Abstract P1-09-09: Determination of the first evidence-based diagnosis of secondary upper limb lymphedema

2015 ◽  
Author(s):  
Sharon L Kilbreath ◽  
Elizabeth S Dylke ◽  
Geoff P Schembri ◽  
Leigh C Ward ◽  
Dale L Bailey ◽  
...  
Keyword(s):  
Upper Limb ◽  
Evidence Based

The determination of correlation between stature and upper limb and hand measurements in Iranian adults

2016 ◽  
Vol 260 ◽  
pp. 27-30 ◽  
Author(s):  
S. Mahakizadeh ◽  
F. Moghani -Ghoroghi ◽  
Gh Moshkdanian ◽  
T. Mokhtari ◽  
G. Hassanzadeh
Keyword(s):  
Upper Limb

scholarly journals Evidence-based practice ‘on-the-go’: using ViaTherapy as a tool to enhance clinical decision making in upper limb rehabilitation after stroke, a quality improvement initiative

2019 ◽  
Vol 8 (3) ◽  
pp. e000592 ◽  
Author(s):  
Nicola J Hancock ◽  
Kathryn Collins ◽  
Charlie Dorer ◽  
Steven L Wolf ◽  
Mark Bayley ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Upper Limb ◽  
Stroke Rehabilitation ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Evidence Based ◽  
Improvement Project ◽  
Upper Limb Rehabilitation ◽  
Community Rehabilitation ◽  
Limb Rehabilitation

Recovery of upper limb function after stroke is currently sub-optimal, despite good quality evidence showing that interventions enabling repetitive practice of task-specific activity are effective in improving function. Therapists need to access and engage with such evidence to optimise outcomes with people with stroke, but this is challenging in fast-paced stroke rehabilitation services. This quality improvement project aimed to investigate acceptability and service impact of a new, international tool for accessing evidence on upper limb rehabilitation after stroke—‘ViaTherapy’—in a team of community rehabilitation therapists. Semi-structured interviews were undertaken at baseline to determine confidence in, and barriers to, evidence-based practice (EBP) to support clinical decision making. Reported barriers included time, lack of access to evidence and a research-practice disconnect. The clinicians then integrated use of ‘ViaTherapy’ into their practice for 4 weeks. Follow-up interviews explored the accessibility of the tool in community rehabilitation practice, and its impact on clinician confidence, treatment planning and provision. Clinicians found the tool, used predominantly in mobile device app format, to be concise and simple to use, providing evidence ‘on-the-go’. Confidence in accessing and using EBP grew by 22% from baseline. Clinicans reported changes in intensity of delivery of interventions, as rapid access to recommended doses via the tool was available. Following this work, the participating health and social care service provider changed provision of therapists’ technology to enable use of apps. Barriers to use of EBP in stroke rehabilitation persist; the baseline situation here supported the need for more accessible means of integrating best evidence into clinical processes. This quality improvement project successfully integrated ViaTherapy into clinical practice, and found that the tool has potential to underpin positive changes in upper limb therapy service delivery after stroke, by increasing accessibility to, use of and confidence in EBP. Definitive evaluation is now indicated.

scholarly journals Current therapy for the upper limb after stroke: a cross-sectional survey of UK therapists

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030262 ◽  
Author(s):  
Rachel Stockley ◽  
Rosemary Peel ◽  
Kathryn Jarvis ◽  
Louise Connell
Keyword(s):  
Upper Limb ◽  
Online Survey ◽  
Current Therapy ◽  
Future Research ◽  
Evidence Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Constraint Induced Movement Therapy ◽  
Therapy Interventions ◽  
The Uk

ObjectivesTo survey the reported content, frequency and duration of upper limb treatment provided by occupational and physiotherapists for people after stroke in the UK.DesignA cross-sectional online survey was used. Description and analysis of the data were based on items from the Template for Intervention Description and Replication (Who, Where, What and How much).SettingThe online survey was distributed via professional and social networks to UK-based therapists.ParticipantsRespondents were occupational or physiotherapists currently working clinically in the UK with people after stroke. Over the 6 week data collection period, 156 respondents opened the survey, and 154 completed it. Respondents comprised 85 physiotherapists and 69 occupational therapists.ResultsRespondents reported treating the upper limb a median of three times a week (range: 1 to 7) for a mean of 29 min (SD: 18). Most (n=110) stated this was supplemented by rehabilitation assistants, family and/or carers providing additional therapy a median of three times a week (range 1 to 7). Functional training was the most commonly reported treatment for people with mild and moderate upper limb deficits (>40%). There was much less consistency in treatments reported for people with severe upper limb deficits with less than 20% (n=28) reporting the same treatments.ConclusionsThis study provides a contemporaneous description of reported therapy in the UK for people with upper limb deficits after stroke and a detailed template to inform standard therapy interventions in future research. Several evidence-based therapies were reported to be used by respondents (eg, constraint induced movement therapy), but others were not (eg, mental imagery). The findings also highlight that the current reported provision of upper limb therapy is markedly less than what is likely to be effective. This underlines an urgent need to configure and fund services to empower therapists to deliver greater amounts of evidence-based treatment for people with upper limb deficits after stroke.

scholarly journals What is the feasibility and observed effect of two implementation packages for stroke rehabilitation therapists implementing upper limb guidelines? A cluster controlled feasibility study

2020 ◽  
Vol 9 (2) ◽  
pp. e000954
Author(s):  
Laura Jolliffe ◽  
Tammy Hoffmann ◽  
Leonid Churilov ◽  
Natasha A Lannin
Keyword(s):  
Feasibility Study ◽  
Upper Limb ◽  
Guideline Adherence ◽  
Stroke Rehabilitation ◽  
Group Differences ◽  
Evidence Based ◽  
Medical File ◽  
Group A ◽  
Group B ◽  
Implementation Package

BackgroundHand and arm activity after stroke improves with evidence-based rehabilitation. Therapists face known barriers when providing evidence-based rehabilitation and require support to implement guidelines. The aim of this study was to investigate the feasibility of two implementation packages on guideline adherence by occupational therapists and physiotherapists, and explore effect on patient upper limb outcomes.MethodThis was a non-randomised clustered feasibility study of occupational and physiotherapy rehabilitation services (n=3 inpatient and n=3 outpatient services). Services were allocated to one of three groups: (group A) facilitator-mediated implementation package, (group B) self-directed implementation package or (group C) usual care (control); we recruited n=1 inpatient and n=1 outpatient service per group. Outcomes of feasibility, adherence to guidelines (medical file audits) and patient upper limb impairment (Fugl-Meyer Upper Extremity Assessment), activity (Box and Block Test) and practice (minutes/week) were collected at baseline and after 3 months of intervention.Results29 therapists (8 in group A, 13 in groups B and 8 in group C) and 55 patients participated. Both the facilitator-mediated and the self-directed implementation packages were feasible to deliver in the rehabilitation setting. Therapists in group A improved with respect to guideline adherence (medical file audits; median within-group proportion difference of 0.29 (95% CI 0.22 to 0.36, p<0.0001) preintervention to postintervention). No significant within-group differences from baseline to postintervention were found in group B or group C, and no between-group differences were found for upper limb outcomes.ConclusionA facilitator-mediated package was acceptable to therapists working in stroke rehabilitation, and feasibility data suggest increased guideline uptake following implementation. An adequately powered study is planned to understand how to support therapists to provide evidence-based upper limb rehabilitation after stroke.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000596101).

scholarly journals Determination of the power-duration relationship in upper-limb exercises

2010 ◽  
Author(s):  
Domingos Belasco Junior ◽  
Fernando R. Oliveira ◽  
José A. N. Serafini
Keyword(s):  
Upper Limb ◽  
Duration Relationship

Effect of adding upper limb rehabilitation to botulinum toxin-A on upper limb activity after stroke: Protocol for the InTENSE trial

2018 ◽  
Vol 13 (6) ◽  
pp. 648-653 ◽  
Author(s):  
Natasha A Lannin ◽  
Louise Ada ◽  
Coralie English ◽  
Julie Ratcliffe ◽  
Maria Crotty
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Goal Attainment ◽  
Botulinum Toxin A ◽  
Phase Iii ◽  
Evidence Based ◽  
Toxin A ◽  
Movement Training ◽  
Severe Spasticity ◽  
To Receive

Rationale Although clinical practice guidelines recommend that management of moderate to severe spasticity include the use of botulinum toxin-A in conjunction with therapy, there is currently no evidence to support the addition of therapy. Aims To determine the effect and cost-benefit of adding evidence-based movement training to botulinum toxin-A. Sample size estimate A total of 136 participants will be recruited in order to be able to detect a between-group difference of seven points on the Goal Attainment Scale T-score with 80% power at a two-tailed significance level of 0.05. Methods and design The InTENSE trial is a national, multicenter, Phase III randomized trial with concealed allocation, blinded assessment and intention-to-treat analysis. Stroke survivors who are scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke greater than three months ago, who have completed formal rehabilitation and have no significant cognitive impairment will be randomly allocated to receive botulinum toxin-A plus evidence-based movement training or botulinum toxin-A alone. Study outcomes The primary outcomes are goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at three months (end of intervention) and at 12 months (beyond the intervention). Secondary outcomes are spasticity, range of motion, strength, pain, burden of care and health-related quality of life. Direct costs, personal costs and health system costs will be collected at 12 months. Discussion The results of the InTENSE trial are anticipated to directly influence intervention for moderate to severe spasticity after stroke. Trial Registration ANZCTR12615000616572.

scholarly journals An Evidence-Based Determination of Issues Affecting Quality of Life and Patient-Reported Outcomes in Lung Cancer: Results of a Survey of 660 Patients

2014 ◽  
Vol 9 (9) ◽  
pp. 1243-1248 ◽  
Author(s):  
Richard J. Gralla ◽  
Patricia J. Hollen ◽  
Pavlos Msaouel ◽  
Beverly Vincent Davis ◽  
Judith Petersen
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Patient Reported Outcomes ◽  
Evidence Based ◽  
Patient Reported

scholarly journals Examining recruitment feasibility and related outcomes in adults post-stroke

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Erin C King ◽  
Megan Doherty ◽  
Daniel Corcos ◽  
Mary Ellen Stoykov
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Intervention Study ◽  
Evidence Based ◽  
Recruitment Methods ◽  
Post Stroke ◽  
Study Enrollment ◽  
Accrual Rate ◽  
Sample Characteristics ◽  
Is Value

Abstract Background There are limited effective and evidence-based interventions for upper extremity hemiparesis post-stroke. To prepare for an RCT and minimize misuse of resources, there is value in conducting a feasibility study. Objective To examine the feasibility of recruitment and other related outcomes for an intense upper limb intervention. Methodology Feasibility outcomes included retention, adherence, accrual rate, sample characteristics, and identification of productive recruitment methods. Other outcomes included satisfaction with the study, fidelity, and equipoise of both staff and participants. Results Participants were enrolled at a rate of 1.33 per month. The recruitment timeline had to be extended by 4 months, to meet the target of 16 randomized participants. Staggered recruitment was the most successful strategy. We found that following up with individuals who missed initial appointments prior to study enrollment led to decreased adherence. Conclusion It is feasible to recruit and retain post-stroke participants for an intense intervention study. Trial registration NCT02277028

Sign in / Sign up

Export Citation Format

Share Document