UNASSIGNED: Selected members of an expert panel composed of international therapists formed at the 2018 International Congress for Upper Limb Surgery for Tetraplegia conducted a literature review of current practice that identified gaps and inconsistencies in measurement protocols and presented to workshop attendees. To resolve discrepancies, a set of questions was presented to workshop attendees who voted electronically. Consensus was set at 75% agreement.
UNASSIGNED: For manual muscle testing, consensus was reached for using the Medical Research Council scale, without plus or minus, and the use of resistance through range when testing grade 4 and grade 5 strength. Pectoralis major and serratus anterior should be routinely tested, however there was no consensus on other shoulder muscles. Grip and pinch strength should be tested according to the American Society of Hand Therapists positioning. For grip strength, either the Jamar or Biometrics dynamometer expressed in kilograms should be used. For grip and pinch strength, three measurements should be performed at each testing. No consensus was reached on a device for pinch strength.
UNASSIGNED: This work is an important step to enable comparable data in the future. Further consensus methods will work toward developing more comprehensive guidelines in this population. Building international consensus for pre- and postoperative measures of function supports objective evaluation of novel therapies and interpretation of multicenter studies.
■由国际治疗师组成的专家小组的选定成员组成,该专家小组在2018年国际四肢瘫痪上肢手术大会上成立,对当前的实践进行了文献综述,确定了测量方案中的差距和不一致之处,并向研讨会与会者介绍。为了解决差异,向以电子方式投票的研讨会与会者提出了一组问题。达成共识的比例为75%。
■对于手动肌肉测试,就使用医学研究理事会量表达成共识,没有加号或减号,和使用电阻通过范围时测试4级和5级强度。胸大肌和前锯肌应该常规检查,然而,对其他肩部肌肉没有达成共识。握力和捏力应根据美国手部治疗师协会的定位进行测试。对于握力,应使用以千克表示的Jamar或Biometrics测功机。对于握力和捏合强度,每次测试应进行三次测量。对于捏合强度的装置没有达成共识。
■这项工作是未来实现可比数据的重要一步。进一步的共识方法将有助于在这一人群中制定更全面的指导方针。建立关于术前和术后功能测量的国际共识支持对新疗法的客观评估和对多中心研究的解释。