Clinical Outcome Assessments for Functional Performance in Spastic Paresis: Systematic Review, Critique, and Recommendations

IF 7.7 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2026-07-21 Epub Date: 2026-03-30 DOI:10.1002/mds.70288

Martina Hoskovcova MD, PhD, Marjolaine Baude MD, PhD, Bo Biering-Sørensen MD, NDAPM, MPG, Ota Gal PhD, Mary P Galea PhD, FAHMS, Jean-Michel Gracies MD, PhD, Carmen Rodriguez-Blazquez PhD, Theodore Wein MD, Michelle Hyczy de Siqueira Tosin PhD, MSN, Álvaro Sánchez-Ferro MD, PhD, Tiago A Mestre MD, PhD, Matej Skorvanek MD, PhD, Robert Jech MD, PhD, The members of the MDS Clinical Outcome Assessments Scientific Evaluation Committee and MDS Spasticity Study Group

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引用次数: 0

Abstract

Background

Spastic paresis, resulting from central nervous system lesions, significantly impairs functional performance. In the framework of the International Classification of Functioning, Disability, and Health, functional performance was defined as functioning at the activity level in relation to the impairment of body functions and structures, that is, symptoms of spastic paresis syndrome. Reliable clinical outcome assessments (COAs) for functional performance evaluation are needed.

Objective

This systematic review evaluates the clinimetric properties of functional performance COAs in spastic paresis and provides recommendations for their use.

Methods

A literature search identified relevant COAs, which were systematically assessed by an international expert panel and classified as “recommended,” “recommended with caveats,” “suggested,” or “listed” following the Movement Disorder Society-COA methodology.

Results

Seventy-one COAs were identified, and 14 COAs used in over 2% of studies were reviewed. Five COAs assessing lower limb functional performance met the “recommended” criteria, whereas none of the upper limb COAs met the criteria for “recommended.” Two upper-limb COAs were evaluated as “recommended with caveats.”

Conclusions

Two variants of the 10-Meter Walk Test, along with the 2-Minute or 6-Minute Walk Test (to account for fatigability), are recommended for assessing lower limb functional performance in patients with spastic paresis. The Wisconsin Gait Scale is recommended, although its clinical feasibility is limited. For the upper limb, the 13-item Arm Motor Ability Test and the Modified Frenchay Scale are classified as “recommended with caveats” because of identified limitations. Establishing consistent scoring guidelines and standardized protocols will be essential to enhance their clinical applicability and diffusion. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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查看原文本刊更多论文

痉挛性轻瘫患者功能表现的临床结果评估：系统回顾、批评和建议。

背景：痉挛性轻瘫是由中枢神经系统病变引起的，严重损害了功能表现。在《国际功能、残疾和健康分类》的框架内，功能表现被定义为与身体功能和结构受损有关的活动水平的功能，即痉挛性轻瘫综合征的症状。需要可靠的临床结果评估（COAs）来评估功能表现。目的：本系统综述评价功能性coa在痉挛性轻瘫中的临床特性，并为其使用提供建议。方法通过文献检索确定相关coa，由国际专家小组进行系统评估，并按照运动障碍学会- coa方法将其分类为“推荐”、“有警告的推荐”、“建议”或“列出”。结果共鉴定出71个coa，其中14个coa在超过2%的研究中被使用。评估下肢功能表现的五个coa符合“推荐”标准，而上肢coa均不符合“推荐”标准。两例上肢coa被评估为“有警告的推荐”。结论：推荐两种不同的10分钟步行测试，以及2分钟或6分钟步行测试（考虑疲劳），用于评估痉挛性轻瘫患者的下肢功能表现。威斯康星步态量表是推荐的，尽管它的临床可行性是有限的。对于上肢，13项手臂运动能力测试和修改的Frenchay量表被归类为“建议使用，但有注意事项”，因为它们具有明确的局限性。建立一致的评分指南和标准化的方案对于增强其临床适用性和推广至关重要。©2026作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.