ATRAS

Work Package 2

Published Evidence

AT Definition

An AT is a mechanical or electrical

device used in a functional task

orientated training process which will

have a systemic or rehabilitative

effect on the person.

WP Progress

• Searched databases• Initial Screening Audited• Developed Website Forms• Allocated Papers• Inter-Library Loans• Share point import data

Access Excel• Spreadsheets for ‘Agreeing Score’

Databases searched

AMED,CINAHL, Cochrane Library

including DARECSA Illumina, EMBASE,MEDLINEPsycInfo,Web of Science,

PeDRo COMPENDEXINSPEC

RECAL Legacy

CIRRIE, REHABDATA

National Research Register (clinical trials),

Reports from professional bodies (RCP Guidelines, CSP),

Papers for scoring

763Screening checked by

2nd reviewer

2424Titles found

464Accepted

95 Review papers

299Rejected

1361Failed

selection criteria

369 Research papers

Initial Screening

Study DesignsLevel Type of Study Number of

Studies

1Case studies or single system study design 95

2

Quasi-controlled studies (same sample repeated measure design) 112

3Quasi-controlled studies (independent sample design)

33

4

Randomised controlled study design (not powered or powered below 80% and 0.05 significance level)

78

RCTs & Quasi-Controlled studies

Technology Level 4 Level 3

BF 3 5CIT 23 3ES 25 9R 11 5

TMS 5 0Trig EMG 6 5

VR 1 1

CPM 1 0CS 2 3

Splint+Btx 1 1

ATs, Joints & Design

BF CIT CS ES ES tr R TMS VR Splint& Btx

0

5

10

15

20

25

UL-4UL-3Sh-4Sh-3E-4E-3W/H-4W/H-3

Review Paper Assessment

Review Paper Assessment

• CRD Guidance

• PeDRo

• DARE

• PRISMA

Review Paper

Assessment

1. Is the purpose of the review clearly defined? 2. Type of review paper 3. Peer reviewed 4. Were search terms reported? 5. Were search terms comprehensive? 6. Was the search strategy reported? 7. Was the search strategy satisfactory? 8 . Were relevant databases searched? 9. No papers excluded on basis of language? 10. Unlimited search timeframe? 11. How many reviewers independently reviewed each paper? 12. How was the validity of studies assessed? 13. Name lowest quality of studies retained for data extraction? 14. Was raw data extracted from papers and/or the research team?15. Was a meta-analysis carried out?16. Were study details synthesised and summarised?

RPA Results

95 Review papers

1 Duplicate

2 Non-English

15 Experimemtal not Review papers

77 Review papersScored

Scored with Van tulder24 Metanalysis

Meta-analysisWoodford HJ; Price CIM

EMG biofeedback for the recovery of motor function after stroke Nov2005

Pomeroy VM; King LM; Baily-Hallam A; Langhorne P

Electrostimulation for promoting recovery of movement or functional ability after stroke (Review) Jan 2004

Mehrholz J; PlatzT; Kugler J; Pohl M

Electromechanical and robot-assisted arm training forimproving arm function and activities of daily living afterstroke (Review) Oct 2007

Price, CIMElectrical stimulation for preventing and treating post-stroke shoulder pain: a systematic Cochrane review Dec1999

Brosseau, L - The Ottawa Panel

Ottawa Panel evidence-based clinical practice guidelines for post-stroke rehabilitation Dec2004

Ada, LStrengthening interventions increase strength and improve activity after stroke: a systematic review Jan 2005

77 Review papersScored

Score Number

12 6

11 5

10 3

9 4

8 3

7 5

≤6 51

van Tulder Scoring

van Tulder Scoring

• Reviewer Name *• Reviewer Order *• Author Name *• Title of article *• Year *• Ref Works ID *

1. Were the eligibility criteria specified?

2. Was a method of randomization performed?

3. Was treatment allocation concealed?

4. Were prognostic indicators similar for groups at baseline?

5.Were the index & control interventions explicitly described?

6. Was the care provider blinded to the intervention?

7.Were co-interventions avoided or comparable?

8. Was the compliance reported in all groups?

9. Was the patient blinded to the intervention?

10.Was the outcome assessor blinded to the intervention?

11.Were the outcome measures relevant?

12.Were adverse effects described?

13.Was the withdrawal/drop-out rate described?

14.Was a short-term follow-up measurement performed?

15.Was a long-term follow-up measurement performed?

16.Was timing comparable for outcome assessment in both groups?

17.Was the sample size for each group described?

18.Did the analysis include an intention-to-treat analysis?

19.Was the variability given for primary outcome measures?

Reviewer's Remarks *

Van Tulder Update

369 +15 papers require 384 agreed scores

41 + 33 = 74 Agreed Scores

542 completed forms

45 same score with out discussion

154 single reviews

Tasks

• Complete van Tulder Screening

• Screen and review updates

• Prepare data extraction form

• WP2 –Data extraction familiarization meeting (wb May 17th at Keele)

Data Extraction

Treatment related• Impairment or Activity

– Odds Ratio (OR)– Effect Size

• Adverse events (OR)• Complexity

– Duration (set up / treatment)

– Frequency– Expertise

Stroke related• Time• Severity• L:R

Tasks 2

• Audit van Tulder Process

• Check Cochrane database and clinical trials register

• Complete data extraction –July/August

• Prepare Report / Matrix for Sept meeting

Join us in May

Thanks For Reviewing