Browsing by Person "Morris, J."

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A Comparison of Bilateral and Unilateral Upper-Limb Task Training in Early Poststroke Rehabilitation: A Randomized Controlled Trial
(2008-07) Morris, J.; van Wijck, Frederike; Joice, S.; Ogston, S. A.; Cole, I.; MacWalter, R. S.
Morris JH, van Wijck F, Joice S, Ogston SA, Cole I, MacWalter RS. A comparison of bilateral and unilateral upper-limb task training in early poststroke rehabilitation: a randomized controlled trial. Objective: To compare the effects of bilateral task training with unilateral task training on upper-limb outcomes in early poststroke rehabilitation. Design: A single-blinded randomized controlled trial, with outcome assessments at baseline, postintervention (6wk), and follow-up (18wk). Setting: Inpatient acute and rehabilitation hospitals. Participants: Patients were randomized to receive bilateral training (n=56) or unilateral training (n=50) at 2 to 4 weeks poststroke onset. Intervention: Supervised bilateral or unilateral training for 20 minutes on weekdays over 6 weeks using a standardized program. Main Outcome Measures: Upper-limb outcomes were assessed by Action Research Arm Test (ARAT), Rivermead Motor Assessment upper-limb scale, and Nine-Hole Peg Test (9HPT). Secondary measures included the Modified Barthel Index, Hospital Anxiety and Depression Scale, and Nottingham Health Profile. All assessment was conducted by a blinded assessor. Results: No significant differences were found in short-term improvement (0-6wk) on any measure (P>.05). For overall improvement (0-18wk), the only significant between-group difference was a change in the 9HPT (95% confidence interval [CI], 0.0-0.1; P=.05) and ARAT pinch section (95% CI, 0.3-5.6; P=.03), which was lower for the bilateral training group. Baseline severity significantly influenced improvement in all upper-limb outcomes (P<.05), but this was irrespective of the treatment group. Conclusions: Bilateral training was no more effective than unilateral training, and in terms of overall improvement in dexterity, the bilateral training group improved significantly less. Intervention timing, task characteristics, dose, and intensity of training may have influenced the results and are therefore areas for future investigation. 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.
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.
PATSy: a multimedia distributed web-base resource for aphasiologists in research and education.
(Psychology Press, 1999) Lum, C.; Cox, R.; Kilgour, J.; Morris, J.; Tobin, R.
This paper describes PATSy, a distributed, multimedia system designed to be a repository of patient cases and their test data. PATSy will initially consist of adult aphasia cases, though it can eventually accommodate test data from a variety of neurological and non-neurological adult and child cases. The genetic aspects of PATSy also allow it to accept test data from various disciplines. Authorized users will have passwords to allow them to access PATSy via the internet. The development of PATSy addresses several challenges in research and education. These include archiving data from rare and unusual cases, limiting loss of data, improving opportunities for data re-utilization by other researchers, and forging more direct and transparent links between research and education. Users will have access to raw test data of patients reported by researchers. Above all, the structure and design of PATSy is highly suited to case-based learning, though other methods of teaching are also accommodated.
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.
Physiotherapy treatment approaches following stroke: major update of Cochrane systematic review of evidence
(Wiley, 2013-12) Pollock, A.; Campbell, P.; Morris, J.; Forster, A.; Pomeroy, V.; Langhorne, P. P.; Baer, Gill
Introduction:-Physiotherapists traditionally base stroke rehabilitation practice on global 'approaches' (e.g. Bobath and Motor Learning approaches). A 2007 Cochrane systematic review explored the effect of different physiotherapy approaches for stroke, but failed to include all foreign-language (particularly Chinese) trials. We aim to update this Cochrane review, restructuring to incorporate all current international evidence relating to effectiveness of physiotherapy treatment approaches. Method:-Our Cochrane review update is based on searches of electronic databases (including CENTRAL, MEDLINE, EMBASE, CINAHL, AMED) from 2005-December 2012. Foreign-language abstracts have been translated. Two independent reviewers applied selection criteria with disagreements resolved by a third reviewer. Two review authors will independently categorise the interventions within identified trials, document methodological quality, and extract data. Cochrane risk of bias tool will be used to assess methodological quality. Data from included studies will be pooled within meta-analyses, calculating standardised mean differences and 95% confidence intervals, using a random-effects model, for disability, motor impairment and participation outcomes. Results:-(June 2013) We considered 11,576 titles, screened 592 abstracts and included 75 new RCTs (n-=-896, plus 13 awaiting assessment). 49/75 RCTs were completed in China. 38/75 RCTs compare a physical rehabilitation approach with no rehabilitation. Our updated review synthesises evidence from 95 trials (n-=-10,048). Data extraction is ongoing and meta-analyses will be completed by October 2013. Conclusion:-This major Cochrane review update substantially increases the volume of evidence, with trials including over 10,000 participants, providing the most comprehensive, up-to-date synthesis of international evidence relating to the effect of physiotherapy treatment approaches after stroke.
Simultaneous bilateral training for improving arm function after stroke
(Wiley, 2009) Coupar, Fiona; van Wijck, Frederike; Morris, J.; Pollock, A.; Langhorne, P.
This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the effects of simultaneous bilateral training for improving arm function after stroke compared with: (1) usual care; (2) other specific upper limb interventions or programmes; (3) placebo or no intervention. Questions to be answered (1) Is simultaneous bilateral training more effective at improving arm function than usual care, in patients with upper limb impairment after stroke? (2) Is simultaneous bilateral training more effective at improving arm function than other specific upper limb interventions or programmes, in patients with upper limb impairment after stroke? (3) Is simultaneous bilateral training more effective at improving arm function than placebo or no intervention in patients with upper limb impairment after stroke?
Using the nominal group technique to engage stakeholders with experience of stroke in a Cochrane systematic review of physiotherapy treatment approaches.
(Wiley, 2013-12) Campbell, P.; Baer, Gill; Morris, J.; Forster, A.; Pollock, A.
Introduction:-It has been recommended that people affected by a healthcare condition are actively involved in systematic reviews; ensuring completed reviews are clinically relevant. We aimed to engage stroke survivors, carers and physiotherapists in a Cochrane systematic review of physiotherapy treatment approaches for patients with stroke. Method:-We convened a stakeholder group, comprising 13 purposively selected stroke survivors, carers and physiotherapists. Nominal group techniques were used to reach consensus decisions around review aims and methods, focusing on clinical relevance. The group specifically discussed the categorisation of interventions and inclusion of evidence from a number of international trials, and voted on two key statements: A.-The current categories are appropriate and clinically relevant-; B.-These international trials should be included in our review of physiotherapy treatment approaches-. The proportion agreeing with each statement was determined. Consensus decision meetings were audio-recorded and transcribed verbatim. Qualitative data were coded and analysed using NVivo software. Results:-84% of group members disagreed with statement A. 100% agreed with statement B. Two key themes, and several sub-themes, emerged from transcribed data. Key themes were: (1) current intervention categories should be amended to enable inclusion of all international evidence; (2) there are limitations with current physiotherapy taxonomies and concerns surrounding the relevance to clinical practice in the UK. Conclusion:-Involving key stakeholders in a Cochrane systematic review of physiotherapy treatment approaches for patients with stroke has influenced decisions around the scope and format of the review, and ensured relevance and accessibility of the output.