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

G. Kwakkel*, E. E.H. van Wegen, J. H. Burridge, C. J. Winstein, L. E.H. van Dokkum, M. Alt Murphy, M. F. Levin, J. W. Krakauer, Catherine E. Lang, Thierry Keller, Tomoko Kitago, Nurdiana Nordin, Valery Pomeroy, Janne M. Veerbeek, Frederike van Wijck

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)951-958
Number of pages8
JournalNeurorehabilitation and Neural Repair
Volume33
Issue number11
DOIs
Publication statusPublished - 1 Nov 2019

Funding

Kwakkel G. 1 van Wegen E. E. H. 2 Burridge J. H. 3 Winstein C. J. 4 van Dokkum L. E. H. 5 Alt Murphy M. 6 Levin M. F. 7 Krakauer J. W. 8 Lang Catherine E Keller Thierry Kitago Tomoko Nordin Nurdiana Pomeroy Valery Veerbeek Janne M. van Wijck Frederike on behalf of the ADVISORY group 1 Amsterdam UMC, VU Medical Centre, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam, The Netherlands 2 Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam, The Netherlands 3 School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK 4 Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA 5 I2FH, Institue d’imagerie Fonctionelle Humaine, Montpellier University Hospital Guide, Chauliac, France 6 Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden 7 School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada 8 Departments of Neurology, Neuroscience, Physical Medicine & Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, USA G. Kwakkel, Department of Rehabilitation Medicine, Amsterdam UMC, VU Medical Center, Amsterdam, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Email: [email protected] 10 2019 1545968319886477 © The Author(s) 2019 2019 American Society of Neurorehabilitation 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. Stroke rehabilitation biomechanics measurement upper extremity recovery consensus edited-state corrected-proof We thank the ADVISORY group [Catherine E Lang (Physical Therapy, Occupational Therapy, Neurology Washington University School of Medicine, St. Louis, MO USA), Thierry Keller (Neurorehabilitation Department, Health Division, Tecnalia Research & Innovation, San Sebastian, Spain), Tomoko Kitago (Burke Neurological Institute and Department of Neurology, Weill Cornell Medicine, USA), Nurdiana Nordin (Centre for Robotics and Industrial Automation, Fakulti Kejuruteraan Elektrik, Universiti Teknikal Malaysia Melaka, Malaysia), Valery Pomeroy (School of Health Sciences, University of East Anglia, Norwich, United Kingdom), Janne M. Veerbeek (Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland; Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland) and Frederike van Wijck (School of Health and Life Sciences, Glasgow Caledonian University Cowcaddens Road, United Kingdom)] for being part of the external advisory group for this working group. We would like to acknowledge Julie Bernhardt for convening the second Stroke Rehabilitation and Recovery Roundtable (SRRR II), Dale Corbett and Karen Borschmann for organizing the meeting and Farrell Leibovitch for moderating the overall discussions within the different SRRR groups. We like to thank Alejandro Melendez-Calderon for his suggestions. Supplementary material for this article is available on the Neurorehabilitation & Neural Repair website at https://journals.sagepub.com/home/nnr . Declaration of Conflicting Interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The authors disclose receipt of the following financial support to conduct this meeting: Canadian Institutes of Health Research (CIHR) CaSTOR (Canadian Stroke Trials for Optimized Results) Group (note that CasTOR is a joint initiative of the Canadian Stroke Consortium and the Canadian Partnership for Stroke Recovery), Heart and Stroke Canadian Partnership for Stroke Recovery, and NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery. An unrestricted educational grant was provided by Ipsen Pharma. Note This contribution, first published in International Journal of Stroke , is being co-published in the following journals: Neurorehabilitation and Neural Repair .

FundersFunder number
Burke Neurological Institute and Department of Neurology
Canadian Partnership for Stroke Recovery
Canadian Stroke Consortium
Canadian Stroke Trials for Optimized Results
Frederike van Wijck
Heart and Stroke
Ipsen Pharma
NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery
Occupational Therapy
School of Health
Weill Cornell Medical College
Glasgow Caledonian University
Washington University School of Medicine in St. Louis
Canadian Institutes of Health Research
University of East Anglia
Universität Zürich
STROKE-Riksförbundet

    Keywords

    • biomechanics
    • consensus
    • measurement
    • recovery
    • rehabilitation
    • Stroke
    • upper extremity

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