Methodological Quality of Motor Intervention Randomized Controlled Trials in Stroke Rehabilitation

Did this research tell us anything useful at all? In understandable English; What the hell was the reason behind doing this and the results?
http://www.strokejournal.org/article/S1052-3057%2815%2900510-8/abstract

Amanda McIntyre, RN, and MSc

,

Nerissa Campbell, PhD

,

Julianne Vermeer, MPH

,

Rachel Mays, BSc

,

Shannon Janzen, MSc

,

Robert Teasell, MD, FRCPC

Received: July 27, 2015; Received in revised form: September 15, 2015; Accepted: September 21, 2015; Published Online: October 20, 2015

Publication stage: In Press Corrected Proof

DOI: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.09.024

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Purpose

The objective of the study was to evaluate the methodological quality of motor intervention randomized controlled trials (RCTs) published in the stroke rehabilitation literature and to examine trends in quality over time.

Methods

A systematic literature search was conducted for all English articles (published up to December 2013) examining rehabilitation for motor recovery poststroke. All RCTs with a human sample, of which at least 50% had a stroke, were included in the analysis. A Physiotherapy Evidence Database (PEDro) score was assigned to assess methodological quality. A one-way analysis of variance was conducted to examine adherence to quality items overall and over time, with post hoc t-tests performed where appropriate.

Results

Six hundred seventy-six RCTs met inclusion criteria, of which 32.0% had excellent, 42.0% good, 23.1% fair, and 3.0% poor methodological qualities. The overall mean PEDro score was 6.6 ± 1.6; with scores improving significantly between 1979-1983 and 2009-2013 (5.0 ± 1.4 versus 7.0 ± 1.5; P = .0003); however, no significant improvements in individual items were found (P > .05).

Conclusions

This study showed improvements in the total methodological quality of motor intervention RCTs in stroke rehabilitation over time.??? However, no relationship was found between individual quality items and improvement over time.

Reasoning Training in the ACTIVE Study How Much Is Needed and Who Benefits?

One of the side effects of stroke is sometimes inability to reason and see your deficits.

I would think that stroke survivors should get this type of training. You do want better reasoning after stroke, don't you? Then ask your doctor for it because your doctor won't even know about this.

Reasoning Training in the ACTIVE Study How Much Is Needed and Who Benefits?

1. Sherry L. Willis, PhD1
2. Grace I. L. Caskie, PhD2

1. ¹University of Washington, Seattle, WA, USA
2. ²Lehigh University, Bethlehem, PA, USA

1. Sherry L. Willis, PhD, Department of Psychiatry and Behavioral Sciences, University of Washington Medical School, 180 Nickerson St, Suite 260, Seattle, WA 98109, USA. Email: oldage@u.washington.edu

Abstract

Objective: To characterize change through 5-year follow-up, associated with training, booster, adherence, and other characteristics. Methods: Sample included all individuals randomly assigned to reasoning training (N = 699). Piecewise latent growth modeling was used to examine trajectory of performance on outcome measures. Results: Training resulted in improved reasoning performance through Year 5. A significant third annual booster effect was one-half the size of the training effect. Training adherence resulted in greater training effects. Higher education, Mini-Mental State Exam (MMSE), better health, and younger age related to higher baseline performance. Higher MMSE was related to larger training effects, larger linear slopes, and smaller booster effects. Significant functional outcomes included a training effect for complex reaction time (CRT), and first annual booster effects for the CRT and observed tasks of daily living. Discussion: Initial training gain was comparable with magnitude of age-related cognitive decline over 5 years with no training. Neither age nor gender predicted training or booster effects, indicating the generality of training effects across age (65-90 years).