Evidence for your Practice: Improving Upper Limb Function Poststroke

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Article for review:

Wattchow, K.A., McDopnnell, M.N., & Hillier, S.L. (2018). Rehabilitation interventions for upper limb function in the first four weeks following stroke: A systematic review and meta-analysis of the evidence. Archives of Physical Medicine and Rehabilitation, 99(2), 367-82. doi: 10.1016/j.apmr.2017.06.014

This systematic review investigates the evidence for a range of interventions for upper limb (UL) function in adults within 4 weeks poststroke.  The review included “any physical therapy (PT) or occupational therapy (OT) technique designed to address impairment and/or activity of the affected UL after stroke,” but did not distinguish between interventions in evaluating efficacy for intervention.

Conclusion:

Meta-analyses revealed support for modified constraint-induced movement therapy (mCIMT) and task-specific training in improving UL functional outcomes.  The review also suggests biofeedback and electrical stimulation are useful as supplementary therapies to support UL rehabilitation poststroke.  On the other hand, the review discourages using Bobath therapy.  Insufficient evidence was found to either support or refute other OT/PT interventions (air splints, bilateral arm training, circuit class therapy, somatosensory interventions, Kinesio Tape, mechanical arm trainer, medication, mirror box therapy, music therapy passive movement, reflex inhibiting/immobilization, robotics, shoulder strapping/orthosis, static positional strength training, and virtual reality training/video gaming). 

Read the abstract

Post by Alana Marshall, fieldwork student with CAOT-BC

#OT365

Evidence for your Practice: Repetitive task training for improving functional ability after stroke

Article for Review: French, B., Thomas, L.H., Coupe, J., et al. (2016). Repetitive task training for improving functional ability after stroke. Cochrane Database of Systematic reviews, 11

This systematic review included 33 trials with a total of 1853 participants. This study reviewed randomised and quasi-randomised trials in adults after stroke, with an intervention of single session training with active motor sequences that were administered repetitively. The purpose of the review was to examine if repetitive task training (RTT) improved  functional physical ability in patients who had had a stroke.

Conclusion: The systematic review found low to moderate quality evidence that repetitive task training improves upper and lower limb function. It also showed that improvements in function were maintained up to six months after treatment.

Read abstract here

By Christl Bradley, fieldwork student with CAOT-BC

Evidence for you Practice: Early or delayed provision of AFO in patients with stroke

Article for review:

Nikamp, C. D., Buurke, J. H., van der Palen, J., Hermens, H. J., & Rietman, J. S. (2016). Early or delayed provision of an ankle-foot orthosis in patients with acute and subacute stroke: A randomized controlled trial. Clinical Rehabilitation.

This randomized control trial evaluated early (at inclusion) and delayed provision (eight weeks later) of ankle-foot orthosis for patients with acute and subacute stroke.

Conclusions: Researchers found positive effects of providing ankle-foot orthoses in (sub)acute stroke subjects that had not used these orthoses before, regardless of early or delayed provision.

Access abstract here

CAOT-BC Neurology Practice Network Meeting: November 30, 2016

Topic:Cognition and the Brainwave Approach, Part 2. This session will include a review of Part 1 for those who did not attend the previous meeting. 

This meeting will take place by webinar. Registration is required to participate.

Date: November 30, 2016

Time: 4:30pm – 5:30pm Pacific Time

Location: Webinar

Registration: https://www.caot.ca/store/events/registration.aspx?event=SIG26OCT16

Cost:

Free for CAOT-BC members

$15 for non-members

Registration takes only a minute in a few easy steps:

1. Click on registration link
2. Log in to your profile
3. Click "Register"
4. Click "Add to Cart"
5. Click "My Cart"
6. Click "Pay Now"
7. Click "Place Order"

You will receive a confirmation letter immediately after completing your online registration. Please check your spam/junk box, as sometimes these letters can be filtered out of regular email. If you still do not receive a confirmation after completing all the steps, please email caotbc@caot.ca for additional support.

If you have any questions please contact Sarabjeet Charchun 

Evidence for your Practice: Additional Weekend Therapy and Average Length of Stay in an Inpatient Rehabilitation Setting

Article for Review

English, C., Shields, N., Brusco, N.K., et al. (2016). Additional weekend therapy may reduce length of rehabilitation stay after stroke: A meta-analysis of individual patient data. Journal of Physiotherapy 62(3), 124-129.

This individual patient data meta-analysis aimed to investigate the effectiveness of providing additional weekend therapy services (PT and/or OT) to people with stroke, compared to usual care in an inpatient rehabilitation setting. Pooled analysis was completed for two randomized controlled trials, one in which participants received additional therapy on Saturdays, and another in which participants received additional therapy on Saturdays and Sundays.

Conclusion:

Unadjusted pooling of individual patient data from existing trials does not identify a significant improvement in length of stay. When the analyses were adjusted for important patient-related factors and hospital site, there was significantly shorter average length of stay in the rehabilitation hospital for people receiving additional weekend therapy.

Access the full text article here.

Upcoming Special Interest Group Meetings: Neurology & IEOT

CAOT-BC Neurology Special Interest Group Meeting

Topic:Cognition and the Brainwave Approach, Part 2. This session will include a review of Part 1 for those who did not attend the previous meeting. 

This meeting will take place by webinar. Registration is required to participate.

Date: September 21st, 2016

Time: 4:30pm – 5:30pm Pacific Time

Location: Webinar

Registration: https://www.caot.ca/store/events/registration.aspx?event=SIG21SEP16

Cost:

Free for CAOT-BC members

$15 for non-members

Registration takes only a minute in a few easy steps:

1. Click on registration link
2. Log in to your profile
3. Click "Register"
4. Click "Add to Cart"
5. Click "My Cart"
6. Click "Pay Now"
7. Click "Place Order"

You will receive a confirmation letter immediately after completing your online registration. Please check your spam/junk box, as sometimes these letters can be filtered out of regular email. If you still do not receive a confirmation after completing all the steps, please email caotbc@caot.ca for additional support.

If you have any questions please contact Sarabjeet Charchun

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CAOT-BC IEOT Practice Network Meeting 

Topic: Substantial Equivalency Assessment System (SEAS) Q&A

ACOTRO SEAS Credentialing Officer Ruheena Sangrar will be available to answer your questions about the SEAS.

Submit question(s) ahead of time, or join the session with your question(s) in mind. 

Please note, a SEAS Frequently Asked Questions (FAQ) page is also available. 

This meeting will take place by webinar. Registration is required to participate.

Date: September 19th, 2016

Time: 9:00am - 10:00am Pacific Time

Location: Webinar

Registration: https://www.caot.ca/store/events/registration.aspx?event=SIG19SEP16

Cost:

Free for CAOT-BC members

$15 for non-members

Registration takes only a minute in a few easy steps:

1. Click on registration link
2. Log in to your profile
3. Click "Register"
4. Click "Add to Cart"
5. Click "My Cart"
6. Click "Pay Now"
7. Click "Place Order"

You will receive a confirmation letter immediately after completing your online registration. Please check your spam/junk box, as sometimes these letters can be filtered out of regular email. If you still do not receive a confirmation after completing all the steps, please email caotbc@caot.ca for additional support.

If you have any questions please contact Sarah Slocombe: sslocombe@caot.ca

Evidence for your Practice: Evaluating a Task-Oriented Rehabilitation Program

Article for review:

Winstein CJ, Wolf SL, Dromerick, AW, et al. (2016). Effect of a task-oriented rehabilitation program on upper extremity recovery following motor stroke: The ICARE randomized clinical trial. Journal of American Medical Association, 315(6): 571-581. doi: 10.1001/jama/2016.0276.

This randomized clinical trial compared a structured, task-oriented motor training program versus usual and customary occupational therapy of equivalent or lower dose.

Conclusion: 

For those with motor stroke and upper extremity impairment, a structured, task-oriented rehabilitation program did not significantly improve motor function or recovery beyond usual occupational therapy rehabilitation.

Access the full text article here.

Neurology SIG: May 18th, 2016

TOPIC: Cognition and the Brain Wave Approach

This meeting will take place by teleconference. Registration is required to participate.

Date: May 18th, 2016

Time: 4:00pm – 5:00pm Pacific Time

Location: Teleconference

Registration: https://www.caot.ca/store/events/registration.aspx?event=SIG18MAY16

Cost:

Free for CAOT-BC members

$15 for non-members

Registration takes only a minute in a few easy steps:

1. Click on registration link
2. Log in to your profile
3. Click "Register"
4. Click "Add to Cart"
5. Click "My Cart"
6. Click "Checkout"
7. Click "Place Order"

You will receive a confirmation letter immediately after completing your online registration. Please check your spam/junk box, as sometimes these letters can be filtered out of regular email. If you still do not receive a confirmation after completing all the steps, please email caotbc@caot.ca for additional support.

If you have any questions please contact Sarabjeet Charchun at: Sarabjeet.Charchun@fraserhealth.ca

Neurology SIG Meeting: February 24, 2016

What:
Neurology Special Interest Group Meeting


Topic/Guest: 
Article Review and 2016 Planning

When:  

February 24, 2016
5:00pm-6:30pm

Where:

Teleconference

Cost: $15 (Free for members)

RSVP:  

Online Registration Required

How to register:

1. Click on registration link
2. Log in to your profile
3. Click "Register"
4. Click "Add to Cart"
5. Click "My Cart"
6. Click "Checkout"
7. Click "Place Order"

Evidence for your Practice: Stroke Rehabilitation

Photo credit: EUSKALANATO/ photo on Flickr

Evidence-Based Review of Stroke Rehabilitation offers an up-to-date, comprehensive review of literature to support best practice in stroke rehabilitation.

Resources include:

• Review of over 2000 studies synthesized into helpful chapters, including Upper Extremity Interventions and Perceptual Disorders
• Clinician’s Handbook with detailed reviews of assessments and interventions
• Education modules which allow clinicians to test themselves on the material included in the chapters

Access these resources here.

CAOT-BC Neurology SIG Meeting: February 25

When:  

February 25, 2015
430pm-530pm

Where:

Surrey Memorial Hospital &
Teleconference

RSVP:  

Email CAOT-BC directly to register: caotbc@caot.ca 

Cost: $15

Free for CAOT-BC members