A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke

Kathryn S. Hayward; Sharon F. Kramer; Vincent Thijs; Julie Ratcliffe; Nick S. Ward; Leonid Churilov; Laura Jolliffe; Dale Corbett; Geoffrey Cloud; Tina Kaffenberger; Amy Brodtmann; Julie Bernhardt; Natasha A. Lannin

doi:10.1186/s13643-019-1093-6

A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke

Kathryn S. Hayward, Sharon F. Kramer, Vincent Thijs, Julie Ratcliffe, Nick S. Ward, Leonid Churilov, Laura Jolliffe, Dale Corbett, Geoffrey Cloud, Tina Kaffenberger, Amy Brodtmann, Julie Bernhardt, Natasha A. Lannin

College of Nursing and Health Sciences

Research output: Contribution to journal › Review article › peer-review

30 Citations (Scopus)

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Abstract

Background: Improving upper limb (UL) motor recovery after stroke represents a major clinical and scientific goal. We aim to complete three systematic reviews to estimate the (1) association between time to start of UL therapy and motor recovery, (2) relative efficacy of different UL therapy approaches post-stroke and (3) cost-effectiveness of UL therapy interventions. Methods: We have designed a systematic review protocol to address three systematic review questions that were each registered with PROSPERO. The search will be conducted in MEDLINE, EMBASE, and Cochrane Controlled Register of Trials. We will include randomised controlled trials, non-randomised clinical trials, before-after studies and observational studies of adult stroke survivors with an average stroke onset < 6 months, undergoing hospital-based therapy to improve UL function. Eligible interventions will aim to promote UL functional recovery. Two reviewers will independently screen, select and extract data. Study risk of bias will be appraised using appropriate tools. Clinical measures of motor recovery will be investigated (primary measure Fugl Meyer UL assessment), as well as measures of health-related quality of life (primary measure EQ-5D) and all cost-effectiveness analyses completed. Secondary outcomes include therapy dose (minutes, weeks, repetitions as available) and safety (i.e. adverse events, serious adverse events). A narrative synthesis will describe quality and content of the evidence. If feasible, we will conduct random effects meta-analyses where appropriate. Discussion: We anticipate the findings of this review will increase our understanding of UL therapy and inform the generation of novel, data-driven hypotheses for future UL therapy research post-stroke. Systematic review registration: PROSPERO, http://www.crd.york.ac.UK/PROSPERO/display record.php?ID=CRD42018019367, http://www.crd.york.ac.UK/PROSPERO/display record.php?ID=CRD42018111629, http://www.crd.york.ac.UK/PROSPERO/display-record.php?ID=CRD42018111628.

Original language	English
Article number	187
Journal	Systematic Reviews
Volume	8
Issue number	1
DOIs	https://doi.org/10.1186/s13643-019-1093-6
Publication status	Published - 25 Jul 2019

Bibliographical note

Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Keywords

Protocol
Recovery
Rehabilitation
Stroke
Systematic review
Therapy
Upper limb

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Hayward, K. S., Kramer, S. F., Thijs, V., Ratcliffe, J., Ward, N. S., Churilov, L., Jolliffe, L., Corbett, D., Cloud, G., Kaffenberger, T., Brodtmann, A., Bernhardt, J., & Lannin, N. A. (2019). A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke. Systematic Reviews, 8(1), Article 187. https://doi.org/10.1186/s13643-019-1093-6

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abstract = "Background: Improving upper limb (UL) motor recovery after stroke represents a major clinical and scientific goal. We aim to complete three systematic reviews to estimate the (1) association between time to start of UL therapy and motor recovery, (2) relative efficacy of different UL therapy approaches post-stroke and (3) cost-effectiveness of UL therapy interventions. Methods: We have designed a systematic review protocol to address three systematic review questions that were each registered with PROSPERO. The search will be conducted in MEDLINE, EMBASE, and Cochrane Controlled Register of Trials. We will include randomised controlled trials, non-randomised clinical trials, before-after studies and observational studies of adult stroke survivors with an average stroke onset < 6 months, undergoing hospital-based therapy to improve UL function. Eligible interventions will aim to promote UL functional recovery. Two reviewers will independently screen, select and extract data. Study risk of bias will be appraised using appropriate tools. Clinical measures of motor recovery will be investigated (primary measure Fugl Meyer UL assessment), as well as measures of health-related quality of life (primary measure EQ-5D) and all cost-effectiveness analyses completed. Secondary outcomes include therapy dose (minutes, weeks, repetitions as available) and safety (i.e. adverse events, serious adverse events). A narrative synthesis will describe quality and content of the evidence. If feasible, we will conduct random effects meta-analyses where appropriate. Discussion: We anticipate the findings of this review will increase our understanding of UL therapy and inform the generation of novel, data-driven hypotheses for future UL therapy research post-stroke. Systematic review registration: PROSPERO, http://www.crd.york.ac.UK/PROSPERO/display record.php?ID=CRD42018019367, http://www.crd.york.ac.UK/PROSPERO/display record.php?ID=CRD42018111629, http://www.crd.york.ac.UK/PROSPERO/display-record.php?ID=CRD42018111628.",

keywords = "Protocol, Recovery, Rehabilitation, Stroke, Systematic review, Therapy, Upper limb",

author = "Hayward, {Kathryn S.} and Kramer, {Sharon F.} and Vincent Thijs and Julie Ratcliffe and Ward, {Nick S.} and Leonid Churilov and Laura Jolliffe and Dale Corbett and Geoffrey Cloud and Tina Kaffenberger and Amy Brodtmann and Julie Bernhardt and Lannin, {Natasha A.}",

note = "Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.",

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doi = "10.1186/s13643-019-1093-6",

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Hayward, KS, Kramer, SF, Thijs, V, Ratcliffe, J, Ward, NS, Churilov, L, Jolliffe, L, Corbett, D, Cloud, G, Kaffenberger, T, Brodtmann, A, Bernhardt, J & Lannin, NA 2019, 'A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke', Systematic Reviews, vol. 8, no. 1, 187. https://doi.org/10.1186/s13643-019-1093-6

TY - JOUR

T1 - A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke

AU - Hayward, Kathryn S.

AU - Kramer, Sharon F.

AU - Thijs, Vincent

AU - Ratcliffe, Julie

AU - Ward, Nick S.

AU - Churilov, Leonid

AU - Jolliffe, Laura

AU - Corbett, Dale

AU - Cloud, Geoffrey

AU - Kaffenberger, Tina

AU - Brodtmann, Amy

AU - Bernhardt, Julie

AU - Lannin, Natasha A.

N1 - Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

PY - 2019/7/25

Y1 - 2019/7/25

N2 - Background: Improving upper limb (UL) motor recovery after stroke represents a major clinical and scientific goal. We aim to complete three systematic reviews to estimate the (1) association between time to start of UL therapy and motor recovery, (2) relative efficacy of different UL therapy approaches post-stroke and (3) cost-effectiveness of UL therapy interventions. Methods: We have designed a systematic review protocol to address three systematic review questions that were each registered with PROSPERO. The search will be conducted in MEDLINE, EMBASE, and Cochrane Controlled Register of Trials. We will include randomised controlled trials, non-randomised clinical trials, before-after studies and observational studies of adult stroke survivors with an average stroke onset < 6 months, undergoing hospital-based therapy to improve UL function. Eligible interventions will aim to promote UL functional recovery. Two reviewers will independently screen, select and extract data. Study risk of bias will be appraised using appropriate tools. Clinical measures of motor recovery will be investigated (primary measure Fugl Meyer UL assessment), as well as measures of health-related quality of life (primary measure EQ-5D) and all cost-effectiveness analyses completed. Secondary outcomes include therapy dose (minutes, weeks, repetitions as available) and safety (i.e. adverse events, serious adverse events). A narrative synthesis will describe quality and content of the evidence. If feasible, we will conduct random effects meta-analyses where appropriate. Discussion: We anticipate the findings of this review will increase our understanding of UL therapy and inform the generation of novel, data-driven hypotheses for future UL therapy research post-stroke. Systematic review registration: PROSPERO, http://www.crd.york.ac.UK/PROSPERO/display record.php?ID=CRD42018019367, http://www.crd.york.ac.UK/PROSPERO/display record.php?ID=CRD42018111629, http://www.crd.york.ac.UK/PROSPERO/display-record.php?ID=CRD42018111628.

AB - Background: Improving upper limb (UL) motor recovery after stroke represents a major clinical and scientific goal. We aim to complete three systematic reviews to estimate the (1) association between time to start of UL therapy and motor recovery, (2) relative efficacy of different UL therapy approaches post-stroke and (3) cost-effectiveness of UL therapy interventions. Methods: We have designed a systematic review protocol to address three systematic review questions that were each registered with PROSPERO. The search will be conducted in MEDLINE, EMBASE, and Cochrane Controlled Register of Trials. We will include randomised controlled trials, non-randomised clinical trials, before-after studies and observational studies of adult stroke survivors with an average stroke onset < 6 months, undergoing hospital-based therapy to improve UL function. Eligible interventions will aim to promote UL functional recovery. Two reviewers will independently screen, select and extract data. Study risk of bias will be appraised using appropriate tools. Clinical measures of motor recovery will be investigated (primary measure Fugl Meyer UL assessment), as well as measures of health-related quality of life (primary measure EQ-5D) and all cost-effectiveness analyses completed. Secondary outcomes include therapy dose (minutes, weeks, repetitions as available) and safety (i.e. adverse events, serious adverse events). A narrative synthesis will describe quality and content of the evidence. If feasible, we will conduct random effects meta-analyses where appropriate. Discussion: We anticipate the findings of this review will increase our understanding of UL therapy and inform the generation of novel, data-driven hypotheses for future UL therapy research post-stroke. Systematic review registration: PROSPERO, http://www.crd.york.ac.UK/PROSPERO/display record.php?ID=CRD42018019367, http://www.crd.york.ac.UK/PROSPERO/display record.php?ID=CRD42018111629, http://www.crd.york.ac.UK/PROSPERO/display-record.php?ID=CRD42018111628.

KW - Protocol

KW - Recovery

KW - Rehabilitation

KW - Stroke

KW - Systematic review

KW - Therapy

KW - Upper limb

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UR - http://purl.org/au-research/grants/nhmrc/GNT1088449

UR - http://purl.org/au-research/grants/nhmrc/GNT1154904

UR - http://purl.org/au-research/grants/nhmrc/GNT1114522

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DO - 10.1186/s13643-019-1093-6

M3 - Review article

C2 - 31345263

AN - SCOPUS:85069923032

SN - 2046-4053

VL - 8

JO - Systematic Reviews

JF - Systematic Reviews

IS - 1

M1 - 187

ER -

A systematic review protocol of timing, efficacy and cost effectiveness of upper limb therapy for motor recovery post-stroke

Abstract

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Keywords

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