Clinical outcome measures to evaluate the effects of orthotic management post-stroke: a systematic review

Purpose: To identify, and classify, according to International Classification of Functioning, Disability and Health (ICF), clinically applicable outcome measures that have been used to evaluate lower limb orthotic management post-stroke and to investigate which outcome measures recorded the largest effect sizes. Materials and methods: Electronic searches were performed in Pubmed, Cochrane, Web of Science, Cinahl, Scopus and Embase databases from inception to May 2020. Articles were included if they investigated clinical outcomes in people post-stroke who had received a lower-limb orthotic intervention. Results: 88 articles underwent full-text review and 54 were included in the review, which was performed in accordance with the Preferred Reporting Items for Systematic Review (PRISMA) principles. 48 different outcome measures were identified; effect sizes were able to be calculated from 39 studies. The most frequently applied outcome measures were the 10-metre Walk Test and the timed-up-and-go test. Outcome measures that recorded large effect sizes in two or more studies were the 10-metre Walk Test, Functional Reach Test, and Physiological Cost Index. When coded according to the ICF, the most frequently represented codes were d450 (Walking) and d455 (moving around). Conclusions: Results suggest that outcome measures related to mobility (ICF chapter d4) are most often applied to evaluate orthotic management post-stroke. Effect sizes appear to be greatest in outcome measures related to velocity, balance, and energy expenditure.

Automated summary

The study aimed to identify and classify clinically applicable outcome measures for evaluating lower limb orthotic management post-stroke according to ICF, and found that the most frequently applied outcome measures were the 10-metre Walk Test and the timed-up-and-go test, with outcome measures recording large effect sizes including the 10-metre Walk Test, Functional Reach Test, and Physiological Cost Index. Results suggest that outcome measures related to mobility are most often used to evaluate orthotic management post-stroke.