Performance-based functional assessment instruments validated for Portuguese-Brazil individuals with stroke and their applicability in telerehabilitation: A systematic review protocol
DOI:
https://doi.org/10.62827/fb.v27i3.1170Keywords:
Stroke; Telerehabilitation; Physical Functional Performance; Rehabilitation.Abstract
Introduction: Telerehabilitation has been adopted to expand access to care and ensure continuity of post-stroke rehabilitation, especially in the face of geographical barriers and limited access to services. Remote functional assessment, particularly through observed performance, is essential for monitoring clinical progress and guiding therapeutic decisions; however, it is unclear which instruments are available or validated in Portuguese and applicable to telerehabilitation. Objective: To identify functional assessment instruments based on observed performance applied to individuals with stroke and available or validated in Portuguese, analyze their measurement properties and applicability in telerehabilitation, and classify them according to components of the International Classification of Functioning, Disability, and Health (ICF). Methods: Systematic review protocol registered in PROSPERO, following PRISMA and COSMIN guidelines. Searches will be conducted in the PubMed/MEDLINE, Web of Science, Scopus, LILACS, PEDro, and Embase databases. Studies evaluating the measurement properties of instruments applied to adults with stroke will be included. Study selection, data extraction, and methodological assessment will be performed by independent reviewers. Measurement properties will be analyzed according to COSMIN, and the quality of evidence will be assessed using the GRADE system. Results: A survey of instruments available/validated in Portuguese, a summary of their psychometric properties, and a discussion of their applicability in telerehabilitation settings, classified according to the ICF. Conclusion: The findings are expected to guide the selection of instruments in clinical practice and inform future research on post-stroke telerehabilitation.
References
Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int J Stroke. 2022;17(1):18-29. doi:10.1177/17474930211065917
Gorelick PB. The global burden of stroke: persistent and disabling. Lancet Neurol. 2019;18(5):417-8. doi:10.1016/S1474-4422(19)30030-4
GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-22. doi:10.1016/S0140-6736(20)30925-9
Levin MF, Piscitelli D. Motor control concepts in rehabilitation. Motor Control. 2022;26(4):497-517. doi:10.1123/mc.2022-0026
Palstam A, Sjödin A, Sunnerhagen KS. Participation and autonomy five years after stroke: a longitudinal observational study. PLoS One. 2019;14(7):e0219513. doi:10.1371/journal.pone.0219513
World Health Organization. CIF: Classificação Internacional de Funcionalidade, Incapacidade e Saúde. São Paulo: Editora da Universidade de São Paulo; 2004.
Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet. 2011;377(9778):1693-702. doi:10.1016/S0140-6736(11)60325-5
Moore JL, Potter K, Blankshain K, Kaplan SL, O'Dwyer LC, Sullivan JE. A core set of outcome measures for adults with neurologic conditions undergoing rehabilitation: a clinical practice guideline. J Neurol Phys Ther. 2018;42(3):174-220. doi:10.1097/NPT.0000000000000229
Potter K, Fulk GD, Salem Y, Sullivan J. Outcome measures in neurological physical therapy practice: part I. Making sound decisions. J Neurol Phys Ther. 2011;35(2):57-64. doi:10.1097/NPT.0b013e318219a51a
Bartolo M, Bargellesi S, Castioni CA, Intiso D, Fontana A, Copetti M, et al. Clinical scales for measuring stroke rehabilitation promote functional recovery by supporting teamwork. Eur J Phys Rehabil Med. 2016;52(2):195-202.
Cacho RO, Moro CHC, Bazan R, Guarda SNF, Pinto EB, Andrade SMMS, et al. Access to rehabilitation after stroke in Brazil (AReA study): multicenter study protocol. Arq Neuropsiquiatr. 2022;80(10):1067-74. doi:10.1055/s-0042-1758558
Teasell R, Salbach NM, Foley N, Mountain A, Cameron JI, Jong A, et al. Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation following Stroke. Part One: Rehabilitation and Recovery Following Stroke; 6th edition update 2019. Int J Stroke. 2020;15(7):763-88. doi:10.1177/1747493019897843
Mokkink LB, de Vet HCW, Prinsen CAC, Patrick DL, Alonso J, Bouter LM, et al. COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures. Qual Life Res. 2018;27(5):1171-9. doi:10.1007/s11136-017-1765-4
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71
Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647. doi:10.1136/bmj.g7647
Elsman EBM, Mokkink LB, Terwee CB, Beaton D, Gagnier JJ, Tricco AC, et al. Guideline for reporting systematic reviews of outcome measurement instruments (OMIs): PRISMA-COSMIN for OMIs 2024. Health Qual Life Outcomes. 2024;22(1):48. doi:10.1186/s12955-024-02256-9
Mokkink LB, Elsman EBM, Terwee CB. COSMIN guideline for systematic reviews of patient-reported outcome measures version 2.0. Qual Life Res. 2024;33(11):2929-39. doi:10.1007/s11136-024-03761-6
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737-45. doi:10.1016/j.jclinepi.2010.02.006
Cieza A, Geyh S, Chatterji S, Kostanjsek N, Ustun B, Stucki G. ICF linking rules: an update based on lessons learned. J Rehabil Med. 2005;37(4):212-8. doi:10.1080/16501970510040263
Cieza A, Fayed N, Bickenbach J, Prodinger B. Refinements of the ICF Linking Rules to strengthen their potential for establishing comparability of health information. Disabil Rehabil. 2019;41(5):574-83. doi:10.3109/09638288.2016.1145258
Polese JC, Servio TC, Chaves GSS, Britto RR, Teixeira-Salmela LF. Relationships between self-reported and performance-based measures of functional capacity in individuals with chronic stroke. J Phys Ther Sci. 2016;28(4):1208-1212. doi:10.1589/jpts.28.1208.
Zischke C, Simas V, Hing W, Milne N, Spittle A, Pope R. The utility of physiotherapy assessments delivered by telehealth: a systematic review. J Glob Health. 2021;11:04072. doi:10.7189/jogh.11.04072.
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Copyright (c) 2026 Caroline Bergamasco, Angélica Cristiane Ovando, Gisele de Fátima Moura de Barros, Natalia Duarte Pereira (Autor)
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