Psychometric properties of measures of upper limb activity performance in adults with and without spasticity undergoing neurorehabilitation – A systematic review

Journal article

Pike, Shannon, Cusick, Anne, Wales, Kylie, Cameron, Lisa, Turner-Stokes, Lynne, Ashford, Stephen and Lannin, Natasha A.. (2021). Psychometric properties of measures of upper limb activity performance in adults with and without spasticity undergoing neurorehabilitation – A systematic review. PLoS ONE. 16, p. Article e0246288. https://doi.org/10.1371/journal.pone.0246288
AuthorsPike, Shannon, Cusick, Anne, Wales, Kylie, Cameron, Lisa, Turner-Stokes, Lynne, Ashford, Stephen and Lannin, Natasha A.
Abstract

Introduction
This systematic review appraises the measurement quality of tools which assess activity and/or participation in adults with upper limb spasticity arising from neurological impairment, including methodological quality of the psychometric studies. Differences in the measurement quality of the tools for adults with a neurological impairment, but without upper limb spasticity, is also presented.

Methods
29 measurement tools identified in a published review were appraised in this systematic review. For each identified tool, we searched 3 databases (Medline, Embase, CINAHL) to identify psychometric studies completed with neurorehabilitation samples. Methodological quality of instrument evaluations was assessed with use of the Consensus-based Standards for the Selection of Health Status Measurement Instruments (COSMIN) checklist. Synthesis of ratings allowed an overall rating of the psychometric evidence for each measurement tool to be calculated.

Results
149 articles describing the development or evaluation of psychometric properties of 22 activity and/or participation measurement tools were included. Evidence specific to tool use for adults with spasticity was identified within only 15 of the 149 articles and provided evidence for 9 measurement tools only. Overall, COSMIN appraisal highlighted a lack of evidence of measurement quality. Synthesis of ratings demonstrated all measures had psychometric weaknesses or gaps in evidence (particularly for use of tools with adults with spasticity).

Conclusions
The systematic search, appraisal and synthesis revealed that currently there is insufficient measurement quality evidence to recommend one tool over another. Notwithstanding this conclusion, newer tools specifically designed for use with people with neurological conditions who have upper limb spasticity, have emergent measurement properties that warrant further research.

Systematic review registration
PROSPERO CRD42014013190.

Year2021
JournalPLoS ONE
Journal citation16, p. Article e0246288
PublisherPublic Library of Science
ISSN1932-6203
Digital Object Identifier (DOI)https://doi.org/10.1371/journal.pone.0246288
PubMed ID33571238
Scopus EID2-s2.0-85101401639
PubMed Central IDPMC7877653
Open accessPublished as ‘gold’ (paid) open access
Page range1-54
FunderResearch Training Program Scholarship (RTP), Australian Government
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online11 Feb 2021
Publication process dates
Accepted15 Jan 2021
Deposited04 Jun 2025
Additional information

© 2021 Pike et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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