Browsing by Person "Pomeroy, V. M."

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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.
Physiotherapy Treatment Approaches for Stroke
(2008) Pollock, A.; Baer, Gill; Langhorne, P.; Pomeroy, V. M.
There are several different approaches to physiotherapy treatment after stroke. These can broadly be divided into approaches that are based on neurophysiological, motor learning, or orthopaedic principles. Some physiotherapists base their treatment on a single approach, whereas others use a mixture of components from a number of different approaches. The practical application of these approaches can result in substantial differences in patient treatment. At present, the Bobath Approach, based on neurophysiological principles, probably remains the most widely used approach in the Western world.1-5 However, there is a lack of convincing evidence to support any specific physiotherapy treatment approach.3,6 This systematic review aims to assess the effects of physiotherapy treatment if it is based on orthopaedic, motor learning, or neurophysiological principles, or on a mixture of these treatment principles.
Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke
(The Cochrane Collaboration, 2003) Pollock, A.; Baer, Gill; Pomeroy, V. M.; Langhorne, P.; Pollock, A.
Background There are a number of different approaches to physiotherapy treatment following stroke that, broadly speaking, are based on neurophysiological, motor learning and orthopaedic principles. Some physiotherapists base their treatment on a single approach, while others use a mixture of components from a number of different approaches. Objectives To determine if there is a difference in the recovery of postural control and lower limb function in patients with stroke if physiotherapy treatment is based on orthopaedic or neurophysiological or motor learning principles, or on a mixture of these treatment principles. Search strategy We searched the Cochrane Stroke Group Trials Register (last searched May 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to May 2005), EMBASE (1980 to May 2005) and CINAHL (1982 to May 2005). We contacted experts and researchers with an interest in stroke rehabilitation. Selection criteria Randomised or quasi-randomised controlled trials of physiotherapy treatment approaches aimed at promoting the recovery of postural control and lower limb function in adult participants with a clinical diagnosis of stroke. Outcomes included measures of disability, motor impairment or participation. Data collection and analysis Two review authors independently categorised the identified trials according to the inclusion and exclusion criteria, documented their methodological quality, and extracted the data. Main results Twenty-one trials were included in the review, five of which were included in two comparisons. Eight trials compared a neurophysiological approach with another approach; eight compared a motor learning approach with another approach; and eight compared a mixed approach with another approach. A mixed approach was significantly more effective than no treatment or placebo control for improving functional independence (standardised mean difference (SMD) 0.94, 95% confidence intervals (CI) 0.08 to 1.80). There was no significant evidence that any single approach had a better outcome than any other single approach or no treatment control. Authors' conclusions There is evidence that physiotherapy intervention, using a mix of components from different approaches, is significantly more effective than no treatment or placebo control in the recovery of functional independence following stroke. There is insufficient evidence to conclude that any one physiotherapy approach is more effective in promoting recovery of lower limb function or postural control following stroke than any other approach. We recommend that future research should concentrate on investigating the effectiveness of clearly described individual techniques and task-specific treatments, regardless of their historical or philosophical origin.
Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke (Review)
(The Cochrane Collaboration, 2007) Pollock, A.; Baer, Gill; Pomeroy, V. M.; Langhorne, P.
Background There are a number of different approaches to physiotherapy treatment following stroke that, broadly speaking, are based on neurophysiological, motor learning and orthopaedic principles. Some physiotherapists base their treatment on a single approach, while others use a mixture of components from a number of different approaches. Objectives To determine if there is a difference in the recovery of postural control and lower limb function in patients with stroke if physiotherapy treatment is based on orthopaedic or neurophysiological or motor learning principles, or on a mixture of these treatment principles. Search strategy We searched the Cochrane Stroke Group Trials Register (last searchedMay 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to May 2005), EMBASE (1980 to May 2005) and CINAHL (1982 to May 2005). We contacted experts and researchers with an interest in stroke rehabilitation. Selection criteria Randomised or quasi-randomised controlled trials of physiotherapy treatment approaches aimed at promoting the recovery of postural control and lower limb function in adult participants with a clinical diagnosis of stroke. Outcomes included measures of disability, motor impairment or participation. Data collection and analysis Two review authors independently categorised the identified trials according to the inclusion and exclusion criteria, documented their methodological quality, and extracted the data. Main results Twenty-one trialswere included in the review, five ofwhichwere included in two comparisons. Eight trials compared a neurophysiological approach with another approach; eight compared a motor learning approach with another approach; and eight compared a mixed approach with another approach. Amixed approach was significantly more effective than no treatment or placebo control for improving functional independence (standardised mean difference (SMD) 0.94, 95% confidence intervals (CI) 0.08 to 1.80). There was no significant evidence that any single approach had a better outcome than any other single approach or no treatment control. Authors' conclusions There is evidence that physiotherapy intervention, using a mix of components from different approaches, is significantly more effective than no treatment or placebo control in the recovery of functional independence following stroke. There is insufficient evidence to conclude that any one physiotherapy approach is more effective in promoting recovery of lower limb function or postural control following stroke than any other approach. We recommend that future research should concentrate on investigating the effectiveness of clearly described individual techniques and task-specific treatments, regardless of their historical or philosophical origin. Plain language summary Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke Physiotherapy, using a mix of components from different treatment approaches, appears best for promoting functional independence following stroke; no single physiotherapy approach is clearly best for promoting recovery after stroke. A stroke interrupts the blood flow to the brain, often leading to damage to some brain functions. This can cause paralysis of some parts of the body or other difficulties with various physical functions. Physiotherapy is an important part of rehabilitation for people who have had a stroke. A number of physiotherapy approaches have been developed based on different ideas about how people recover after a stroke. This review of 21 trials found there is no evidence that any one approach was clearly better than another for improving leg strength, balance, walking speed or the ability to perform everyday tasks. However, physiotherapy using a mixture of components from the different approaches was better than no treatment or placebo treatment for improving aspects of function following a stroke.
Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke: a systematic review
(2007-05) Pollock, A.; Baer, Gill; Langhorne, P.; Pomeroy, V. M.
Objectives: To determine whether there is a difference in global dependency and functional independence in patients with stroke associated with different approaches to physiotherapy treatment. Data sources: We searched the Cochrane Stroke Group Trials Register (last searched May 2005), Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library Issue 2, 2005), MEDLINE (1966 to May 2005), EMBASE (1980 to May 2005) and CINAHL (1982 to May 2005). We contacted experts and researchers with an interest in stroke rehabilitation. Review methods: Inclusion criteria were: (a) randomized or quasi-randomized controlled trials; (b) adults with a clinical diagnosis of stroke; (c) physiotherapy treatment approaches aimed at promoting postural control and lower limb function; (d) measures of disability, motor impairment or participation. Two independent reviewers categorized identified trials according to the inclusion/exclusion criteria, documented the methodological quality and extracted the data. Results: Twenty trials (1087 patients) were included in the review. Comparisons included: neurophysiological approach versus other approach; motor learning approach versus other approach; mixed approach versus other approach for the outcomes of global dependency and functional independence. A mixed approach was significantly more effective than no treatment control at improving functional independence (standardized mean difference (SMD) 0.94, 95% confidence interval (CI) 0.08 to 1.80). There were no significant differences found for any other comparisons. Conclusions: Physiotherapy intervention, using a 'mix' of components from different 'approaches' is more effective than no treatment control in attaining functional independence following stroke. There is insufficient evidence to conclude that any one physiotherapy 'approach' is more effective in promoting recovery of disability than any other approach.