ATRAS Work Package 2 Published Evidence. AT Definition An AT is a mechanical or electrical device used in a functional task orientated training process.

ATRASATRAS

Work Package 2Work Package 2Published EvidencePublished Evidence

AT DefinitionAT Definition

An AT is a mechanical or electrical An AT is a mechanical or electrical

device used in a functional task device used in a functional task

orientated training process which will orientated training process which will

have a systemic or rehabilitative have a systemic or rehabilitative

effect on the person. effect on the person.

North o’ the BorderNorth o’ the Border

• GlasgowGlasgow– Peter LanghornePeter Langhorne– Fiona CouparFiona Coupar– Phil Rowe Phil Rowe – Alex PollackAlex Pollack

• EdinburghEdinburgh– Peter SandercockPeter Sandercock– Sarah KeirSarah Keir– Malcolm MacLeodMalcolm MacLeod– Charles WarlowCharles Warlow– et alet al

SearchingSearching

MeSH : Stroke or MeSH : Stroke or stroke (text)stroke (text)

MeSH : Upper extremity or ‘upper extremity’(Text)Upper limb*Arm*Hand*Shoulder*Elbow*Wrist*Finger*Thumb*

Assistive TechnologiesAssistive TechnologiesCast*Orthot*Orthos*Splint* Dynamic devices“Contracture Correction Device” OR CCD

Electric* Stimulat*FES or ‘Functional Electrical Stimulation’ESENS or ‘electrical neuromuscular stimulation’IFT or “Inferential Therapy”“Cortical Stim*”“Transcranial Magnetic Stimulation” or TMS

Electro* Mech*Robo*

CIMT mitt “Constraint induced”

OR “Forced Use”

CPM or ‘continuous passive movement’ or ‘continuous passive motion’

Biofeedback or Bio feedback

“Virtual Reality” or VR or “Wii”

DatabasesDatabases

AMED,AMED,

CINAHL, CINAHL,

CochraneCochrane

CSA Illumina, CSA Illumina,

EMBASE,EMBASE,

MEDLINEMEDLINE

PsycINFO,PsycINFO,

Web of Science, Web of Science,

PEDRo

RECAL Legacy

CIRRIE, REHABDATA

COMPENDEX

INSPEC

National Research Register (clinical trials)

Reports from professional bodies (RCP Guidelines, CSP)

Dissertation Abstracts, Conference proceedings.

Further searchesFurther searches

• Check search terms against Check search terms against Cochrane terms especially for StrokeCochrane terms especially for Stroke

• Check additional databasesCheck additional databases– www.clinical trials.govwww.clinical trials.gov– www.strokecenter.org

Cochrane Stroke Group Cochrane Stroke Group

• Topic termsTopic terms

• Registered Registered – TitlesTitles– ProtocolsProtocols– ReviewsReviews

Data ExtractionData Extraction

• Initial ScreeningInitial Screening

• Van Tulder CriteriaVan Tulder Criteria

• Clinical RelevanceClinical Relevance

• Data ExtractionData Extraction

• Review papersReview papers

Focussing Data Focussing Data ExtractionExtraction

• Reduce data to be extractedReduce data to be extracted

• Create form for data entryCreate form for data entry

• Paper copy Paper copy

Not only Not only but alsobut also

Scientific rationaleScientific rationalePathophysiology and Pathophysiology and

Treatment Treatment

Recovery Recovery or or

CompensationCompensation

Outcome measuresOutcome measuresImpairmentImpairmentActivity LimitationActivity LimitationParticipationParticipation

Functional ThresholdFunctional Threshold

Inter-rater AgreementInter-rater Agreement

TimetablingTimetabling

WP2 - Literature review09Q1 Q2 Q3 Q4

10Q1 Q2 Q3 Q4

11Q1 Q2 Q3 Q4

Planning the review                        

Conducting the searches                        

Selection of articles                        

Review process                        

Peer review by management team                        

Audit of article selection                        

Audit of reviewed articles                        

Updating of reviews                        

Publication of systematic reviews                        

Reports      20/11/2009      

20/11/2010

01/03/2011    

20/11/2010

Revised PlanRevised Plan

• Initial ScreeningInitial Screening– Project Coordinator and WP2 Lead Project Coordinator and WP2 Lead

• Van Tulder SheetVan Tulder Sheet– All reviewersAll reviewers

• Selection of Review PapersSelection of Review Papers– Project Coordinator and WP2 Lead Project Coordinator and WP2 Lead

• Data extractionData extraction– Project Coordinator and WP2 Lead Project Coordinator and WP2 Lead

Auditing our ProcessAuditing our Process

Planning for WP4Planning for WP4

• Review findingsReview findings

• Conference proceedings (delegate this Conference proceedings (delegate this PG/UG student)PG/UG student)

• Ongoing Trials (from clinical trials Ongoing Trials (from clinical trials register)register)

Matrix to help with WP4Matrix to help with WP4

Can have the following layers...Can have the following layers...• Levels of evidenceLevels of evidence• ICF (aims of treatment)ICF (aims of treatment)• Ongoing Trials (from clinical trials Ongoing Trials (from clinical trials

register) + Conferenceregister) + Conference• Severity of strokeSeverity of stroke• Time post strokeTime post stroke• JointJoint• ATAT

THANK YOUTHANK YOU