Upper limb Assessment in Neurorehabilitation
I will argue for using a core set of reliable, valid and accessible outcome measures in neurorehabilitation. Such measures are needed to distinguish recovery from compensation, to define underlying mechanisms of impairment and functional limitation, direct therapy and assess outcomes of upper limb neurorehabilitation.
I will focus on two tranches of research. The first, a European COST Action, in which we developed the European evidence-based recommendations for Clinical Assessment of the Upper limb In Neurorehabilitation (CAULIN) and the second, the output from the Stroke Rehabilitation Research Roundtable (SRRR1 and SRRR2) which reached a consensus on kinetic and kinematic measures that should be used in research trials.
Due to the complexity and subjectivity of neurorehabilitation, we do not have the luxury of simple interventions or simple assessment measures, yet to generate evidence for effectiveness of interventions and to apply interventions appropriately we must have objective measures. Most importantly we need to apply those measures to large cohorts of patients using the same, or similar methodologies. Only by doing so can we generate the evidence, advance the field of understanding and ensure that resources are used wisely for the benefit of patients.