Appendix. 6. Have the authors provided labels for the categories? Do they use standard movement language?
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1 Appendix Author 1. Did article describe ons of patients for one condition or across? 2. Did article describe one classifica tion of patients or more than one? 3. Did article describe a on system related to a single task or could it be used for variety of tasks? 4. What is oretical framework used and/or purpose of on? 5. Are included classificat ions related to impairme nts (I), activity limitation s (AL), participati on restrictio ns (PR)? 6. Have provided labels for categories? Do y use standard language? 7. Did article provide a guide to reasoning/de cision making? 8. Was an process for identifying patient on s described? Does lead to system diagnoses? 9. Are o ns linked to prognosis? 10. Do ons lead to evidence based interventi ons? 11. Does o n system include a behavioral component? 12. Will classifica tions be useful for research? 13. Have concepts of o n system been validated? Behrman et al. 5 Spinal Cord Injury (SCI) tasks - Compreh ensive lower extremity and trunk function; standing, stepping; sit up and reverse classify functional motor recovery after incomplete SCI based on preinjury patterns. Goal is to decrease variability of populations level of function within each phase, (specifically for AIS C and D.) I, AL YES. Breakdown of AIS levels C and D into 4 specific phases; used labels specific to NRS for motor incomplete SCI. Specific breakdown of AIS levels C and D into 4 specific phases characterized by performance on functional activities. No Evaluations included AIS, Berg Balance Scale, six minute and ten meter walk tests. Use of 11 functional tasks. Specific elements with specific descriptions of tests and what to do with results; emphasizes performance of tasks without compensator y strategies patients may or may not progress through phases identified. YES Scores compared with traditional outcome measures. Patients in different phases have different scores on traditional outcome measures. 1
2 Biering-Sorensen SCI et al. 59 Bland et al. 48 stroke tasks - UE tasks grasp/rel ease and reach tasks - upper extremity (UE) and lower extremity (LE) tasks standardize collection and reporting of a minimal amount of information about UE status in accordance with general purpose and vision of International SCI Data Sets. It classifies basic hand-ue function into one of 5 categories, and shoulder function into one of 4 categories. create meaningful groups based on initial sensorimotor, cognition, language and activity measures that may be used to predict patient discharge status AL but do not use language UE function; namely grasp/release and reach; n re are "axes" for use of assistive devices, UE complications, and surgeries YES I, AL - discharge disposition YES There was a difference in percentage of discharge recommend ations across groups. 2
3 Chinsongkram e al. 60 Stroke, but can applied across or tasks that require identify primary components of that are impaired in people with dysfunction for purpose of being able to target interventions Based on a conceptual model of that includes several subconstructs I In BESTest several related labels are provided (biomechanical constraints, stability limits and verticality, anticipatory postural adjustments, automatic postural responses, sensory organization, and stability in gait) findings help rapist to understand which subsystems are involved and direct interventions accordingly The proposed scheme for BESTest in a previous publication 55 YES inter and intra rater reliability and concurrent validity in sub acute stroke population; applicable across range of abilities; no floor or ceiling effect. Fasano et al. 49 Giladi et al. 61 Hedman et al. 57 One task - Gait One One task - gait One task - locomotio n establish ons/term inology for gait disorders in people with neurological. Pathophysiology and phenomology classify gait dysfunction based on dominant observable gait disturbance. identify fundamental problems with I, AL Of 24 labels provided, 4 are -related (dyskinetic, freezing of gait, tremor, akinesia) and ors are condition-based. AL Some of language used is -related (e.g., ataxic, dyskinetic, bradykinetic). I, AL all labels use language (e.g., initiation, for medical management suggest that an exam process is described. Some on s are system based, and some are pathokinesio logic. Exam leads to on as eir continuous, episodic, or mixed gait disturbance. YES anxiety, fear of falling, depression and psychogeni c factors are considered. Walking Confidence Purposeful YES YES DELPHI survey. Full (58 experts) consensus 3
4 walking in order to guide and intervention. motor control framework of bipedal locomotion progression during stance, anticipatory dynamic ) requirements could help rapist identify issues not seen in traditional gait analysis and guide and intervention ness on 5 locomotor requiremen ts and partial consensus for 7 or requiremen ts Herman et al. 62 Parkinson s Disease (PD) tasks - Walking,, functional mobility subdivide PD population by primary presenting symptoms Different signs and symptoms may represent different underlying pathophysiologic mechanisms I, AL Tremor dominant (TD), predominately TD (p-td) postural instability gait difficulty (PIGD) and predominately PIGD (t-pigd) original TD and PIGD groups have different prognoses YES Martin et al. 63 Hypotonia One No tasks - impairme nt based identify characteristics of hypotonia for purpose of determining a definition I N/A Describes assessment of hypotonia in terms of strength, posture against gravity, and ability to reach development al milestones, but does not provide any objective criteria for YES 4
5 quantifying hypotonia; Quinn et al. 64 Huntingto n s Disease tasks e.g. functional tasks, ambulatio n, sort patients with HD into groups to guide selection of intervention strategies I, AL, PR planning and sequencing of tasks, mobility, falls risk, abnormal posturing propose on can be used as a guide to selecting appropriate evaluation measures and intervention strategies each o n is linked to stage of disease develope d as a treatment based on and treatment options are presented for each on YES Not addressed in this paper, but have examined validity in a follow-up paper. 54 Scheets et al. 25 tasks e.g. sit to stand, ambulatio n, Purpose: To classify patients with neuromuscular on basis on ir primary system problem for purpose of guiding selection of interventions, decreasing variability in PT practice, and creating homogeneous groups of patients for research I, AL three labels for system problems were described: force production deficit, fractionated deficit, and perceptual deficit findings, impairments, and analysis of critical tasks guide reasoning standardized in concert with definitions for diagnoses for 3 system problems, prognosis was discussed in each case YES 5
6 Scheets et al. 56 Snijders et al. 50 Backward disequilibr ium One tasks - e.g. sit to stand, ambulatio n, One task - Walking describe signs, symptoms and exam findings for a patient classified with Backward Disequilibrium differentiate/classif y gait disorders in a manner easy to use in practice/based on. All parts of nervous system are needed for normal walking. Older individuals tend to have complex gait disorders with multifactorial origin from affects of aging and underlying disease processes. I, AL Backward disequilibrium defined as posterior bias in perception of postural vertical, and used or terminology in differential diagnosis including force production deficit and sensory detection deficit I, AL several and behaviorally based labels are provided such as antalgic, spastic, dyskinetic and cautious gait YES provide a detailed to diagnose backward disequilibriu m to assist physical rapists in identifying this condition and employing proposed intervention YES - a detailed exam was provided and findings associated with backward disequilibriu m were described a 3-step process is described: Step 1: gait observation, gait or tests, associated symptoms and signs. Step 2: specialized tests, response to treatment/m eds data, and disease progression info. Step 3: post-mortem exam to validate specific neuropathol ogic etiology certain gait disturbanc es may predict disease or mortality YES a detailed interventi on plan was proposed however it is unclear if re is sufficient evidence to supports its efficacy consider gait disorders due to decreased confidence and or psychogeni c origins It may be be useful to identify this specific conditio n and to specifica lly test interven tions. YES 6
7 Staab et al. 65 Chronic dizziness tasks related sort patients with dizziness into discreet groups to better understand causative factors.. I presented as sub- types of chronic dizziness otologic exam and history includes chronic subjective dizziness and anxiety YES Stebbins et PD al. 66 tasks e.g. ambulatio n and tasks Medical model: physiological signs and symptoms that make up a syndrome associated with dizziness define sub forms of PD using Movement Disorder Society Unified Parkinson s Disease Rating Scale (MDS-UPDRS) I, AL Tremor dominant (TD) and postural instability/gait difficulty (PIGD). Definitions, findings, guide reasoning Used definitions of PD problems (TD and PGID) that have been traditionally used in research and literature. Validated revisions to original UPDRS that addressed critical deficits YES Validates measure for calibrating UPDRS to MDS- UPDRS Widely accepted UPDRS to differentiate TD vs. PIGD PD; correlating scores with revised MDS- UPDRS. 7
8 Williams et al. 67 Traumatic Brain Injury One task - gait classify gait disorders commonly seen in people with brain injury Taxonomy was developed from a framework previously used in cerebral palsy. I, AL 6 categories 1) Spastic hemipareis, 2) nonspastic hemiparesis; 3) ataxia/dyspraxia/un ilateral; 4) spastic bilateral paresis; 5) nonspastic bilateral paresis; ) ataxia/dyspraxia - bilateral motion analysis used in study; suggest clinicians could categorize patients, by judgment Classificatio ns derived from motion analysis matched ly derived o ns 82% of time (n = 102) 8
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