A proposal for an Italian minimum data set assessment protocol for robot-assisted rehabilitation: a Delphi study

Abstract

Background: At present there is no agreement on a common evaluation protocol to assess improvement in stroke patients after robotic therapy.

Aim: The aim of this study was to identify a Minimum Data Set Assessment Protocol, using an agreement-based survey.

Design: A Delphi survey.

Setting: This study was conceived by the Italian Robotic Neurorehabilitation Research Group (IRNRG), an Italian group involved in the clinical application of robot-assisted rehabilitation devices

Population: Stroke subjects.

Methods: A 3-round Delphi survey was carried out through the electronic submission of questionnaires to a panel of experts identified in fourteen rehabilitation centers. For each generated item, experts were asked to rate questions on a 5 point Likert Scale.

Results: After the 1st round the questionnaire was filled out by 43 (84.3%) out of 51 experts invited to participate in the study. In the 2nd and 3rd rounds we explored the specific evaluation tools for each of the ICF domains identified in the 1st round. The experts identified the following assessment tools for the upper limb: the Ashworth Scale, the Fugl-Meyer assessment scale, the Frenchay Arm Test, the Medical Research Council scale, the Motricity Index, Frenchay Activities Index and Modified Barthel Index; and for the lower limb: the Ashworth Scale, the Motricity Index, the 10 meter walking Test, the 6 minutes walking Test, the Functional Ambulatory Classification, the Timed Up and Go Test, the Walking Handicap Scale, the Borg Rating of Perceived Exertion, the Heart Rate, the Medical Research Council Scale, the Tinetti Balance Scale and the Modified Barthel Index.

Conclusion: The Delphi survey presented in this study allows the identification of a shared assessment protocol to be applied in clinical practice and research for the evaluation of the real improvement related to robot-assisted rehabilitation of the upper and lower limb in patients after stroke.

Clinical rehabilitation impact: Clinicians and researchers could use the results of this study to obtain a common language in robotic rehabilitation assessments.