Enquiry 1 - Oral Presentation (1)
Transcript of Enquiry 1 - Oral Presentation (1)
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HLT2IEP -Introduction toEvidence Base
Practice
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Outline
1. Research question
2. Search strategy
3. Categorisation of literature
4. Answer from the evidence
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Research Question
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Dostroke patientsusing ankle foot orthosedecreased energy expenditure comparedthose who dont use orthotic devices?
P- Stroke Patients
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Dostroke patientsusing ankle foot orthosedecreased energy expenditure comparedthose who dont use orthotic devices?
P- Stroke Patients
IAnkle Foot Orthoses
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Dostroke patientsusing ankle foot orthosedecreased energy expenditure comparedthose who dont use orthotic devices?
PStroke Patients
IAnkle Foot Orthoses
CNo AFO use
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Dostroke patientsusing ankle foot orthosedecreased energy expenditure comparedthose who dont use orthotic devices?
PStroke Patients
IAnkle Foot Orthoses
CNo AFO useOLess Energy Expenditure
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Databases
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Cochrane Library
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CINAHL
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Medline
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Scopus
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EMBASE
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ProQuest
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Search Strategy
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Person - Stroke Patients
Stroke Synonyms:
Cerebrovascular accident or insult
CVA or CVI
Hemiplegia
Hemiparesis
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Person - Stroke Patients
Stroke Synonyms:
Cerebrovascular accident or insult
CVA or CVI
Hemiplegia
Hemiparesis
cerebro?vascular
CVA OR CVI
hemip*
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Person - Stroke Patients
Stroke Synonyms:
Cerebrovascular accident or insult
CVA or CVI
Hemiplegia
Hemiparesis
cerebro?vascular
CVA OR CVI
hemip*
Search strategy: stroke OR cerebro?vascular OR CVA OR CVI OR hem
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Intervention - AFO use
AFO Synonyms:
AFOs
Ankle foot orthosis
Ankle foot orthoses
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Intervention - AFO use
AFO Synonyms:
AFOs
Ankle foot orthosis
Ankle foot orthoses
AFO*
ankle?foot orthos*
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Intervention - AFO use
AFO Synonyms:
AFOs
Ankle foot orthosis
Ankle foot orthoses
AFO*
ankle?foot orthos*
Search strategy: AFO* OR ankle?foot orthos*
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Outcome - Less Energy Expend
Energy Synonyms:
Calorie
Calories
Cal
Joule
KilojouleOxygen
Oxidise
Expenditure Synonyms:
Expend
Lost
Cost
Wastage
ConsumptionDepletion
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Outcome - Less Energy Expend
Energy Synonyms:
Calorie
Calories
Cal
Joule
KilojouleOxygen
Oxidise
calorie*
cal*
*joule*
ox*
Expenditure Synonyms:
Expend
Lost
Cost
Wastage
ConsumptionDepletion
expend
los*
cost*
wast*
consumdeplet*
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Outcome - Less Energy Expend
Energy Synonyms:
Calorie
Calories
Cal
Joule
KilojouleOxygen
Oxidise
calorie*
cal*
*joule*
ox*
Search strategy: energy OR calorie* OR cal* OR *joule* OR ox* OR expeOR cost* OR wast* OR consum* OR deplet*
Expenditure Synonyms:
Expend
Lost
Cost
Wastage
ConsumptionDepletion
expend
los*
cost*
wast*
consumdeplet*
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Search Strategy Summary
P stroke OR cerebro?vascular* OR CVA OR CVI OR hem
AND
I AFO* OR ankle?foot orthos*
AND
O energy OR calorie* OR cal* OR *joule* OR ox* OR explos* OR cost* OR wast* OR consum* OR deplet*
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Categorisation ofliterature
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AAOP Classification Scale
More accurate
(less biased)
Less accurate(more biased)
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AAOP Classification Scale
More accurate
(less biased)
Less accurate
(more biased)
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AAOP Classification Scale
More accurate
(less biased)
Less accurate
(more biased)
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AAOP Classification Scale
More accurate
(less biased)
Less accurate
(more biased)
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AAOP Classification Scale
More accurate
(less biased)
Less accurate
(more biased)
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AAOP Classification Scale
More accurate
(less biased)
Less accurate
(more biased)
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Our Sources
More accurate
(less biased)
Less accurate
(more biased)
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Top Sources For Each Categ
Energy expenditure
with a carbon compo
Danielsson & Sunne
Effects of a new orth
gait in a subject with
Roehrig & Yates. (20
A systematic review
effect of an ankle-foobiomechanics after s
Tyson, Sadeghi-Dem
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Top Source - Experimental tr
Research question
Do stroke patients using ankle foot orthoses have decreased energy expcompared to those who dont use orthotic devices?
Danielsson study title
Energy expenditure in stroke subjects walking with a carbon composite a
orthosis.
Danielsson, A., & Sunnerhagen, K.A. (2004). Energy expenditure in stroke subjeca carbon composite ankle foot orthosis.Journal of Rehabilitation Medicine, doi: 10.1080/165011970410025126
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Analysis of Search Results
Research question is effect of intervention
Effect of intervention = experimental trial
Most sources were controlled before-and-after trial
Reasons for this include:
Limited literature for P & O
Relatively small number of potential subjects
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Analysis of Search Results
Controlled before-and-after trial:
Normally unreliable
Most biased type of experimental trial
However, for our research topic, before-and-after trial is:
Standard for AFO energy expenditure research
Can place more trust in findings
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Source Relevance
All sources:
Information on AFOs effect on energy expenditure
Subjects were people who have suffered stroke
Control was no AFO
Numeric results for energy expenditure
Analysis of energy expenditure results
Some sources:
Primary focus was AFOs effect on hemiplegic gait
Energy expenditure was secondary component of study
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Answer
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Answer
Ankle-foot orthoses decrease energy
expenditure in stroke patients duringwalking.
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References
References
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Bleyenhuft, C., Caty, G., Lejeune, T., & Detrembleur, C. (2008). Assessment of the Chignon dynamic ankle-foot orthosis using instrumented gait analysis in h
adults.Annales de Readaptation et de Medecine Physique, 51 (3), 154-160. doi: 10.1016/j.annrmp.2007.12.005
Bregman, D.J.J., De Groot, V., Van Diggele, P., Meulman, H., Houdijk, H., & Harlaar, J. (2010). Polypropylene ankle foot orthoses to overcome drop-foot ga
neurological patients: A mechanical and functional evaluation. Prosthetic and Orthotics International, 34(3), 293-304. doi: 10.3109/03093646.2010
Bregman, D.J.J., Harlaar, J., Meskers, C.G.M., & De Groot, V. (2012). Spring-like Ankle Foot Orthoses reduce the energy cost of walking by taking over ank
Posture, 35, 148-153. doi: 10.1016/j.gaitpost.2011.08.026
Bregman, D.J.J., Van der Krogt, M.M., De Groot, V., Harlaar, J., Wisse, M., & Collins, S.H. (2011). The effect of ankle foot orthosis stiffness on the energy co
simulation study. Clinical Biomechanics, 26, 955-961. doi: 10.1016/j.clinbiomech.2011.05.007
Danielsson, A., & Sunnerhagen, K.A. (2004). Energy expenditure in stroke subjects walking with a carbon composite ankle foot orthosis. Journal of Rehabilit
Medicine, 33, 165-168. doi: 10.1080/165011970410025126
Franceschini, M., Massucci, M., Ferarri, L., Agosti,M. & Paroli, C. (2003). Effects of an ankle-foot orthosis on spatiotemporal parameters and energy cost of h
Rehabilitation, 17(4), 368-372. doi: 10.1191/0269215503cr622oa
Herbert, R., Mead, J., & Jamtvedt, G. (2005). Practical Evidence-Based Physiotherapy. Edinburgh, UK: Elsevier Butterworth Heinemann.
Maeda, N., Kato, J., Azuma, Y., Okuyama, S., Yonei, S., Murakami, M., & Shimada, T. (2009). Energy expenditure and walking ability in stroke patients: The
ankle-foot orthoses.Isokinetics and Exercise Science, 17, 57-62. doi: 10.3233.ies-2009-0333
Roehrig, S., & Yates, D.A. (2008). Effects of a new orthosis and physical therapy on gait in a subject with longstanding hemiplegia. Journal of Geriatric Phys
31(1), 38-46. Retrieved from http://0-search.proquest.com.alpha2.latrobe.edu.au/docview/213614475/fulltextPDF?accountid=12001
Thijssen, D. H., Paulus, R., Van Uden, C. J., Kooloos, J. G. & Hopman, M. T. (2007). Decreased energy cost and improved gait pattern using a new orthosis
long-term stroke. Archives of physical medicine and rehabilitation, 88(2), 181-186. doi: 10.1016/j.apmr.2006.11.014
Tyson, S.F., Sadeghi-Demneh, E., & Nester, C.J. (2013). A systematic review and meta-analysis of the effect of an ankle-foot orthosis on gait biomechanics
Clinical Rehabilitation, 27(10), 879-891. doi: 10.1177/0269215513486497
http://dx.doi.org/10.1016/j.annrmp.2007.12.005http://dx.doi.org/10.3109/03093646.2010.495969http://dx.doi.org/10.1191/0269215503cr622oahttp://0-search.proquest.com.alpha2.latrobe.edu.au/docview/213614475/fulltextPDF?accountid=12001http://dx.doi.org/10.1177/0269215513486497http://dx.doi.org/10.1177/0269215513486497http://dx.doi.org/10.1177/0269215513486497http://0-search.proquest.com.alpha2.latrobe.edu.au/docview/213614475/fulltextPDF?accountid=12001http://0-search.proquest.com.alpha2.latrobe.edu.au/docview/213614475/fulltextPDF?accountid=12001http://0-search.proquest.com.alpha2.latrobe.edu.au/docview/213614475/fulltextPDF?accountid=12001http://0-search.proquest.com.alpha2.latrobe.edu.au/docview/213614475/fulltextPDF?accountid=12001http://dx.doi.org/10.1191/0269215503cr622oahttp://dx.doi.org/10.1191/0269215503cr622oahttp://dx.doi.org/10.3109/03093646.2010.495969http://dx.doi.org/10.1016/j.annrmp.2007.12.005http://dx.doi.org/10.1016/j.annrmp.2007.12.005