Browsing by Author "Schoonraad, Nabila"
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- ItemOutcome measures validated for use in stroke rehabilitation in low- and middle-income countries : a systematic review(Stellenbosch : Stellenbosch University, 2020-03) Schoonraad, Nabila; Louw, Quinette A.; Inglis-Jassiem, Gakeemah; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Physiotherapy.ENGLISH ABSTRACT : Introduction: The use of outcome measures necessary for effective clinical practice and in order to obtain reliable results in research. The commonly used outcome measures in stroke rehabilitation was developed in well-resourced high-income countries. When these outcome measures are used in a different setting, such as in low- and middle-income countries, it may require translation, cross-cultural adaptation and an evaluation of its measurement properties. Objective: Review the current literature reporting on outcome measures used in stroke rehabilitation that were validated for use in low- and middle-income countries. Methods: A comprehensive search of the following electronic databases was conducted: Africa Journal Online; AOSIS Publishing; BioMed Central; Cochrane Library; EBSCO Africa-Wide Information & CINAHL; PEDro/Physiotherapy Choices; ProQuest; PubMed: MedLine; Sabinet African Journals; Science Direct; Scopus and Web of Science. A unique search string was used for each database. Specific inclusion and exclusion criteria were used when considering eligibility of studies, and the reference list of included studies were searched for additional studies. All the included studies underwent an evaluation of its quality. A self-developed data extraction sheet was used for information gathering and analysis. The studies reporting on the translation and cross-cultural adaptation process was assessed against the criteria as stated in Beaton et al., (2000). A critical appraisal tool as described by Brink and Louw (2011) was applied to all included studies in order to evaluate its methodological procedures. The reported results of statistical tests were used to interpret the psychometric properties of each outcome measure. The updated criteria for good measurement properties as reported in COSMIN (Mokkink et al., 2018) was used as a reference in this analysis. Results: A total of 24 studies were included in this review. Three studies took place in low income countries (Uganda and Benin). Four studies occurred in lower middle-income countries (India, Philippines and Nigeria). The remaining 16 studies took place in upper middleincome countries (Iran, Colombia, Thailand, Brazil, South Africa, Turkey and China). After the evaluation of the methodological quality of the studies and an analysis of the psychometric properties of its outcome measures and correlation with reference standards, a final total of 23 outcome measures was recommended for use in LMICs. These outcome measures include: ABILOCO; 10MWT; BESTest; Berg Balance Scale; Postural Assessment Scale; Community Balance and Mobility scale; MiniBESTest; FIM-P; Comfortable gait speed; Maximal gait speed; Comfortable ascending stairs; Maximal ascending stairs; Comfortable descending stairs; Maximal descending stairs; Timed ‘Up and Go’; Modified Ashworth Scale; Modified Modified Ashworth Scale; Persian version of the Modified Ashworth Scale; Bahasa Malaysian version of the Montreal Cognitive Assessment; Ibadan version of the Stroke Specific Pain Scale; Upright Motor Control Test (Knee Flexion subscale & Knee Extension subscale); Wisconsin Gait Scale. Conclusion: These outcome measures have been validated for use in lower income countries and within a specific sample population only. It is advised that clinicians and researchers consider these factors when choosing an outcome measure in the management of people with stroke. This is to ensure the measurement property of the outcome measure and thus obtain credible results.