Jiaqi Li, Patrick W Kwong, Wang Lin, Kenneth N Fong, Wenping Wu, Ananda Sidarta
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引用次数: 0
Abstract
Introduction: Although kinematic assessments for stroke-induced lower limb impairments offer a promising alternative to conventional scale evaluations, interpreting high-dimensional kinematic data remains challenging due to numerous metrics reported in past studies. This study aimed to provide an exhaustive overview of existing studies using kinematics data to assess the gait impairments in individuals with stroke, along with examining their clinimetric properties for future clinical applications.
Evidence acquisition: A systematic search was conducted across PubMed (08/2024), Scopus (08/2024), Web of Science (08/2024), CINAHL (08/2024), EMBASE (08/2024), and IEEE (08/2024). We included articles that recruited individuals over 18 years old with stroke and utilized motion capture technologies to evaluate lower limb kinematics. Similar metrics were consolidated in the analysis, and the COSMIN Risk of Bias Checklist was used to evaluate the methodological quality of studies investigating the clinimetric properties of kinematic metrics. Convergent validity of metrics was evaluated by examining their association with the Fugl-Meyer scale of lower limbs and walking speed. Moreover, the GRADE approach was used to rate the quality of evidence.
Evidence synthesis: A total of 383 studies were classified into 10 categories. Seven studies on metric reliability were rated high for methodological quality. Metrics with satisfactory reliability included spatiotemporal, spatial metrics, and a data-driven score. Six studies with high methodological quality assessed convergent validity. The dynamic gait index, angular component of the coefficient of correspondence (ACC), change in cadence, stride length, and hip range of motion showed satisfactory validity. Among the 13 studies, 12 studies were rated as moderate quality of evidence using the GRADE approach.
Conclusions: There are significant variations in measurements across studies, and high-quality studies evaluating clinimetric properties are scarce. For a more standardized evidence-based approach to kinematic lower limb assessment, further high-quality research validating these assessments' clinimetric properties is essential.
虽然对中风引起的下肢损伤的运动学评估为传统的尺度评估提供了一个有希望的替代方案,但由于过去研究中报道的众多指标,解释高维运动学数据仍然具有挑战性。本研究旨在对现有研究进行详尽的概述,利用运动学数据来评估中风患者的步态障碍,并为未来的临床应用检查其临床测量特性。证据获取:系统检索PubMed(08/2024)、Scopus(08/2024)、Web of Science(08/2024)、CINAHL(08/2024)、EMBASE(08/2024)和IEEE(08/2024)。我们纳入的文章招募了18岁以上的中风患者,并利用运动捕捉技术评估下肢运动学。在分析中合并了类似的指标,并使用COSMIN偏倚风险检查表来评估研究运动学指标临床特性的方法学质量。通过检查指标与Fugl-Meyer下肢量表和步行速度的关联来评估指标的收敛效度。此外,GRADE方法用于评价证据的质量。证据综合:共有383项研究被分为10类。7项关于度量可靠性的研究在方法质量上被评为高。可靠性令人满意的指标包括时空、空间指标和数据驱动评分。六项具有高方法学质量的研究评估了收敛效度。动态步态指数、对应系数角分量、步速变化、步幅长度和髋部活动范围均具有较好的有效性。在13项研究中,使用GRADE方法将12项研究评为中度证据质量。结论:不同研究的测量值存在显著差异,评估临床测量特性的高质量研究很少。对于更加标准化的基于证据的下肢运动学评估方法,进一步的高质量研究验证这些评估的临床特性是必不可少的。