Valid and reliable instruments for arm-hand assessment at ICF activity level in persons with hemiplegia: a systematic review

Contains fulltext : 110141.pdf (publisher's version ) (Open Access)BACKGROUND: Loss of arm-hand performance due to a hemiparesis as a result of stroke or cerebral palsy (CP), leads to large problems in daily life of these patients. Assessment of arm-hand performance is important in both clinical practice and research. To gain more insight in e.g. effectiveness of common therapies for different patient populations with similar clinical characteristics, consensus regarding the choice and use of outcome measures is paramount. To guide this choice, an overview of available instruments is necessary. The aim of this systematic review is to identify, evaluate and categorize instruments, reported to be valid and reliable, assessing arm-hand performance at the ICF activity level in patients with stroke or cerebral palsy. METHODS: A systematic literature search was performed to identify articles containing instruments assessing arm-hand skilled performance in patients with stroke or cerebral palsy. Instruments were identified and divided into the categories capacity, perceived performance and actual performance. A second search was performed to obtain information on their content and psychometrics. RESULTS: Regarding capacity, perceived performance and actual performance, 18, 9 and 3 instruments were included respectively. Only 3 of all included instruments were used and tested in both patient populations. The content of the instruments differed widely regarding the ICF levels measured, assessment of the amount of use versus the quality of use, the inclusion of unimanual and/or bimanual tasks and the inclusion of basic and/or extended tasks. CONCLUSIONS: Although many instruments assess capacity and perceived performance, a dearth exists of instruments assessing actual performance. In addition, instruments appropriate for more than one patient population are sparse. For actual performance, new instruments have to be developed, with specific focus on the usability in different patient populations and the assessment of quality of use as well as amount of use. Also, consensus about the choice and use of instruments within and across populations is needed

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Instruments for assessment of impairments and activity limitations in patients with hand conditions: an European delphi study

Objective: To reach multidisciplinary European consensus on the assessment tools for impairments and activity limitations in patients with hand conditions. Design: Electronic Delphi method. Subjects: Thirty experts from European societies for hand therapy, hand surgery, and physical and rehabilitation medicine. Methods: In 3 rounds, participants were asked which of 13 preselected categories of the Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Hand Conditions should be assessed. In addition, they were asked to choose which of 55 preselected instruments they preferred for each category by confirming or rejecting instrument-specific statements. Results: All 13 preselected ICF categories were considered relevant. Consensus was based on >= 75% agreement. After 3 rounds, 9 instruments were selected: Shape Texture Identification Test, Semmes Weinstein Monofilament Test, Visual Analogue Scale for pain, goniometer, Jamar Dynamometer, Pinch Gauge Device, Cold Intolerance Symptom Severity questionnaire, Canadian Occupational Performance Measure, and Disabilities of the Arm, Shoulder and Hand Questionnaire. It remained undecided whether to use the Nine-Hole Pegboard Test or the Purdue Pegboard Test. Conclusion: In this European Delphi study, multidisciplinary consensus was reached on 9 assessment tools for impairments and activity limitations in patients with hand conditions addressing 13 categories of the Brief ICF Core Set for Hand Conditions

Standardized tests of handwriting readiness: a systematic review of the literature

Contains fulltext : 97368.pdf (publisher's version ) (Closed access)AIM: To establish if there are psychometrically sound standardized tests or test items to assess handwriting readiness in 5- and 6-year-old children on the levels of occupations activities/tasks and performance. METHOD: Electronic databases were searched to identify measurement instruments. Tests were included in a systematic review if: (1) participants are 5 and 6 years old, (2) the focus was on handwriting readiness, and (3) the measurement was standardized. In the second step a further electronic search was undertaken for selected relevant measurement instruments to evaluate the content, psychometric properties, and feasibility of these instruments. RESULTS: The search identified 1113 citations. In the final selection 39 articles with information about 12 tests were included. The content, feasibility, and psychometric properties of these 12 tests were evaluated and none of the instruments was satisfactory, according to the specific criteria. INTERPRETATION: None of the instruments include all necessary components to evaluate writing readiness. Therefore, the development of an all encompassing assessment is necessary to test handwriting readiness and to make tailored interventions possible

The advanced appreciation of upper limb rehabilitation in cervical SCI

The nature of an upper limb function impairment following a cervical spinal cord injury (SCI) is bilateral and rather symmetric, which increases the impact of the injury on the independence and quality of life of the affected patient. Therefore, this disorder is very different from stroke and other damages within the peripheral nervous system. Physical training therapy is of high clinical importance in patients with a cervical SCI so as to increase neural plasticity, and thereby improve motor recovery. New rehabilitation therapies based on robots, passive workstations, and functional electrical stimulation (FES) systems have been developed. However, the overall clinical value of these new technology-based therapies in SCI patients needs to be evaluated. Different methods can be used to test or describe the condition of the upper limb function before and after a novel physical training therapy session. We present a detailed functional classification of the hand that can distinguish different levels of impairment with typical impacts on activities of daily living. In consequence, changes between these levels (improvement or deterioration) can be considered clinically meaningful. In addition, upper limb function following SCI can be assessed with measures of capacity and performance, as well as surrogates (electrophysiological and biomedical recordings). While performance tests target on clinically relevant changes by assessing activities related to daily life (i.e., hand function), measures of capacity and surrogates focus on detailed functions (motor and sensory scores, conduction velocity) that do not necessarily correlate with clinically meaningful changes. Nevertheless, capacity tests and surrogates can detect subtle changes induced by interventions that might be missed by clinical measures