[ { "key": "8DMQCXD2", "version": 4, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/8DMQCXD2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/8DMQCXD2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "lastModifiedByUser": { "id": 1185106, "username": "earlmerson2", "name": "Earl Merson on Ian's Laptop", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson2", "type": "text/html" } } }, "creatorSummary": "Charlton and Johnson", "parsedDate": "2006-08-01", "numChildren": 1 }, "data": { "key": "8DMQCXD2", "version": 4, "itemType": "journalArticle", "title": "A model for the prediction of the forces at the glenohumeral joint", "creators": [ { "creatorType": "author", "firstName": "I. W.", "lastName": "Charlton" }, { "creatorType": "author", "firstName": "G. R.", "lastName": "Johnson" } ], "abstractNote": "The design, validation, and application of a three-dimensional musculoskeletal model of the upper limb is presented here, for the study of joint, muscle, and ligament forces during selected tasks of daily living. Much of the model was constructed using data gathered from real cadavers, including the extensive ‘visible human’ data set, together with information gathered from published post mortem studies on cadavers. Validation was carried out through comparison of model outcomes with available data in the literature. The model was then used to examine the glenohumeral joint loading during ten previously selected activities of daily living.\nThe predicted glenohumeral joint contact forces during everyday activities were found to range from 23 to 75 per cent body weight. A linear regression method for estimating the joint load from externally measured kinetics was developed, giving a 95 per cent confidence interval in predicted joint forces of 8 per cent body weight. The model presented here, namely the Newcastle shoulder model, provides a basis for future studies into biomechanical problems relating to the understanding of musculoskeletal pathology and implant design and performance.", "publicationTitle": "Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine", "publisher": "", "place": "", "date": "2006-08-01", "volume": "220", "issue": "8", "section": "", "partNumber": "", "partTitle": "", "pages": "801-812", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine", "DOI": "10.1243/09544119JEIM147", "citationKey": "", "url": "http://pih.sagepub.com/content/220/8/801", "accessDate": "2012-10-27T23:04:28Z", "PMID": "", "PMCID": "", "ISSN": "0954-4119, 2041-3033", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "en", "libraryCatalog": "pih.sagepub.com", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "biomechanical", "type": 1 }, { "tag": "loading", "type": 1 }, { "tag": "model", "type": 1 }, { "tag": "musculoskeletal", "type": 1 }, { "tag": "scapula", "type": 1 }, { "tag": "shoulder", "type": 1 } ], "collections": [ "ZPIJ2FEB" ], "relations": { "dc:replaces": "http://zotero.org/groups/103986/items/8DMQCXD2" }, "dateAdded": "2012-10-27T23:04:28Z", "dateModified": "2012-12-13T13:40:30Z" } }, { "key": "MT693ATA", "version": 2, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/MT693ATA", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/MT693ATA", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "lastModifiedByUser": { "id": 1185106, "username": "earlmerson2", "name": "Earl Merson on Ian's Laptop", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson2", "type": "text/html" } } }, "creatorSummary": "Farmer et al.", "parsedDate": "2012-07-04", "numChildren": 1 }, "data": { "key": "MT693ATA", "version": 2, "itemType": "journalArticle", "title": "Assessment of the risk of bias in rehabilitation reviews", "creators": [ { "creatorType": "author", "firstName": "Sybil E", "lastName": "Farmer" }, { "creatorType": "author", "firstName": "Duncan", "lastName": "Wood" }, { "creatorType": "author", "firstName": "Ian D", "lastName": "Swain" }, { "creatorType": "author", "firstName": "Anand D", "lastName": "Pandyan" } ], "abstractNote": "Systematic reviews are used to inform practice, and develop guidelines and protocols. A questionnaire to quantify the risk of bias in systematic reviews, the review paper assessment (RPA) tool, was developed and tested. A search of electronic databases provided a data set of review articles that were then independently reviewed by two assessors using the RPA. The inter-rater reliability was between moderate and good (κ scores 0.46-0.95). Many reviews did not describe the purpose in terms of population, intervention, comparator and outcome measure (i.e. PICO format), making inter-rater agreement on this question difficult. The RPA discriminated between high-quality reviews and those with a risk of bias (e.g. inadequate reporting of search terms, lack of independent reviewing or inclusion of non-randomized-controlled trials). The RPA questionnaire was revised to ensure that questions (on the basis of clarity of purpose, extent of search, independence of reviewers, randomized-controlled trial inclusion and availability of data) had dichotomous answers so that the positive responses scored one. The risk of bias increases as the score reduces.Anhand von systematischen Prüfungen werden die Praxis informiert und Richtlinien und Protokolle entwickelt. Ein Fragebogen zur Quantifizierung des statistischen Verzerrungsrisikos (Bias-Risikos) bei systematischen Prüfungen - das RPA-Tool (Review Paper Assessment) - wurde entwickelt und getestet. Recherchen in elektronischen Datenbanken förderten Datensätze von Übersichtsartikeln zutage, die mit Hilfe des RPA-Tools von zwei unabhängigen Assessoren geprüft wurden. Die Inter-Rater-Reliabilität lag bei mittelmäßig bis gut (κ-Scores 0.46-0.95). Viele Prüfungen beschrieben nicht ihren Zweck hinsichtlich Population, Intervention, Vergleich und Zielgröße (d. h. PICO-Format), wodurch Inter-Rater-Übereinstimmungen bei dieser Frage sich als schwer erwiesen. Das RPA-Tool unterschied zwischen hochwertigen Prüfungen und solchen, die ein Bias-Risiko in sich trugen (z. B. unangemessene Berichterstattung zu den Suchkriterien, mangelnde unabhängige Prüfung oder Einschluss von nicht-randomisierten Kontrollstudien). Der RPA-Fragebogen wurde einer Prüfung unterzogen, um so sicherzustellen, dass die Fragen (auf der Grundlage von klaren Zielvorgaben, Ausmaß der Recherche, Unabhängigkeit der Prüfer, Einschluss in randomisierte Kontrollstudien und Verfügbarkeit von Daten) dichotom beantwortet wurden, damit die positiven Antworten eine Wertung ergaben. Das Bias-Risiko steigt mit abnehmendem Score.Las revisiones sistemáticas se utilizan para fundamentar la práctica y elaborar directrices y protocolos. Se creó y se evaluó un cuestionario, la herramienta de evaluación de revisiones (RPA) (review paper assessment) para cuantificar el riesgo de sesgo en las revisiones sistemáticas. Tras realizar una búsqueda en una serie de bases de datos electrónicas, se obtuvo un conjunto de datos sobre artículos que habían sido revisados de forma independiente por dos revisores utilizando la herramienta RPA. Se obtuvo una fiabilidad interclasificadores entre moderada y buena (puntuaciones κ del 0.46-0.95). Muchas de las revisiones no describían el objetivo en términos de población, intervención, grupo control y resultados de las mediciones, dificultando por tanto el acuerdo sobre la fiabilidad interclasificadores. La herramienta RPA distinguió entre revisiones de alta calidad y revisiones con riesgo de sesgo (por ejemplo, revisiones que incluían información inadecuada sobre los términos de búsqueda, que no habían sido revisadas de forma independiente o que incorporaban ensayos controlados no aleatorios). El cuestionario RPA se revisó con el objetivo de garantizar que todas las preguntas obtuvieran respuestas dicotómicas (partiendo de aspectos tales como la claridad del objetivo, el grado de búsqueda, la independencia de los revisores, la incorporación de un ensayo controlado aleatorio y la disponibilidad de datos), de modo que a cada respuesta positiva se le asignaba un punto. El riesgo de sesgo aumenta conforme disminuye la puntuación.Des examens systématiques sont utilisés pour éclairer les pratiques et élaborer des lignes directrices et des protocoles. Un questionnaire pour quantifier le risque de biais dans les examens systématiques, l'outil document de synthèse d'évaluation (RPA), a été développé et testé. Une recherche dans les bases de données électroniques a permis de dégager un jeu d'articles de synthèse qui ont ensuite été indépendamment examinés par deux évaluateurs utilisant le RPA. La fiabilité inter-évaluateurs se situait entre modérée et bonne (scores κ 0.46-0.95). Nombre d'évaluations ne décrivent pas les objectifs en termes de population, d'intervention, de comparateur et de mesure des résultats (par exemple, format PICO), ce qui rend difficile un accord entre les évaluateurs sur ces points. Le RPA fait la distinction entre les commentaires de haute qualité et ceux qui présentent un risque de biais (par exemple communication inadéquate des termes de recherche, manque d'examen indépendant ou inclusion d'essais non-contrôlés et randomisés). Le questionnaire RPA a été révisé pour s'assurer que les questions (en termes de clarté des objectifs, de portée de la recherche, d'indépendance des évaluateurs, d'inclusion d'essai randomisés-contrôlés et de disponibilité des données) reçoivent des réponses dichotomiques de sorte que les réponses positives se voient attribué un score de un. Le risque de partialité augmente à mesure que le score diminue.", "publicationTitle": "International journal of rehabilitation research", "publisher": "", "place": "", "date": "Jul 4, 2012", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1097/MRR.0b013e3283559b6b", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1473-5660", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22760115", "tags": [], "collections": [ "RSDVDJZT" ], "relations": {}, "dateAdded": "2012-10-29T20:18:30Z", "dateModified": "2012-12-13T13:22:19Z" } }, { "key": "VMVZP8M6", "version": 153, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/VMVZP8M6", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/VMVZP8M6", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "van der Lee et al.", "parsedDate": "2001-02", "numChildren": 1 }, "data": { "key": "VMVZP8M6", "version": 153, "itemType": "journalArticle", "title": "Exercise therapy for arm function in stroke patients: a systematic review of randomized controlled trials", "creators": [ { "creatorType": "author", "firstName": "J H", "lastName": "van der Lee" }, { "creatorType": "author", "firstName": "I A", "lastName": "Snels" }, { "creatorType": "author", "firstName": "H", "lastName": "Beckerman" }, { "creatorType": "author", "firstName": "G J", "lastName": "Lankhorst" }, { "creatorType": "author", "firstName": "R C", "lastName": "Wagenaar" }, { "creatorType": "author", "firstName": "L M", "lastName": "Bouter" } ], "abstractNote": "OBJECTIVE\n\nAssessment of the available evidence for the effectiveness of exercise therapy to improve arm function in patients who have suffered from a stroke.\n\n\nMETHODS\n\nA systematic search of bibliographical databases and reference checking were performed to identify publications on randomized controlled trials (RCTs) which evaluated the effect of exercise therapy on arm function in stroke patients. The methodological quality was assessed systematically by two raters, based on a standardized list of methodological criteria. Study characteristics, such as the chronicity and severity of impairment of the patient population, the amount and duration of interventions, and specific methodological criteria, were related to reported effects.\n\n\nRESULTS\n\nThirteen RCTs were identified, six of which reported positive results on an arm function test. In five of these six studies there was a contrast in amount or duration of exercise therapy between groups. Methodological scores ranged from 5 to 15 (maximum possible score: 19 points).\n\n\nCONCLUSION\n\nInsufficient evidence made it impossible to draw definitive conclusions about the effectiveness of exercise therapy on arm function in stroke patients. The difference in results between studies with and without contrast in the amount or duration of exercise therapy between groups suggests that more exercise therapy may be beneficial.", "publicationTitle": "Clinical rehabilitation", "publisher": "", "place": "", "date": "Feb 2001", "volume": "15", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "20-31", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Clin Rehabil", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0269-2155", "archive": "", "archiveLocation": "", "shortTitle": "Exercise therapy for arm function in stroke patients", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 11237158", "tags": [ { "tag": "Arm", "type": 1 }, { "tag": "Exercise Therapy", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Motor Skills Disorders", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Range of Motion, Articular", "type": 1 }, { "tag": "Stroke", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "UUW7JT9A", "ZPIJ2FEB" ], "relations": {}, "dateAdded": "2012-10-27T19:34:46Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "FEHPQ9R2", "version": 151, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/FEHPQ9R2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/FEHPQ9R2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Bonaiuti et al.", "parsedDate": "2007-06", "numChildren": 1 }, "data": { "key": "FEHPQ9R2", "version": 151, "itemType": "journalArticle", "title": "The constraint induced movement therapy: a systematic review of randomised controlled trials on the adult stroke patients", "creators": [ { "creatorType": "author", "firstName": "D", "lastName": "Bonaiuti" }, { "creatorType": "author", "firstName": "L", "lastName": "Rebasti" }, { "creatorType": "author", "firstName": "P", "lastName": "Sioli" } ], "abstractNote": "AIM\n\nThe aim of this study was to analyse the evidence of effectiveness on adult stroke patients of the Constraint Induced Movement Therapy (CIMT), an original rehabilitation method that consists in strongly encouraging patients to use the affected arm, mainly immobilising the unaffected arm.\n\n\nMETHODS\n\nWe only took into account the randomised controlled trials on CIMT where the experimental treatment was compared with a conventional treatment without any discrepancy of organization or session duration. As we could not measure the statistical significance of differences between treated and control patients, we compared their respective post-treatment percent changes and computed the minimal clinically important difference (MCID), defined as a change of at least 10% of the maximum score of the scale used.\n\n\nRESULTS\n\nThe literature search found 13 randomised controlled trials (RCTs), 4 of which were excluded because they aimed at comparing different intensity of CIMT. The 9 RCTs finally included into the review applied the CIMT in either acute, subacute or chronic stroke patients and according to different modalities. Findings were positive in all studies, but the MCID was reached only in smaller ones, which may have been influenced by patients' characteristics.\n\n\nCONCLUSION\n\nAlthough all studies achieved positive results, it is impossible to draw any clear-cut conclusion on the effectiveness of the CIMT. The main limitations are the lack of homogeneity in the outcome measures used, the inadequacy of data provided and the small samples' size. Multicentre studies, using robust outcome measures and considering both motor- and sensory-disabled patients are needed.", "publicationTitle": "Europa medicophysica", "publisher": "", "place": "", "date": "Jun 2007", "volume": "43", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "139-146", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Eura Medicophys", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0014-2573", "archive": "", "archiveLocation": "", "shortTitle": "The constraint induced movement therapy", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 17525700", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Arm", "type": 1 }, { "tag": "Exercise Therapy", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Paresis", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Restraint, Physical", "type": 1 }, { "tag": "Stroke", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "ZPIJ2FEB" ], "relations": {}, "dateAdded": "2012-10-27T19:56:43Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "E4TTUUPA", "version": 133, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/E4TTUUPA", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/E4TTUUPA", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Senn et al.", "parsedDate": "2004", "numChildren": 1 }, "data": { "key": "E4TTUUPA", "version": 133, "itemType": "bookSection", "title": "Repeated measures in clinical trials: simple strategies for analysis using summary measures", "creators": [ { "creatorType": "author", "firstName": "S", "lastName": "Senn" }, { "creatorType": "author", "firstName": "L", "lastName": "Stevens" }, { "creatorType": "author", "firstName": "N", "lastName": "Chaturvedi" }, { "creatorType": "editor", "firstName": "Ralph B.", "lastName": "D'Agostino" } ], "abstractNote": "The summary measures approach to analysing repeated measures is described. The circumstances under which it can be advantageous to use such measures are considered. Strategies for baseline adjustment where there are multiple baselines are examined, as is the choice of appropriate summary statistic. A compromise trend/mean measure, regression through the origin, is proposed as being useful under some circumstances. An analysis using this measure is illustrated with a suitable example.", "bookTitle": "Tutorials in Biostatistics, Statistical Methods in Clinical Studies", "series": "", "seriesNumber": "", "volume": "1", "numberOfVolumes": "", "edition": "", "date": "2004", "publisher": "Wiley", "place": "", "originalDate": "", "originalPublisher": "", "originalPlace": "", "format": "", "pages": "379-395", "ISBN": "0470023651", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Biometry", "type": 1 }, { "tag": "Clinical Trials as Topic", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Research Design", "type": 1 } ], "collections": [ "ZPIJ2FEB" ], "relations": {}, "dateAdded": "2012-10-28T08:48:20Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "8MPQFJ85", "version": 129, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/8MPQFJ85", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/8MPQFJ85", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Price and Pandyan", "parsedDate": "2000", "numChildren": 1 }, "data": { "key": "8MPQFJ85", "version": 129, "itemType": "journalArticle", "title": "Electrical stimulation for preventing and treating post-stroke shoulder pain", "creators": [ { "creatorType": "author", "firstName": "C I", "lastName": "Price" }, { "creatorType": "author", "firstName": "A D", "lastName": "Pandyan" } ], "abstractNote": "BACKGROUND\n\nShoulder pain after stroke is common and disabling. The optimal management is uncertain, but electrical stimulation (ES) is often used to treat and prevent pain.\n\n\nOBJECTIVES\n\nThe objective of this review was to determine the efficacy of any form of surface ES in the prevention and / or treatment of pain around the shoulder at any time after stroke.\n\n\nSEARCH STRATEGY\n\nWe searched the Cochrane Stroke Review Group trials register and undertook further searches of MEDLINE, EMBASE and CINAHL. Contact was established with equipment manufacturers and centres that have published on the topic of ES.\n\n\nSELECTION CRITERIA\n\nWe considered all randomised trials that assessed any surface ES technique (functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) or other), applied at any time since stroke for the purpose of prevention or treatment of shoulder pain.\n\n\nDATA COLLECTION AND ANALYSIS\n\nTwo reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.\n\n\nMAIN RESULTS\n\nFour trials (a total of 170 subjects) fitted the inclusion criteria. Study design and ES technique varied considerably, often precluding the combination of studies. Population numbers were small. There was no significant change in pain incidence (Odds Ratio (OR) 0.64; 95% CI 0.19 to 2.14) or change in pain intensity (Standardised Mean Difference (SMD) 0.13; 95% CI -1.0 to 1.25) after ES treatment compared to control. There was a significant treatment effect in favour of ES for improvement in pain-free range of passive humeral lateral rotation (Weighted Mean Difference (WMD) 9.17; 95% CI 1.43 to 16.91). In these studies ES reduced the severity of glenohumeral subluxation (SMD -1.13; 95% CI -1.66 to -0.60), but there was no significant effect on upper limb motor recovery (SMD 0.24; 95% CI -0.14 to 0.62) or upper limb spasticity (WMD 0.05; 95% CI -0.28 to 0.37). There did not appear to be any negative effects of electrical stimulation at the shoulder.\n\n\nREVIEWER'S CONCLUSIONS\n\nThe evidence from randomised controlled trials so far does not confirm or refute that ES around the shoulder after stroke influences reports of pain, but there do appear to be benefits for passive humeral lateral rotation. A possible mechanism is through the reduction of glenohumeral subluxation. Further studies are required.", "publicationTitle": "Cochrane database of systematic reviews (Online)", "publisher": "", "place": "", "date": "2000", "volume": "", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "CD001698", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD001698", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 11034725", "tags": [ { "tag": "Electric Stimulation Therapy", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Range of Motion, Articular", "type": 1 }, { "tag": "Shoulder Pain", "type": 1 }, { "tag": "Stroke", "type": 1 } ], "collections": [ "ZPIJ2FEB" ], "relations": {}, "dateAdded": "2012-10-27T23:53:05Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "TWDIPTDE", "version": 127, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/TWDIPTDE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/TWDIPTDE", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "van Tulder et al.", "parsedDate": "1997-10-15", "numChildren": 1 }, "data": { "key": "TWDIPTDE", "version": 127, "itemType": "journalArticle", "title": "Method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group for Spinal Disorders", "creators": [ { "creatorType": "author", "firstName": "M W", "lastName": "van Tulder" }, { "creatorType": "author", "firstName": "W J", "lastName": "Assendelft" }, { "creatorType": "author", "firstName": "B W", "lastName": "Koes" }, { "creatorType": "author", "firstName": "L M", "lastName": "Bouter" } ], "abstractNote": "", "publicationTitle": "Spine", "publisher": "", "place": "", "date": "Oct 15, 1997", "volume": "22", "issue": "20", "section": "", "partNumber": "", "partTitle": "", "pages": "2323-2330", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Spine", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0362-2436", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 9355211", "tags": [ { "tag": "Back Pain", "type": 1 }, { "tag": "Evidence-Based Medicine", "type": 1 }, { "tag": "Guidelines as Topic", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Meta-Analysis as Topic", "type": 1 }, { "tag": "Publishing", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Spinal Diseases", "type": 1 } ], "collections": [ "ZPIJ2FEB" ], "relations": {}, "dateAdded": "2012-10-28T08:42:31Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "72RK2VIT", "version": 117, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/72RK2VIT", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/72RK2VIT", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Langhorne and Pollock", "parsedDate": "2002-09", "numChildren": 1 }, "data": { "key": "72RK2VIT", "version": 117, "itemType": "journalArticle", "title": "What are the components of effective stroke unit care?", "creators": [ { "creatorType": "author", "firstName": "Peter", "lastName": "Langhorne" }, { "creatorType": "author", "firstName": "Alex", "lastName": "Pollock" } ], "abstractNote": "BACKGROUND\n\nThe effectiveness of organized inpatient (stroke unit) care has been demonstrated in systematic reviews of clinical trials. However, the key components of stroke unit care are poorly understood.\n\n\nMETHODS\n\nWe conducted a survey of recent trials (published 1985-2000) of a stroke unit/ward which had demonstrated a beneficial effect consistent with the stroke unit systematic review.\n\n\nRESULTS\n\nWe identified 11 eligible stroke unit trials of which the majority described similar approaches to i) assessment procedures (medical, nursing and therapy assessments), ii) early management policies (e.g. early mobilization; avoidance of urinary catheterization; treatment of hypoxia, hyperglycaemia and suspected infection), iii) ongoing rehabilitation policies (e.g. co-ordinated multidisciplinary team care, early assessment for discharge).\n\n\nCONCLUSIONS\n\nThis survey provides a description of stroke unit care which can serve as a benchmark for general stroke patient care and future clinical research.", "publicationTitle": "Age and ageing", "publisher": "", "place": "", "date": "Sep 2002", "volume": "31", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "365-371", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Age Ageing", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1468-2834", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 12242199", "tags": [ { "tag": "Benchmarking", "type": 1 }, { "tag": "Efficiency, Organizational", "type": 1 }, { "tag": "Health Care Surveys", "type": 1 }, { "tag": "Hospital Units", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Outcome Assessment (Health Care)", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Stroke", "type": 1 } ], "collections": [ "R5XAG7TF" ], "relations": {}, "dateAdded": "2012-10-28T12:29:22Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "SR45IEZI", "version": 113, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/SR45IEZI", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/SR45IEZI", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Peurala et al.", "parsedDate": "2012-03", "numChildren": 1 }, "data": { "key": "SR45IEZI", "version": 113, "itemType": "journalArticle", "title": "Effectiveness of constraint-induced movement therapy on activity and participation after stroke: a systematic review and meta-analysis of randomized controlled trials", "creators": [ { "creatorType": "author", "firstName": "Sinikka H", "lastName": "Peurala" }, { "creatorType": "author", "firstName": "Mari P", "lastName": "Kantanen" }, { "creatorType": "author", "firstName": "Tuulikki", "lastName": "Sjögren" }, { "creatorType": "author", "firstName": "Jaana", "lastName": "Paltamaa" }, { "creatorType": "author", "firstName": "Maarit", "lastName": "Karhula" }, { "creatorType": "author", "firstName": "Ari", "lastName": "Heinonen" } ], "abstractNote": "OBJECTIVE\n\nTo examine the effect of constraint-induced movement therapy and modified constraint-induced movement therapy on activity and participation of patients with stroke (i.e. the effect of different treatment durations and frequency) by reviewing the results of randomized controlled trials. Data sources: A systematic literature search was conducted in MEDLINE, CINAHL, EMBASE, PEDro, OTSeeker, CENTRAL and by manual search.\n\n\nREVIEW METHODS\n\nRandomized controlled trials for patients over 18 years old with stroke and published in Finnish, Swedish, English or German were included. Studies were collected up to the first week in May 2011. The evidence was high, moderate, low or no evidence according to the quality of randomized controlled trial and the results of meta-analyses.\n\n\nRESULTS\n\nSearch resulted in 30 papers reporting constraint-induced movement therapy, including 27 randomized controlled trials published between 2001 and 2011. Constraint-induced movement therapy practice for 60-72 hours over two weeks produced better mobility (i.e. ability to carry, move and handle objects) with high evidence compared to control treatment. Constraint-induced movement therapy for 20-56 hours over two weeks, 30 hours over three weeks and 15-30 hours over 10 weeks improved mobility of the affected upper extremity. However, with self-care as an outcome measure, only 30 hours of constraint-induced movement therapy practice over three weeks demonstrated an improvement.\n\n\nCONCLUSION\n\nConstraint-induced movement therapy and modified constraint-induced movement therapy proved to be effective on affected hand mobility and to some extent self-care on the World Health Organization's International Classification of Functioning, Disability and Health activity and participation component, but further studies are needed to find out the optimal treatment protocols for constraint-induced movement therapy.", "publicationTitle": "Clinical rehabilitation", "publisher": "", "place": "", "date": "Mar 2012", "volume": "26", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "209-223", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Clin Rehabil", "DOI": "10.1177/0269215511420306", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1477-0873", "archive": "", "archiveLocation": "", "shortTitle": "Effectiveness of constraint-induced movement therapy on activity and participation after stroke", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22070990", "tags": [ { "tag": "Activities of Daily Living", "type": 1 }, { "tag": "Exercise Movement Techniques", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Finland", "type": 1 }, { "tag": "Hemiplegia", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Patient Participation", "type": 1 }, { "tag": "Prognosis", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Recovery of Function", "type": 1 }, { "tag": "Restraint, Physical", "type": 1 }, { "tag": "Risk Assessment", "type": 1 }, { "tag": "Self Care", "type": 1 }, { "tag": "Stroke", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 }, { "tag": "Upper Extremity", "type": 1 } ], "collections": [ "IGES8M2C" ], "relations": {}, "dateAdded": "2012-10-28T19:49:41Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "QNIQINDJ", "version": 107, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/QNIQINDJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/QNIQINDJ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Mehrholz et al.", "parsedDate": "2008", "numChildren": 1 }, "data": { "key": "QNIQINDJ", "version": 107, "itemType": "journalArticle", "title": "Electromechanical and robot-assisted arm training for improving arm function and activities of daily living after stroke", "creators": [ { "creatorType": "author", "firstName": "Jan", "lastName": "Mehrholz" }, { "creatorType": "author", "firstName": "Thomas", "lastName": "Platz" }, { "creatorType": "author", "firstName": "Joachim", "lastName": "Kugler" }, { "creatorType": "author", "firstName": "Marcus", "lastName": "Pohl" } ], "abstractNote": "BACKGROUND\n\nElectromechanical and robot-assisted arm training devices are used in rehabilitation and might help to improve arm function after stroke.\n\n\nOBJECTIVES\n\nTo assess the effectiveness of electromechanical and robot-assisted arm training for improving activities of daily living and arm function and motor strength of patients after stroke, and the acceptability and safety of the therapy.\n\n\nSEARCH STRATEGY\n\nWe searched the Cochrane Stroke Group Trials Register (last searched October 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2007), MEDLINE (1950 to October 2007), EMBASE (1980 to October 2007), CINAHL (1982 to October 2007), AMED (1985 to October 2007), SPORTDiscus (1949 to October 2007), PEDro (searched October 2007), COMPENDEX (1972 to October 2007) and INSPEC (1969 to October 2007). We also handsearched relevant conference proceedings, searched trials and research registers, checked reference lists, and contacted trialists, experts and researchers in our field, and manufacturers of commercial devices.\n\n\nSELECTION CRITERIA\n\nRandomised controlled trials comparing electromechanical and robot-assisted arm training for recovery of arm function with other rehabilitation interventions or no treatment for patients after stroke.\n\n\nDATA COLLECTION AND ANALYSIS\n\nTwo review authors independently selected trials for inclusion, assessed trial quality and extracted data. We contacted trialists for additional information. We analysed the results as standardised mean differences (SMDs) for continuous variables and relative risk differences (RD) for dichotomous variables.\n\n\nMAIN RESULTS\n\nWe included 11 trials (328 participants) in this review. Electromechanical and robot-assisted arm training did not improve activities of daily living (SMD = 0.29; 95% confidence interval (CI) -0.47 to 1.06; P = 0.45; I(2 )= 85%). Arm motor function and arm motor strength improved (SMD = 0.68, 95% CI 0.24 to 1.11; P = 0.002; I(2 )= 56% and SMD = 01.03, 95% CI 0.29 to 1.78; P = 0.007; I(2 )= 79% respectively). Electromechanical and robot-assisted arm training did not increase the risk of patients to drop out (RD) (fixed-effect model) = 0.01; 95% CI -0.05 to 0.06; P = 0.77; I(2 )= 0.0%) and adverse events were rare.\n\n\nAUTHORS' CONCLUSIONS\n\nPatients who receive electromechanical and robot-assisted arm training after stroke are not more likely to improve their activities of daily living, but arm motor function and strength of the paretic arm may improve. However, the results must be interpreted with caution because there were variations between the trials in the duration, amount of training and type of treatment, and in the patient characteristics.", "publicationTitle": "Cochrane database of systematic reviews (Online)", "publisher": "", "place": "", "date": "2008", "volume": "", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "CD006876", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD006876.pub2", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 18843735", "tags": [ { "tag": "Activities of Daily Living", "type": 1 }, { "tag": "Artificial Limbs", "type": 1 }, { "tag": "Exercise Therapy", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Recovery of Function", "type": 1 }, { "tag": "Robotics", "type": 1 }, { "tag": "Stroke", "type": 1 }, { "tag": "Upper Extremity", "type": 1 } ], "collections": [ "UUW7JT9A" ], "relations": {}, "dateAdded": "2012-10-28T23:17:48Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "VVJPHXP9", "version": 104, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/VVJPHXP9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/VVJPHXP9", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Sirtori et al.", "parsedDate": "2009", "numChildren": 1 }, "data": { "key": "VVJPHXP9", "version": 104, "itemType": "journalArticle", "title": "Constraint-induced movement therapy for upper extremities in stroke patients", "creators": [ { "creatorType": "author", "firstName": "Valeria", "lastName": "Sirtori" }, { "creatorType": "author", "firstName": "Davide", "lastName": "Corbetta" }, { "creatorType": "author", "firstName": "Lorenzo", "lastName": "Moja" }, { "creatorType": "author", "firstName": "Roberto", "lastName": "Gatti" } ], "abstractNote": "BACKGROUND\n\nIn stroke patients, upper limb paresis affects many activities of daily life. Reducing disability is therefore a major aim of rehabilitation programmes for hemiparetic patients. Constraint-induced movement therapy (CIMT) is a current approach to stroke rehabilitation that implies the forced use and the massed practice of the affected arm by restraining the unaffected arm.\n\n\nOBJECTIVES\n\nTo assess the efficacy of CIMT, modified CIMT (mCIMT), or forced use (FU) for arm management in hemiparetic patients.\n\n\nSEARCH STRATEGY\n\nWe searched the Cochrane Stroke Group trials register (last searched June 2008), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2008), MEDLINE (1966 to June 2008), EMBASE (1980 to June 2008), CINAHL (1982 to June 2008), and the Physiotherapy Evidence Database (PEDro) (June 2008).\n\n\nSELECTION CRITERIA\n\nRandomised control trials (RCTs) and quasi-RCTs (qRCTs) comparing CIMT, mCIMT or FU with other rehabilitative techniques, or none.\n\n\nDATA COLLECTION AND ANALYSIS\n\nTwo review authors independently classified the identified trials according to the inclusion and exclusion criteria, assessed methodological quality and extracted data. The primary outcome was disability.\n\n\nMAIN RESULTS\n\nWe included 19 studies involving 619 participants. The trials included participants who had some residual motor power of the paretic arm, the potential for further motor recovery and with limited pain or spasticity, but tended to use the limb little if at all. Only five studies had adequate allocation concealment. The majority of studies were underpowered (median number of included patients was 15) and we cannot rule out small-trial bias. Six trials (184 patients) assessed disability immediately after the intervention, indicating a significant standard mean difference (SMD) of 0.36, 95% confidence interval (CI) 0.06 to 0.65. For the most frequently reported outcome, arm motor function (11 studies involving 373 patients), the SMD was 0.72 (95% CI 0.32 to 1.12). There were only two studies that explored disability improvement after a few months of follow up and found no significant difference, SMD -0.07 (95% CI -0.53 to 0.40).\n\n\nAUTHORS' CONCLUSIONS\n\nCIMT is a multifaceted intervention: the restriction to the normal limb is accompanied by a certain amount of exercise of the appropriate quality. It is associated with a moderate reduction in disability assessed at the end of the treatment period. However, for disability measured some months after the end of treatment, there was no evidence of persisting benefit. Further randomised trials, with larger sample sizes and longer follow up, are justified.", "publicationTitle": "Cochrane database of systematic reviews (Online)", "publisher": "", "place": "", "date": "2009", "volume": "", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "CD004433", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD004433.pub2", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19821326", "tags": [ { "tag": "Exercise Movement Techniques", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Immobilization", "type": 1 }, { "tag": "Paresis", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Stroke", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Upper Extremity", "type": 1 } ], "collections": [ "65IFAGJF", "RSDVDJZT", "UUW7JT9A" ], "relations": {}, "dateAdded": "2012-10-28T23:22:15Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "3MS4X6CC", "version": 101, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/3MS4X6CC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/3MS4X6CC", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Pomeroy et al.", "parsedDate": "2006", "numChildren": 1 }, "data": { "key": "3MS4X6CC", "version": 101, "itemType": "journalArticle", "title": "Electrostimulation for promoting recovery of movement or functional ability after stroke", "creators": [ { "creatorType": "author", "firstName": "V M", "lastName": "Pomeroy" }, { "creatorType": "author", "firstName": "L", "lastName": "King" }, { "creatorType": "author", "firstName": "A", "lastName": "Pollock" }, { "creatorType": "author", "firstName": "A", "lastName": "Baily-Hallam" }, { "creatorType": "author", "firstName": "P", "lastName": "Langhorne" } ], "abstractNote": "BACKGROUND\n\nElectrostimulation might improve motor recovery after stroke by providing neuromuscular re-training.\n\n\nOBJECTIVES\n\nTo find if electrostimulation improved functional motor ability, and the ability to undertake activities of daily living.\n\n\nSEARCH STRATEGY\n\nWe searched the Cochrane Stroke Group Trials Register (last searched August 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2004), MEDLINE (1966 to January 2004), EMBASE (1980 to January 2004), CINAHL (1982 to January 2004), AMED - Allied and Complementary Medicine Database (1985 to January 2004), Physiotherapy Evidence Database (PEDro), REHABDATA and the ISI Science Citation Index (1981 to 2003). We placed a request on the PHYSIO e-mail discussion list and contacted authors of relevant studies to elicit any unpublished or ongoing studies, searched the reference lists of included trials and contacted trialists.\n\n\nSELECTION CRITERIA\n\nRandomised controlled trials of electrostimulation delivered to the peripheral neuromuscular system which was designed to improve voluntary movement control, functional motor ability and activities of daily living.\n\n\nDATA COLLECTION AND ANALYSIS\n\nTwo review authors independently selected trials for inclusion, assessed trial quality and extracted the data.\n\n\nMAIN RESULTS\n\nOf the 2077 references identified, 24 trials were included in this review. For electrostimulation compared with no treatment this review found that electrostimulation improved some aspects of functional motor ability and some aspects of motor impairment and normality of movement. In addition, there was a significant difference in favour of no treatment compared with electrostimulation for an aspect of functional motor ability. For electrostimulation compared with placebo this review found that electrostimulation improved an aspect of functional motor ability. For electrostimulation compared with conventional physical therapy this review found that electrostimulation improved an aspect of motor impairment. There were no statistically significant differences between electrostimulation and control treatment for all other outcomes. However, these results need to be interpreted with reference to the following: (1) the majority of analyses only contained one trial; (2) variation was found between included trials in time after stroke, level of functional deficit, and dose of electrostimulation; and (3) the possibility of selection and detection bias in the majority of included trials.\n\n\nAUTHORS' CONCLUSIONS\n\nAt present, there are insufficient robust data to inform clinical use of electrostimulation for neuromuscular re-training. Research is needed to address specific questions about the type of electrostimulation that might be most effective, in what dose and at what time after stroke.", "publicationTitle": "Cochrane database of systematic reviews (Online)", "publisher": "", "place": "", "date": "2006", "volume": "", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "CD003241", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD003241.pub2", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16625574", "tags": [ { "tag": "Activities of Daily Living", "type": 1 }, { "tag": "Electric Stimulation Therapy", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Motor Activity", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Recovery of Function", "type": 1 }, { "tag": "Stroke", "type": 1 } ], "collections": [ "RSDVDJZT", "UUW7JT9A" ], "relations": {}, "dateAdded": "2012-10-28T23:40:46Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "Z6BGMF5U", "version": 98, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/Z6BGMF5U", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/Z6BGMF5U", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Edwards et al.", "parsedDate": "2002-05-18", "numChildren": 1 }, "data": { "key": "Z6BGMF5U", "version": 98, "itemType": "journalArticle", "title": "Increasing response rates to postal questionnaires: systematic review", "creators": [ { "creatorType": "author", "firstName": "Phil", "lastName": "Edwards" }, { "creatorType": "author", "firstName": "Ian", "lastName": "Roberts" }, { "creatorType": "author", "firstName": "Mike", "lastName": "Clarke" }, { "creatorType": "author", "firstName": "Carolyn", "lastName": "DiGuiseppi" }, { "creatorType": "author", "firstName": "Sarah", "lastName": "Pratap" }, { "creatorType": "author", "firstName": "Reinhard", "lastName": "Wentz" }, { "creatorType": "author", "firstName": "Irene", "lastName": "Kwan" } ], "abstractNote": "OBJECTIVE\n\nTo identify methods to increase response to postal questionnaires.\n\n\nDESIGN\n\nSystematic review of randomised controlled trials of any method to influence response to postal questionnaires.\n\n\nSTUDIES REVIEWED\n\n292 randomised controlled trials including 258 315 participants INTERVENTION REVIEWED: 75 strategies for influencing response to postal questionnaires.\n\n\nMAIN OUTCOME MEASURE\n\nThe proportion of completed or partially completed questionnaires returned.\n\n\nRESULTS\n\nThe odds of response were more than doubled when a monetary incentive was used (odds ratio 2.02; 95% confidence interval 1.79 to 2.27) and almost doubled when incentives were not conditional on response (1.71; 1.29 to 2.26). Response was more likely when short questionnaires were used (1.86; 1.55 to 2.24). Personalised questionnaires and letters increased response (1.16; 1.06 to 1.28), as did the use of coloured ink (1.39; 1.16 to 1.67). The odds of response were more than doubled when the questionnaires were sent by recorded delivery (2.21; 1.51 to 3.25) and increased when stamped return envelopes were used (1.26; 1.13 to 1.41) and questionnaires were sent by first class post (1.12; 1.02 to 1.23). Contacting participants before sending questionnaires increased response (1.54; 1.24 to 1.92), as did follow up contact (1.44; 1.22 to 1.70) and providing non-respondents with a second copy of the questionnaire (1.41; 1.02 to 1.94). Questionnaires designed to be of more interest to participants were more likely to be returned (2.44; 1.99 to 3.01), but questionnaires containing questions of a sensitive nature were less likely to be returned (0.92; 0.87 to 0.98). Questionnaires originating from universities were more likely to be returned than were questionnaires from other sources, such as commercial organisations (1.31; 1.11 to 1.54).\n\n\nCONCLUSIONS\n\nHealth researchers using postal questionnaires can improve the quality of their research by using the strategies shown to be effective in this systematic review.", "publicationTitle": "BMJ (Clinical research ed.)", "publisher": "", "place": "", "date": "May 18, 2002", "volume": "324", "issue": "7347", "section": "", "partNumber": "", "partTitle": "", "pages": "1183", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "BMJ", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1756-1833", "archive": "", "archiveLocation": "", "shortTitle": "Increasing response rates to postal questionnaires", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 12016181", "tags": [ { "tag": "Data Collection", "type": 1 }, { "tag": "Data Interpretation, Statistical", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Motivation", "type": 1 }, { "tag": "Postal Service", "type": 1 }, { "tag": "Questionnaires", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Research Design", "type": 1 } ], "collections": [ "UUW7JT9A" ], "relations": {}, "dateAdded": "2012-10-28T23:43:27Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "B3642HR9", "version": 91, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/B3642HR9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/B3642HR9", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Hsu et al.", "parsedDate": "2012-07", "numChildren": 1 }, "data": { "key": "B3642HR9", "version": 91, "itemType": "journalArticle", "title": "Effects of repetitive transcranial magnetic stimulation on motor functions in patients with stroke: a meta-analysis", "creators": [ { "creatorType": "author", "firstName": "Wan-Yu", "lastName": "Hsu" }, { "creatorType": "author", "firstName": "Chia-Hsiung", "lastName": "Cheng" }, { "creatorType": "author", "firstName": "Kwong-Kum", "lastName": "Liao" }, { "creatorType": "author", "firstName": "I-Hui", "lastName": "Lee" }, { "creatorType": "author", "firstName": "Yung-Yang", "lastName": "Lin" } ], "abstractNote": "BACKGROUND AND PURPOSE\n\nThe purpose of this study was to perform a meta-analysis of studies that investigated the effects of repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function in patients with stroke.\n\n\nMETHODS\n\nWe searched for randomized controlled trials published between January 1990 and October 2011 in PubMed, Medline, Cochrane, and CINAHL using the following key words: stroke, cerebrovascular accident, and repetitive transcranial magnetic stimulation. The mean effect size and a 95% CI were estimated for the motor outcome and motor threshold using fixed and random effect models.\n\n\nRESULTS\n\nEighteen of the 34 candidate articles were included in this analysis. The selected studies involved a total of 392 patients. A significant effect size of 0.55 was found for motor outcome (95% CI, 0.37-0.72). Further subgroup analyses demonstrated more prominent effects for subcortical stroke (mean effect size, 0.73; 95% CI, 0.44-1.02) or studies applying low-frequency rTMS (mean effect size, 0.69; 95% CI, 0.42-0.95). Only 4 patients of the 18 articles included in this analysis reported adverse effects from rTMS.\n\n\nCONCLUSIONS\n\nrTMS has a positive effect on motor recovery in patients with stroke, especially for those with subcortical stroke. Low-frequency rTMS over the unaffected hemisphere may be more beneficial than high-frequency rTMS over the affected hemisphere. Recent limited data suggest that intermittent theta-burst stimulation over the affected hemisphere might be a useful intervention. Further well-designed studies in a larger population are required to better elucidate the differential roles of various rTMS protocols in stroke treatment.", "publicationTitle": "Stroke; a journal of cerebral circulation", "publisher": "", "place": "", "date": "Jul 2012", "volume": "43", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "1849-1857", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Stroke", "DOI": "10.1161/STROKEAHA.111.649756", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1524-4628", "archive": "", "archiveLocation": "", "shortTitle": "Effects of repetitive transcranial magnetic stimulation on motor functions in patients with stroke", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22713491", "tags": [ { "tag": "Evoked Potentials, Motor", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Motor Cortex", "type": 1 }, { "tag": "Motor Skills", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Stroke", "type": 1 }, { "tag": "Transcranial Magnetic Stimulation", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "UUW7JT9A" ], "relations": {}, "dateAdded": "2012-10-29T01:02:53Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "DKS5T6MM", "version": 86, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/DKS5T6MM", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/DKS5T6MM", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "May et al.", "parsedDate": "2007", "numChildren": 1 }, "data": { "key": "DKS5T6MM", "version": 86, "itemType": "journalArticle", "title": "Understanding the implementation of complex interventions in health care: the normalization process model", "creators": [ { "creatorType": "author", "firstName": "Carl", "lastName": "May" }, { "creatorType": "author", "firstName": "Tracy", "lastName": "Finch" }, { "creatorType": "author", "firstName": "Frances", "lastName": "Mair" }, { "creatorType": "author", "firstName": "Luciana", "lastName": "Ballini" }, { "creatorType": "author", "firstName": "Christopher", "lastName": "Dowrick" }, { "creatorType": "author", "firstName": "Martin", "lastName": "Eccles" }, { "creatorType": "author", "firstName": "Linda", "lastName": "Gask" }, { "creatorType": "author", "firstName": "Anne", "lastName": "MacFarlane" }, { "creatorType": "author", "firstName": "Elizabeth", "lastName": "Murray" }, { "creatorType": "author", "firstName": "Tim", "lastName": "Rapley" }, { "creatorType": "author", "firstName": "Anne", "lastName": "Rogers" }, { "creatorType": "author", "firstName": "Shaun", "lastName": "Treweek" }, { "creatorType": "author", "firstName": "Paul", "lastName": "Wallace" }, { "creatorType": "author", "firstName": "George", "lastName": "Anderson" }, { "creatorType": "author", "firstName": "Jo", "lastName": "Burns" }, { "creatorType": "author", "firstName": "Ben", "lastName": "Heaven" } ], "abstractNote": "BACKGROUND\n\nThe Normalization Process Model is a theoretical model that assists in explaining the processes by which complex interventions become routinely embedded in health care practice. It offers a framework for process evaluation and also for comparative studies of complex interventions. It focuses on the factors that promote or inhibit the routine embedding of complex interventions in health care practice.\n\n\nMETHODS\n\nA formal theory structure is used to define the model, and its internal causal relations and mechanisms. The model is broken down to show that it is consistent and adequate in generating accurate description, systematic explanation, and the production of rational knowledge claims about the workability and integration of complex interventions.\n\n\nRESULTS\n\nThe model explains the normalization of complex interventions by reference to four factors demonstrated to promote or inhibit the operationalization and embedding of complex interventions (interactional workability, relational integration, skill-set workability, and contextual integration).\n\n\nCONCLUSION\n\nThe model is consistent and adequate. Repeated calls for theoretically sound process evaluations in randomized controlled trials of complex interventions, and policy-makers who call for a proper understanding of implementation processes, emphasize the value of conceptual tools like the Normalization Process Model.", "publicationTitle": "BMC health services research", "publisher": "", "place": "", "date": "2007", "volume": "7", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "148", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "BMC Health Serv Res", "DOI": "10.1186/1472-6963-7-148", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1472-6963", "archive": "", "archiveLocation": "", "shortTitle": "Understanding the implementation of complex interventions in health care", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 17880693", "tags": [ { "tag": "Evidence-Based Medicine", "type": 1 }, { "tag": "Guideline Adherence", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Models, Theoretical", "type": 1 }, { "tag": "Physician's Practice Patterns", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 } ], "collections": [ "UUW7JT9A" ], "relations": {}, "dateAdded": "2012-10-29T10:42:58Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "U9UETG9T", "version": 83, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/U9UETG9T", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/U9UETG9T", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Danner et al.", "parsedDate": "2011-10", "numChildren": 1 }, "data": { "key": "U9UETG9T", "version": 83, "itemType": "journalArticle", "title": "Integrating patients' views into health technology assessment: Analytic hierarchy process (AHP) as a method to elicit patient preferences", "creators": [ { "creatorType": "author", "firstName": "Marion", "lastName": "Danner" }, { "creatorType": "author", "firstName": "J Marjan", "lastName": "Hummel" }, { "creatorType": "author", "firstName": "Fabian", "lastName": "Volz" }, { "creatorType": "author", "firstName": "Jeannette G", "lastName": "van Manen" }, { "creatorType": "author", "firstName": "Beate", "lastName": "Wiegard" }, { "creatorType": "author", "firstName": "Charalabos-Markos", "lastName": "Dintsios" }, { "creatorType": "author", "firstName": "Hilda", "lastName": "Bastian" }, { "creatorType": "author", "firstName": "Andreas", "lastName": "Gerber" }, { "creatorType": "author", "firstName": "Maarten J", "lastName": "Ijzerman" } ], "abstractNote": "BACKGROUND\n\nPatient involvement is widely acknowledged to be a valuable component in health technology assessment (HTA) and healthcare decision making. However, quantitative approaches to ascertain patients' preferences for treatment endpoints are not yet established. The objective of this study is to introduce the analytic hierarchy process (AHP) as a preference elicitation method in HTA. Based on a systematic literature review on the use of AHP in health care in 2009, the German Institute for Quality and Efficiency in Health Care (IQWiG) initiated an AHP study related to its HTA work in 2010.\n\n\nMETHODS\n\nThe AHP study included two AHP workshops, one with twelve patients and one with seven healthcare professionals. In these workshops, both patients and professionals rated their preferences with respect to the importance of different endpoints of antidepressant treatment by a pairwise comparison of individual endpoints. These comparisons were performed and evaluated by the AHP method and relative weights were generated for each endpoint.\n\n\nRESULTS\n\nThe AHP study indicates that AHP is a well-structured technique whose cognitive demands were well handled by patients and professionals. The two groups rated some of the included endpoints of antidepressant treatment differently. For both groups, however, the same six of the eleven endpoints analyzed accounted for more than 80 percent of the total weight.\n\n\nCONCLUSIONS\n\nAHP can be used in HTA to give a quantitative dimension to patients' preferences for treatment endpoints. Preference elicitation could provide important information at various stages of HTA and challenge opinions on the importance of endpoints.", "publicationTitle": "International journal of technology assessment in health care", "publisher": "", "place": "", "date": "Oct 2011", "volume": "27", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "369-375", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Int J Technol Assess Health Care", "DOI": "10.1017/S0266462311000523", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1471-6348", "archive": "", "archiveLocation": "", "shortTitle": "Integrating patients' views into health technology assessment", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22004779", "tags": [ { "tag": "Cost-Benefit Analysis", "type": 1 }, { "tag": "Decision Support Techniques", "type": 1 }, { "tag": "Depressive Disorder, Major", "type": 1 }, { "tag": "Germany", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Patient Participation", "type": 1 }, { "tag": "Patient Preference", "type": 1 }, { "tag": "Quality of Life", "type": 1 }, { "tag": "Research Design", "type": 1 }, { "tag": "Technology Assessment, Biomedical", "type": 1 } ], "collections": [ "5PTBR7B4" ], "relations": {}, "dateAdded": "2012-10-29T10:45:04Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "EITR9QNB", "version": 51, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/EITR9QNB", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/EITR9QNB", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Treweek and Zwarenstein", "parsedDate": "2009", "numChildren": 1 }, "data": { "key": "EITR9QNB", "version": 51, "itemType": "journalArticle", "title": "Making trials matter: pragmatic and explanatory trials and the problem of applicability", "creators": [ { "creatorType": "author", "firstName": "Shaun", "lastName": "Treweek" }, { "creatorType": "author", "firstName": "Merrick", "lastName": "Zwarenstein" } ], "abstractNote": "Randomised controlled trials are the best research design for decisions about the effect of different interventions but randomisation does not, of itself, promote the applicability of a trial's results to situations other than the precise one in which the trial was done. While methodologists and trialists have rightly paid great attention to internal validity, much less has been given to applicability. This narrative review is aimed at those planning to conduct trials, and those aiming to use the information in them. It is intended to help the former group make their trials more widely useful and to help the latter group make more informed decisions about the wider use of existing trials. We review the differences between the design of most randomised trials (which have an explanatory attitude) and the design of trials more able to inform decision making (which have a pragmatic attitude) and discuss approaches used to assert applicability of trial results. If we want evidence from trials to be used in clinical practice and policy, trialists should make every effort to make their trial widely applicable, which means that more trials should be pragmatic in attitude.", "publicationTitle": "Trials", "publisher": "", "place": "", "date": "2009", "volume": "10", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "37", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Trials", "DOI": "10.1186/1745-6215-10-37", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1745-6215", "archive": "", "archiveLocation": "", "shortTitle": "Making trials matter", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19493350", "tags": [ { "tag": "Attitude of Health Personnel", "type": 1 }, { "tag": "Evidence-Based Medicine", "type": 1 }, { "tag": "Health Knowledge, Attitudes, Practice", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Reproducibility of Results", "type": 1 }, { "tag": "Research Design", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "65IFAGJF" ], "relations": {}, "dateAdded": "2012-10-29T19:00:18Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "H9DZ9E87", "version": 49, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/H9DZ9E87", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/H9DZ9E87", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Zwarenstein et al.", "parsedDate": "2008", "numChildren": 1 }, "data": { "key": "H9DZ9E87", "version": 49, "itemType": "journalArticle", "title": "Improving the reporting of pragmatic trials: an extension of the CONSORT statement", "creators": [ { "creatorType": "author", "firstName": "Merrick", "lastName": "Zwarenstein" }, { "creatorType": "author", "firstName": "Shaun", "lastName": "Treweek" }, { "creatorType": "author", "firstName": "Joel J", "lastName": "Gagnier" }, { "creatorType": "author", "firstName": "Douglas G", "lastName": "Altman" }, { "creatorType": "author", "firstName": "Sean", "lastName": "Tunis" }, { "creatorType": "author", "firstName": "Brian", "lastName": "Haynes" }, { "creatorType": "author", "firstName": "Andrew D", "lastName": "Oxman" }, { "creatorType": "author", "firstName": "David", "lastName": "Moher" } ], "abstractNote": "BACKGROUND: The CONSORT statement is intended to improve reporting of randomised controlled trials and focuses on minimising the risk of bias (internal validity). The applicability of a trial's results (generalisability or external validity) is also important, particularly for pragmatic trials. A pragmatic trial (a term first used in 1967 by Schwartz and Lellouch) can be broadly defined as a randomised controlled trial whose purpose is to inform decisions about practice. This extension of the CONSORT statement is intended to improve the reporting of such trials and focuses on applicability. Methods At two, two-day meetings held in Toronto in 2005 and 2008, we reviewed the CONSORT statement and its extensions, the literature on pragmatic trials and applicability, and our experiences in conducting pragmatic trials. Recommendations We recommend extending eight CONSORT checklist items for reporting of pragmatic trials: the background, participants, interventions, outcomes, sample size, blinding, participant flow, and generalisability of the findings. These extensions are presented, along with illustrative examples of reporting, and an explanation of each extension. Adherence to these reporting criteria will make it easier for decision makers to judge how applicable the results of randomised controlled trials are to their own conditions. Empirical studies are needed to ascertain the usefulness and comprehensiveness of these CONSORT checklist item extensions. In the meantime we recommend that those who support, conduct, and report pragmatic trials should use this extension of the CONSORT statement to facilitate the use of trial results in decisions about health care.", "publicationTitle": "BMJ (Clinical research ed.)", "publisher": "", "place": "", "date": "2008", "volume": "337", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "a2390", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "BMJ", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1756-1833", "archive": "", "archiveLocation": "", "shortTitle": "Improving the reporting of pragmatic trials", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19001484", "tags": [ { "tag": "Consensus Development Conferences as Topic", "type": 1 }, { "tag": "Decision Making", "type": 1 }, { "tag": "Health Planning Guidelines", "type": 1 }, { "tag": "Health Services Research", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Patient Selection", "type": 1 }, { "tag": "Publishing", "type": 1 }, { "tag": "Quality Control", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Reproducibility of Results", "type": 1 }, { "tag": "Research Design", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2012-10-29T19:17:42Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "EBNBAHN9", "version": 47, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/EBNBAHN9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/EBNBAHN9", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Hendricks et al.", "parsedDate": "2002-11", "numChildren": 1 }, "data": { "key": "EBNBAHN9", "version": 47, "itemType": "journalArticle", "title": "Motor recovery after stroke: a systematic review of the literature", "creators": [ { "creatorType": "author", "firstName": "Henk T", "lastName": "Hendricks" }, { "creatorType": "author", "firstName": "Jacques", "lastName": "van Limbeek" }, { "creatorType": "author", "firstName": "Alexander C", "lastName": "Geurts" }, { "creatorType": "author", "firstName": "Machiel J", "lastName": "Zwarts" } ], "abstractNote": "OBJECTIVE\n\nTo collect and integrate existing data concerning the occurrence, extent, time course, and prognostic determinants of motor recovery after stroke using a systematic methodologic approach.\n\n\nDATA SOURCES\n\nA computer-aided search in bibliographic databases was done of longitudinal cohort studies, original prognostic studies, and randomized controlled trials published in the period 1966 to November 2001, which was expanded by references from retrieved articles and narrative reviews.\n\n\nSTUDY SELECTION\n\nAfter a preliminary screening, internal, external, and statistical validity was assessed by a priori methodologic criteria, with special emphasis on the internal validity.\n\n\nDATA EXTRACTION\n\nThe studies finally selected were discussed, based on the quantitative analysis of the outcome measures and prognostic determinants. Meta-analysis was pursued, but was not possible because of substantial heterogeneity.\n\n\nDATA SYNTHESIS\n\nThe search resulted in 174 potentially relevant studies, of which 80 passed the preliminary screening and were subjected to further methodologic assessment; 14 studies were finally selected. Approximately 65% of the hospitalized stroke survivors with initial motor deficits of the lower extremity showed some degree of motor recovery. In the case of paralysis, complete motor recovery occurred in less than 15% of the patients, both for the upper and lower extremities. Hospitalized patients with small lacunar strokes showed relatively good motor recovery. The recovery period in patients with severe stroke was twice as long as in patients with mild stroke. The initial grade of paresis was the most important predictor for motor recovery (odds ratios [OR], >4). Objective analysis of the motor pathways by motor-evoked potentials (MEPs) showed even higher ORs (ORs, >20).\n\n\nCONCLUSIONS\n\nOur knowledge of motor recovery after stroke in more accurate, quantitative, and qualitive terms is still limited. Nevertheless, our data synthesis and quantitative analysis comprises data from many methodologically robust studies, which may support the clinician in the management of stroke patients. With respect to early prognosis of motor recovery, our review confirms clinical experience that the initial grade of paresis (as measured on admission in the hospital) is the most important predictor, although the accuracy of prediction rapidly improves during the first few days after stroke. Initial paralysis implies the worst prognosis for subsequent motor recovery. Remarkably, the prognostic accuracy of MEPs appears much higher than that of clinical examination for different subgroups of patients.", "publicationTitle": "Archives of physical medicine and rehabilitation", "publisher": "", "place": "", "date": "Nov 2002", "volume": "83", "issue": "11", "section": "", "partNumber": "", "partTitle": "", "pages": "1629-1637", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Arch Phys Med Rehabil", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0003-9993", "archive": "", "archiveLocation": "", "shortTitle": "Motor recovery after stroke", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 12422337", "tags": [ { "tag": "Activities of Daily Living", "type": 1 }, { "tag": "Cohort Studies", "type": 1 }, { "tag": "Data Collection", "type": 1 }, { "tag": "Data Interpretation, Statistical", "type": 1 }, { "tag": "Evoked Potentials, Motor", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Motor Skills", "type": 1 }, { "tag": "Odds Ratio", "type": 1 }, { "tag": "Predictive Value of Tests", "type": 1 }, { "tag": "Prognosis", "type": 1 }, { "tag": "Recovery of Function", "type": 1 }, { "tag": "Reproducibility of Results", "type": 1 }, { "tag": "Research Design", "type": 1 }, { "tag": "Severity of Illness Index", "type": 1 }, { "tag": "Stroke", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "65IFAGJF" ], "relations": {}, "dateAdded": "2012-10-29T19:31:33Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "JJS9DKIQ", "version": 46, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/JJS9DKIQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/JJS9DKIQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "van Tulder et al.", "parsedDate": "1997-09-15", "numChildren": 1 }, "data": { "key": "JJS9DKIQ", "version": 46, "itemType": "journalArticle", "title": "Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions", "creators": [ { "creatorType": "author", "firstName": "M W", "lastName": "van Tulder" }, { "creatorType": "author", "firstName": "B W", "lastName": "Koes" }, { "creatorType": "author", "firstName": "L M", "lastName": "Bouter" } ], "abstractNote": "STUDY DESIGN\n\nA systematic review of randomized controlled trials.\n\n\nOBJECTIVES\n\nTo assess the effectiveness of the most common conservative types of treatment for patients with acute and chronic nonspecific low back pain.\n\n\nSUMMARY OF BACKGROUND DATA\n\nMany treatment options for acute and chronic low back pain are available, but little is known about the optimal treatment strategy.\n\n\nMETHODS\n\nA rating system was used to assess the strength of the evidence, based on the methodologic quality of the randomized controlled trials, the relevance of the outcome measures, and the consistency of the results.\n\n\nRESULTS\n\nThe number of randomized controlled trials identified varied widely with regard to the interventions involved. The scores ranged from 20 to 79 points for acute low back pain and from 19 to 79 points for chronic low back pain on a 100-point scale, indicating the overall poor quality of the trials. Overall, only 28 (35%) randomized controlled trials on acute low back pain and 20 (25%) on chronic low back pain had a methodologic score of 50 or more points, and were considered to be of high quality. Various methodologic flaws were identified. Strong evidence was found for the effectiveness of muscle relaxants and nonsteroidal anti-inflammatory drugs and the ineffectiveness of exercise therapy for acute low back pain; strong evidence also was found for the effectiveness of manipulation, back schools, and exercise therapy for chronic low back pain, especially for short-term effects.\n\n\nCONCLUSIONS\n\nThe quality of the design, execution, and reporting of randomized controlled trials should be improved, to establish strong evidence for the effectiveness of the various therapeutic interventions for acute and chronic low back pain.", "publicationTitle": "Spine", "publisher": "", "place": "", "date": "Sep 15, 1997", "volume": "22", "issue": "18", "section": "", "partNumber": "", "partTitle": "", "pages": "2128-2156", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Spine", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0362-2436", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 9322325", "tags": [ { "tag": "Acute Disease", "type": 1 }, { "tag": "Chronic Disease", "type": 1 }, { "tag": "Databases, Bibliographic", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Low Back Pain", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "RSDVDJZT" ], "relations": {}, "dateAdded": "2012-10-29T20:16:27Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "QC27PZCA", "version": 44, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/QC27PZCA", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/QC27PZCA", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Moher et al.", "parsedDate": "2009-07-21", "numChildren": 1 }, "data": { "key": "QC27PZCA", "version": 44, "itemType": "journalArticle", "title": "Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement", "creators": [ { "creatorType": "author", "firstName": "David", "lastName": "Moher" }, { "creatorType": "author", "firstName": "Alessandro", "lastName": "Liberati" }, { "creatorType": "author", "firstName": "Jennifer", "lastName": "Tetzlaff" }, { "creatorType": "author", "firstName": "Douglas G", "lastName": "Altman" } ], "abstractNote": "", "publicationTitle": "PLoS medicine", "publisher": "", "place": "", "date": "Jul 21, 2009", "volume": "6", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "e1000097", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "PLoS Med.", "DOI": "10.1371/journal.pmed.1000097", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1549-1676", "archive": "", "archiveLocation": "", "shortTitle": "Preferred reporting items for systematic reviews and meta-analyses", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19621072", "tags": [ { "tag": "Evidence-Based Practice", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Meta-Analysis as Topic", "type": 1 }, { "tag": "Periodicals as Topic", "type": 1 }, { "tag": "Publication Bias", "type": 1 }, { "tag": "Publishing", "type": 1 }, { "tag": "Quality Control", "type": 1 }, { "tag": "Review Literature as Topic", "type": 1 }, { "tag": "Terminology as Topic", "type": 1 } ], "collections": [ "RSDVDJZT" ], "relations": {}, "dateAdded": "2012-10-29T20:17:06Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "636WEAAQ", "version": 43, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/636WEAAQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/636WEAAQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Crow et al.", "parsedDate": "1989-12", "numChildren": 1 }, "data": { "key": "636WEAAQ", "version": 43, "itemType": "journalArticle", "title": "The effectiveness of EMG biofeedback in the treatment of arm function after stroke", "creators": [ { "creatorType": "author", "firstName": "J L", "lastName": "Crow" }, { "creatorType": "author", "firstName": "N B", "lastName": "Lincoln" }, { "creatorType": "author", "firstName": "F M", "lastName": "Nouri" }, { "creatorType": "author", "firstName": "W", "lastName": "De Weerdt" } ], "abstractNote": "The study was designed to evaluate the effect of electromyographic (EMG) biofeedback on the recovery of arm function after stroke. Patients who had impaired arm function and were between 2 and 8 weeks after stroke were randomly allocated to receive either treatment incorporating EMG biofeedback or a control treatment in addition to their routine physiotherapy. The two groups of 20 patients were compared before and after 6 weeks of treatment and at follow-up 6 weeks later. There were no significant differences between the groups before treatment or at follow-up, but at the end of treatment those who received EMG biofeedback scored significantly higher on tests of arm function. Patients with severe impairment were shown to benefit most from EMG biofeedback but there was no difference in response to treatment according to patient's age or side of stroke. Men had higher arm function scores than women before and at the end of treatment, but not at follow-up.", "publicationTitle": "International disability studies", "publisher": "", "place": "", "date": "1989 Oct-Dec", "volume": "11", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "155-160", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Int Disabil Stud", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0259-9147", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 2701823", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Arm", "type": 1 }, { "tag": "Biofeedback, Psychology", "type": 1 }, { "tag": "Cerebrovascular Disorders", "type": 1 }, { "tag": "Electromyography", "type": 1 }, { "tag": "Evaluation Studies as Topic", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Follow-Up Studies", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Physical Therapy Modalities", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 } ], "collections": [ "RSDVDJZT" ], "relations": {}, "dateAdded": "2012-10-29T20:19:40Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "EJHK2P78", "version": 42, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/EJHK2P78", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/EJHK2P78", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Moreland and Thomson", "parsedDate": "1994-06", "numChildren": 1 }, "data": { "key": "EJHK2P78", "version": 42, "itemType": "journalArticle", "title": "Efficacy of electromyographic biofeedback compared with conventional physical therapy for upper-extremity function in patients following stroke: a research overview and meta-analysis", "creators": [ { "creatorType": "author", "firstName": "J", "lastName": "Moreland" }, { "creatorType": "author", "firstName": "M A", "lastName": "Thomson" } ], "abstractNote": "BACKGROUND AND PURPOSE\n\nThe purpose of this study was to examine the efficacy of electromyographic biofeedback compared with conventional physical therapy for improving upper-extremity function in patients following a stroke.\n\n\nSUBJECTS AND METHODS\n\nA literature search was done for the years 1976 to 1992. The selection criteria included single-blinded randomized control trials. Study quality was assessed for nine criteria. For functional (disability index or stage of recovery) and impairment outcomes, meta-analyses were performed on odds ratios for improvement versus no improvement. Mann-Whitney U-Test probability values were combined across studies.\n\n\nRESULTS\n\nSix studies were selected, and outcome data were obtained for five studies. The common odds ratio was 2.2 for function and 1.1 for impairments in favor of biofeedback. The estimate of the number needed to treat to prevent a nonresponder was 11 for function and 22 for impairments. None of the meta-analyses were statistically significant.\n\n\nCONCLUSIONS AND DISCUSSION\n\nThe results do not conclusively indicate superiority of either form of therapy. Although there is a chance of Type II error, the estimated size of the effect is small. Given this estimate of little or no difference, therapists need to consider cost, ease of application, and patient preference when selecting these therapies.", "publicationTitle": "Physical therapy", "publisher": "", "place": "", "date": "Jun 1994", "volume": "74", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "534-543; discussion 544-547", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Phys Ther", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0031-9023", "archive": "", "archiveLocation": "", "shortTitle": "Efficacy of electromyographic biofeedback compared with conventional physical therapy for upper-extremity function in patients following stroke", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 8197240", "tags": [ { "tag": "Activities of Daily Living", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and over", "type": 1 }, { "tag": "Arm", "type": 1 }, { "tag": "Bias (Epidemiology)", "type": 1 }, { "tag": "Biofeedback, Psychology", "type": 1 }, { "tag": "Cerebrovascular Disorders", "type": 1 }, { "tag": "Combined Modality Therapy", "type": 1 }, { "tag": "Confidence Intervals", "type": 1 }, { "tag": "Electromyography", "type": 1 }, { "tag": "Follow-Up Studies", "type": 1 }, { "tag": "Health Care Costs", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Odds Ratio", "type": 1 }, { "tag": "Physical Therapy Modalities", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Reproducibility of Results", "type": 1 }, { "tag": "Research Design", "type": 1 }, { "tag": "Severity of Illness Index", "type": 1 }, { "tag": "Single-Blind Method", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [ "RSDVDJZT" ], "relations": {}, "dateAdded": "2012-10-29T20:20:28Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "CTMJAW5B", "version": 41, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/CTMJAW5B", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/CTMJAW5B", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Woodford and Price", "parsedDate": "2007", "numChildren": 1 }, "data": { "key": "CTMJAW5B", "version": 41, "itemType": "journalArticle", "title": "EMG biofeedback for the recovery of motor function after stroke", "creators": [ { "creatorType": "author", "firstName": "H", "lastName": "Woodford" }, { "creatorType": "author", "firstName": "C", "lastName": "Price" } ], "abstractNote": "BACKGROUND\n\nElectromyographic biofeedback (EMG-BFB) is a technique that is believed to have additional benefit when used with standard physiotherapy for the recovery of motor function in stroke patients. However, evidence from individual trials and previous systematic reviews has been inconclusive.\n\n\nOBJECTIVES\n\nTo assess the effects of EMG-BFB for motor function recovery following stroke.\n\n\nSEARCH STRATEGY\n\nWe searched the Cochrane Stroke Group Trials Register (last searched 30 March 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2005), MEDLINE (1966 to November 2005), EMBASE (1980 to November 2005), CINAHL (1983 to November 2005), PsycINFO (1974 to November 2005) and First Search (1966 to November 2005). We scanned reference lists for relevant articles and contacted equipment manufacturers and distributors.\n\n\nSELECTION CRITERIA\n\nRandomised and quasi-randomised studies comparing EMG-BFB with control for motor function recovery in stroke patients.\n\n\nDATA COLLECTION AND ANALYSIS\n\nTwo review authors independently assessed trial quality and extracted data. Where possible we contacted study authors for further information. Any reported adverse effects were noted.\n\n\nMAIN RESULTS\n\nThirteen trials involving 269 people were included. All trials compared EMG-BFB plus standard physiotherapy to standard physiotherapy either alone or with sham EMG-BFB. Only one study used a motor strength assessment scale for evaluation of patients, which indicated benefit from EMG-BFB (WMD 1.09, 95% CI 0.48 to 1.70). EMG-BFB did not have a significant benefit in improving range of motion (ROM) through the ankle (SMD 0.05, 95% CI -0.36 to 0.46), knee or wrist joints. However, one trial suggested a benefit in ROM at the shoulder (SMD 0.88, 95% CI 0.07 to 1.70). Change in stride length or gait speed was not improved by EMG-BFB. Two studies used different assessment scores to quantify gait quality. One of these suggested a beneficial effect of EMG-BFB (SMD 0.90, 95% CI 0.01 to 1.78). Most of the studies examining functional outcomes used different assessment scales, which made meta-analysis impossible. Two studies that used the same scale did show a beneficial effect (SMD 0.69, 95% CI 0.15 to 1.23).\n\n\nAUTHORS' CONCLUSIONS\n\nDespite evidence from a small number of individual studies to suggest that EMG-BFB plus standard physiotherapy produces improvements in motor power, functional recovery and gait quality when compared to standard physiotherapy alone, combination of all the identified studies did not find a treatment benefit. Overall the results are limited because the trials were small, generally poorly designed and utilised varying outcome measures.", "publicationTitle": "Cochrane database of systematic reviews (Online)", "publisher": "", "place": "", "date": "2007", "volume": "", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "CD004585", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD004585.pub2", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 17443550", "tags": [ { "tag": "Biofeedback, Psychology", "type": 1 }, { "tag": "Electromyography", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Motor Skills", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Recovery of Function", "type": 1 }, { "tag": "Stroke", "type": 1 } ], "collections": [ "RSDVDJZT" ], "relations": {}, "dateAdded": "2012-10-29T20:22:02Z", "dateModified": "2012-11-01T19:55:35Z" } }, { "key": "QGKMTU22", "version": 32, "library": { "type": "group", "id": 103986, "name": "SalisburyFES", "links": { "alternate": { "href": "https://www.zotero.org/groups/salisburyfes", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/103986/items/QGKMTU22", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/salisburyfes/items/QGKMTU22", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1181961, "username": "EarlMerson", "name": "Earl Merson", "links": { "alternate": { "href": "https://www.zotero.org/earlmerson", "type": "text/html" } } }, "creatorSummary": "Shi et al.", "parsedDate": "2011-06", "numChildren": 1 }, "data": { "key": "QGKMTU22", "version": 32, "itemType": "journalArticle", "title": "Modified constraint-induced movement therapy versus traditional rehabilitation in patients with upper-extremity dysfunction after stroke: a systematic review and meta-analysis", "creators": [ { "creatorType": "author", "firstName": "Yue X", "lastName": "Shi" }, { "creatorType": "author", "firstName": "Jin H", "lastName": "Tian" }, { "creatorType": "author", "firstName": "Ke H", "lastName": "Yang" }, { "creatorType": "author", "firstName": "Yue", "lastName": "Zhao" } ], "abstractNote": "OBJECTIVE\n\nTo compare the effectiveness of modified constraint-induced movement therapy (CIMT) with traditional rehabilitation (TR) therapy in patients with upper-extremity dysfunction after stroke.\n\n\nDATE SOURCES\n\nComputerized database searches and hand-searches, as 2 main search strategies, were used to collect studies. A comprehensive search of PubMed, EMBASE, the Cochrane Library, the Chinese academic journals full-text database, the Chinese biomedical literature database, the Chinese scientific journals database, and Chinese medical association journals was conducted. Relevant journals and article reference lists were hand-searched. Meanwhile, we searched unpublished trials by using the System for Information on Gray Literature database.\n\n\nSTUDY SELECTION\n\nRandomized controlled trials (RCTs) only about modified CIMT versus TR for treatment of patients with upper-extremity dysfunction after stroke were identified in this systematic review. Participants included adults age over 18 years with a clinical diagnosis of stroke and met the inclusion criteria of modified CIMT. DATE EXTRACTION: Two reviewers extracted relevant information from included studies according to a date extraction form. The methodologic quality of the included studies was assessed using a quality-scoring instrument, which was a 5-point scale that included a description of randomization, double-blind structure, and withdrawals/dropouts.\n\n\nDATA SYNTHESIS\n\nThirteen RCTs involving 278 patients (modified CIMT/TR=143/135) were included. Meta-analysis showed that patients receiving modified CIMT showed higher scores for the Fugl Meyer Assessment (mean difference [MD]=7.8; 95% confidence interval [CI], 4.21-11.38), the Action Research Arm Test (MD=14.15; 95% CI, 10.71-17.59), the FIM (MD=7.00; 95% CI, .75-13.26), and the Motor Activity Log: Amount of Use (MD=.78; 95% CI, .37-1.19) and Quality of Use (MD=.84; 95% CI, .42-1.25) than patients in the TR group. In kinematic variables, patients receiving modified CIMT had a shorter reaction time and a higher percentage of movement time where peak velocity occurred than patients receiving TR (P<.05), while meta-analysis showed that there was no significant difference in normalized movement time (P=.99), normalized total displacement (P=.44), and normalized movement unit (P=.68).\n\n\nCONCLUSIONS\n\nThis systematic review provided fairly strong evidence that modified CIMT could reduce the level of disability, improve the ability to use the paretic upper extremity, and enhance spontaneity during movement time, but evidence is still limited about the effectiveness of modified CIMT in kinematic analysis.", "publicationTitle": "Archives of physical medicine and rehabilitation", "publisher": "", "place": "", "date": "Jun 2011", "volume": "92", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "972-982", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Arch Phys Med Rehabil", "DOI": "10.1016/j.apmr.2010.12.036", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1532-821X", "archive": "", "archiveLocation": "", "shortTitle": "Modified constraint-induced movement therapy versus traditional rehabilitation in patients with upper-extremity dysfunction after stroke", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 21621674", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Biomechanics", "type": 1 }, { "tag": "Exercise Therapy", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Occupational Therapy", "type": 1 }, { "tag": "Outcome Assessment (Health Care)", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Recovery of Function", "type": 1 }, { "tag": "Restraint, Physical", "type": 1 }, { "tag": "Stroke", "type": 1 }, { "tag": "Upper Extremity", "type": 1 } ], "collections": [ "RSDVDJZT" ], "relations": {}, "dateAdded": "2012-10-29T20:34:25Z", "dateModified": "2012-11-01T19:55:35Z" } } ]