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Table 1 Overview of synthesized data from systematic review of OM, review of clinical practice guidelines and expert consensus

From: European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation (CAULIN): data synthesis from systematic reviews, clinical practice guidelines and expert consensus

Systematic reviews

Practice guidelines

Expert consensus

CAULIN recommendation

OM for body functions

Recommendation: Strong evidence for FMA-UE;

Some evidence for MI-arm, CMSA, STREAM, kinematics

Recommendation: No specific set of OM was recommended, although the FMA-UE were most frequently recommended in the included stroke guidelines;

Note: psychometric properties of many OM are not established (e.g. spasticity)

Recommendation: No consensus was reached on specific OM

Recommended for clinicians and researchers: A defined core set including validated clinical OM but also less establish OM with potential for special circumstances and for research; technology-generated measures (e.g. kinematics and wearables)

Recommended for use in research: Quality of movement execution, neurophysiological (EMG, TMS), neuroimaging

Recommendations for clinicians: Effort and amount of assistance (e.g. in robotics)

FMA-UE is the most often recommended OM of UL impairment and has strong psychometric properties

Some evidence to use kinematics (to measure movement quality)

Some evidence to use MI-arm, CMSA, STREAM

OM for activity

Recommendation: Strong evidence: ARAT, BBT, CAHAI, WMFT (activity capacity);

Some evidence: FAT, MAS, NHPT;

Generally recommended: Body-worn sensors to measure activity in daily life (limited evidence on psychometrics)

Recommendation: No specific set of OM was recommended, although ARAT, NHPT, FIM, BI are most frequently recommended in the stroke guidelines

Generally recommended: Body-worn sensors to measure activity in daily life and monitor adherence to exercise programs

Recommendation: No consensus was reached on specific OM

Recommended for clinicians and researchers: A defined core set of established validated clinical OM

Recommended for researchers: Body-worn sensors to monitor activity performance

ARAT is the most often recommended OM of UL activity capacity and has strong psychometric properties

BBT, CAHAI, WMFT have strong psychometric properties

Some evidence to use FAT, MAS, NHPT (of which NHPT recommended twice)

FIM and BI are most often recommended generic ADL instruments (out of scope for UL-specific OM)

Measures of actual arm use (body-worn sensors) should be considered

PROM

Recommendation: Strong evidence: ABILHAND

Recommendation: Patient–reported outcomes should be used along with objective OM

Recommendation: Self-reported measures should be used

Patient–reported outcomes should be used along with objective OM

ABILHAND has strong psychometric properties

Goal-oriented OM

Recommendation: Not applicable (goal-oriented instruments were not included)

Recommendation: Goal attainment OM to link assessment to goal setting and to motivate patients should be used along with objective OM

Recommendation: Personalized goal attainment measures should be used

Goal attainment OM should be used along with objective OM

No specific OM can be recommended

  1. FMA-UE, Fugl-Meyer Assessment, Upper Extremity part; MI-arm, Motricity Index, arm part; CMSA, Chedoke-McMaster Stroke Assessment; STREAM, Stroke Rehabilitation Assessment Movement; OM, outcome measure(s); EMG, electromyography; TMS, trans-cranial magnetic stimulation; ARAT, Action Research Arm Test; BBT, Box and Block Test; CAHAI, Chedoke Arm Hand Activity Inventory; WMFT, Wolf Motor Function Test; FAT, Frenchay Arm Test; MAS, Motor Assessment Scale; NHPT, Nine Hole Peg Test; FIM, Functional Independence Measure; BI, Barthel Index; UL, upper limb; PROM, patient-reported outcome measures