title: [Hand fine motor skills and use of both hand and arm in subjects after a stroke: a systematic review].
abstract: BACKGROUND
  In clinical practice it is important to be able to assess the function of the upper limb of the patient who has suffered a stroke. There is currently no systemic review that could identify assessment tools for the 'fine use of the hand' and 'use of both hand and arm'.
  
  
  OBJECTIVE
  Primary, to identify observational tools which can assess the fine use of the hand and the use of both hand and arm in patients with stroke sequels. Secondary, to analyze the bias risk in the included articles, describing and categorizing the clinical utility, validity and reliability.
  
  
  METHODS
  A search was carried in Medline, LILACS, SciELO and Open Grey, which included articles published until October 2015. Studies that validate assessing tools of the upper limb in subjects with a stroke sequel which evaluate the fine use of the hand and the use of both hand and arm were included.
  
  
  RESULTS
  Eleven tools in evaluate observational haven been selected, which assess the fine use of the hand and the use of hand and arm.
  
  
  CONCLUSIONS
  In every case both validity and reliability have been reported, but clinical utility has been less considered for assessment. The studies that researched these tools showed a high risk of bias in their development. ARAT-19 showed a lower bias risk, but when it has to do with applicability and the reference trial is taken into account, the level of concern is high.
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Ostolaza
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: J
authors.initials: J
authors.lastname: Abudarham
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: S
authors.initials: S
authors.lastname: Dilascio
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: E
authors.initials: E
authors.lastname: Drault-Boedo
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: S
authors.initials: S
authors.lastname: Gallo
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Garcete
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Kramer
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Maiaru
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Mendelevich
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Modica
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Peralta
authors.affiliation: Instituto de Rehabilitacion Psicofisica, Buenos Aires, Argentina.
authors.forename: C
authors.initials: C
authors.lastname: Sanchez-Correa
mesh_terms: D001132:Arm / Q000503:physiopathology*; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D009048:Motor Skills; D020521:Stroke / Q000503:physiopathology*