A new taxonomy of current physiotherapy treatment approaches, developed with a stakeholder group, enables clinically relevant evidence synthesis within a Cochrane systematic review.

Abstract

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.