Outcome measures for evaluating perceived upper limb performance after stroke: a systematic review of measurement properties.

Abstract

This study assessed Patient-Reported Outcome Measures (PROMs) for perceived upper-extremity performance following stroke rehabilitation. A systematic review, adhering to COSMIN guidelines (PROSPERO CRD42024582486), identified PROMs through a primary search, followed by a secondary search for studies on measurement properties. Properties were evaluated using COSMIN criteria and Risk of Bias checklist. PROM items were mapped to International Classification of Functioning, Disability, and Health Activity and Participation domains. Thirty-five studies evaluating 17 PROMs were included. No PROM demonstrated high-quality evidence across all measurement properties. The ABILHAND, Motor Activity Log (MAL)-28, MAL-30, and Rasch-Based MAL showed sufficient content validity, structural validity, internal consistency, and reliability. Across measurement properties, measurement error, cross-cultural validity, and responsiveness are less explored. Most PROM items focused on mobility and self-care, with fewer items addressing complex activities. This systematic review assessed 17 PROMs for perceived upper-limb performance in stroke patients, identifying a need for improved methodological quality and measurement properties. The ABILHAND, MAL-28, MAL-30, and Rasch-Based MAL showed sufficient content validity, structural validity, internal consistency, and reliability, but gaps remain in other measurement properties. High-quality, COSMIN-guided studies are required to strengthen evidence on measurement properties of PROM identified by this study. Clinicians and researchers can use these findings to choose PROMs and direct future research.