ba56e9-4f71-4a11-b0e2-8c716bb93806
Lamers, Ilse
12693dff-230e-4558-9242-4ffd23465cba
McNicholas, Lauren
90976898-5c8f-442e-9b1d-54c9e3422b90
Prange-Lasonder, Gerdienke B
6eb3de8c-8da3-4363-8d63-bd351324948b
Tarkka, Ina M.
56ecb8c4-f970-420d-bf50-fc7ec77a737f
Timmermans, Annick
93ecee85-1e2a-4de2-9f39-e80380da9a20
Hughes, Ann-Marie
11239f51-de47-4445-9a0d-5b82ddc11dea
Burridge, Jane
0110e9ea-0884-4982-a003-cb6307f38f64
Murphy, Margit Alt
8f0cc5b2-d5dc-417d-b9be-dd51ca626346
Buurke, Jaap
4295b8e8-2add-46fc-a9cf-5c4d12cee3bc
Feys, Peter
8f40b436-8c83-4d56-bbaf-85f5ebebc590
Keller, Thierry
7ec5996d-fc65-4107-88c5-50709996a52c
Klamroth-Marganska, Verena
94ba56e9-4f71-4a11-b0e2-8c716bb93806
Lamers, Ilse
12693dff-230e-4558-9242-4ffd23465cba
McNicholas, Lauren
90976898-5c8f-442e-9b1d-54c9e3422b90
Prange-Lasonder, Gerdienke B
6eb3de8c-8da3-4363-8d63-bd351324948b
Tarkka, Ina M.
56ecb8c4-f970-420d-bf50-fc7ec77a737f
Timmermans, Annick
93ecee85-1e2a-4de2-9f39-e80380da9a20
Hughes, Ann-Marie
11239f51-de47-4445-9a0d-5b82ddc11dea

Burridge, Jane, Murphy, Margit Alt, Buurke, Jaap, Feys, Peter, Keller, Thierry, Klamroth-Marganska, Verena, Lamers, Ilse, McNicholas, Lauren, Prange-Lasonder, Gerdienke B, Tarkka, Ina M., Timmermans, Annick and Hughes, Ann-Marie (2019) A review of international clinical guidelines for rehabilitation of people with neurological conditions: what recommendations are made for upper limb assessment? Frontiers in Neurology, 10 (567). (doi:10.3389/fneur.2019.00567).

Record type: Article

Abstract

Background: upper limb impairment is a common problem for people with neurological disabilities, affecting activity, performance, quality of life and independence. Accurate, timely assessments are required for effective rehabilitation, and development of novel interventions. International consensus on upper limb assessment is needed to make research findings be more meaningful, provide a benchmark for quality in clinical practice, more cost-effective neurorehabilitation and improved outcomes for neurological patients undergoing rehabilitation.

Aim: to conduct a systematic review, as part of the output of a European COST Action, to identify what recommendations are
made for upper limb assessment.

Methods: we systematically reviewed published guidance on measures and protocols for assessing upper limb function in
neurological rehabilitation via electronic databases from January 2007 – December 2017. Additional records were then identified through other sources. Records were selected for inclusion based on scanning of titles, abstracts and full text by two authors working independently, and a third author if there was disagreement. Records were included if they referred to ‘rehabilitation’ and ‘assessment’ or ‘measurement’. Reasons for exclusion were documented.

Results: From the initial 552 records identified (after duplicates were removed), 34 satisfied our criteria for inclusion and only six recommended specific outcome measures and /or protocols. Records were divided into National Guidelines and other practice guidelines published in peer reviewed journals. There was agreement that assessment is critical, should be conducted early and at regular intervals and that there is a need for standardised measures. Assessments should be conducted by a healthcare professional trained in using the measure and should encompass body function and structure, activity and participation.

Conclusions: we present a comprehensive, critical and original summary of current recommendations. Defining a core set of measures and agreed protocols requires international consensus between experts representing the diverse and multi-disciplinary field of neurorehabilitation including clinical researchers and practitioners, rehabilitation technology researchers and commercial developers. Current lack of guidance may hold-back progress in understanding function and recovery. Together with a Delphi consensus study and an overview of systematic reviews of outcome measures it will contribute to the development of international guidelines for upper limb assessment in neurological conditions.

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A review of international clinical guidelines for rehabilitation of people with neurological conditions: what recommendations are made for upper limb assessment? - Accepted Manuscript
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Accepted/In Press date: 13 May 2019
e-pub ahead of print date: 25 June 2019

Identifiers

Local EPrints ID: 431039
URI: http://eprints.soton.ac.uk/id/eprint/431039
ISSN: 1664-2295
PURE UUID: 71f41da1-36fa-4a0e-beba-4984a581dc40
ORCID for Jane Burridge: ORCID iD orcid.org/0000-0003-3497-6725
ORCID for Ann-Marie Hughes: ORCID iD orcid.org/0000-0002-3958-8206

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Date deposited: 22 May 2019 16:30
Last modified: 18 Feb 2021 17:06

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