Browsing by Person "Choo, P-L"

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A new taxonomy of current physiotherapy treatment approaches, developed with a stakeholder group, enables clinically relevant evidence synthesis within a Cochrane systematic review.
(Wiley, 2013-12) Baer, Gill; Campbell, P.; Morris, J.; Choo, P-L; Forster, A.; Pollock, A.
Introduction:-Clear, clinically relevant taxonomies of complex rehabilitation interventions are essential to enable objective evidence synthesis within systematic reviews. Classifications of current physiotherapy treatment approaches are generally inadequately defined, difficult to apply objectively, and lack universal international acceptance or interpretation. We aimed to determine an internationally, clinically relevant taxonomy of physiotherapy treatment approaches using language and terminology agreed by physiotherapists and stroke survivors. Method:-We systematically extracted descriptions of physiotherapy approaches from the trials currently included in the Cochrane review, and from foreign-language trials listed as 'awaiting assessment'. We convened a stakeholder group, comprising 13 purposively selected stroke survivors, carers and physiotherapists. Nominal group techniques were used to reach consensus decisions. The group debated the treatment components described within the trials of physiotherapy approaches, reached consensus on key types of intervention components, agreed descriptions of components and determined categorisation for synthesis of evidence within an update of a Cochrane review. Results:-84% of the stakeholder group agreed that the current categories were no longer clinically relevant. 27 intervention components were identified and described from the intervention components described within 31 trials. These were grouped into categories of: functional task training, musculoskeletal intervention (active), musculoskeletal intervention (passive), neurophysiological intervention, cardiopulmonary interventions, assistive devices and modalities. 100% of the stakeholder group agreed with these intervention component descriptions and categories. Conclusion:-A clinically relevant taxonomy of physiotherapy intervention components has been agreed, and will be used to categorise evidence within a major update of a Cochrane systematic review of physiotherapy treatment approaches.
Challenges in integrating international evidence relating to stroke rehabilitation: experiences from a Cochrane systematic review
(Wiley, 2014-12) Pollock, A.; Campbell, P.; Baer, Gill; Choo, P-L; Forster, A.; Morris, J.; Pomeroy, V. M.; Langhorne, P.
There are many randomized controlled trials relating to stroke rehabilitation being carried out in China, which are often published in Chinese-language journals. A recent update to our Cochrane systematic review of physical rehabilitation to improve function and mobility after stroke included 96 trials; over half (51) were conducted in China; 37 of these included studies were published in Chinese. Analyses within this Cochrane review support the conclusion that physical rehabilitation, using a mix of components from different approaches, is effective for the recovery of function and mobility after stroke. The inclusion of the Chinese studies had a substantial impact on the volume of evidence and, consequently, the conclusions. In this paper, we explore whether it is appropriate to draw implications for clinical practice throughout the world from evidence relating to a complex rehabilitation intervention delivered within one particular geographical healthcare setting. We explore the unique challenges associated with incorporating the body of evidence from China, particularly the Chinese-language publications, and identify the ongoing debate about the quality of Chinese research publications. We conclude that the growing body of evidence from China has important implications for future systematic reviews and evidence-based stroke care, but analysis and interpretation raise challenges, and improved reporting is critical.
Content of physical Rehabilitation interventions: Can we generalise from Chinese trials to other geographical regions?
(Wiley, 2014-11) Pollock, A.; Baer, Gill; Campbell, P.; Choo, P-L; Langhorne, P.; Morris, J.; Pomeroy, V. M.; Forster, A.
Physical rehabilitation approaches for the recovery of function and mobility following stroke
(The Cochrane Collaboration, 2014-04-22) Pollock, A.; Baer, Gill; Campbell, P.; Choo, P-L; Forster, A.; Morris, J.; Pomeroy, V. M.; Langhorne, P.
Physical rehabilitation approaches for the recovery of function and mobility following stroke. A major update.
(2014-10) Pollock, A.; Baer, Gill; Campbell, P.; Choo, P-L; Forster, A.; Morris, J.; Pomeroy, V.; Langhorne, P.
Objectives We aimed to determine whether physical rehabilitation approaches are effective in recovery of function and mobility in people with stroke, and to assess whether any one physical rehabilitation approach is more effective than any other approach. Methods A stakeholder group, comprising stroke survivors, caregivers, and physiotherapists, made decisions using consensus-making techniques relating to the scope and focus of this updated review.1 We performed a comprehensive search (to December 2012),1 including randomized controlled trials of physical rehabilitation approaches in adult stroke survivors. Interventions comprised a range of philosophically different approaches to promote recovery of function or mobility. Randomized controlled trials of single specific treatments were excluded. Outcomes analyzed were independence in activities of daily living, motor function, balance, gait, and length of stay. Two reviewers independently applied selection criteria, assessed risk of bias and extracted data. We calculated standardized mean differences (SMD) using a random effects model.