enquiry 1 - oral presentation (1)

8/12/2019 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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P- Stroke Patients

IAnkle Foot Orthoses


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PStroke Patients


CNo AFO use


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PStroke Patients


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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Stroke Synonyms:


CVA or CVI

Hemiplegia

Hemiparesis

cerebro?vascular

CVA OR CVI

hemip*


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Stroke Synonyms:


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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AFO Synonyms:

AFOs

Ankle foot orthosis

Ankle foot orthoses

AFO*

ankle?foot orthos*


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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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Energy Synonyms:

Calorie

Calories

Cal

Joule

KilojouleOxygen

Oxidise

calorie*

cal*

*joule*

ox*


Expend

Lost

Cost

Wastage


expend

los*

cost*

wast*

consumdeplet*


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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*


Expend

Lost

Cost

Wastage


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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More accurate

(less biased)

Less accurate

(more biased)


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More accurate

(less biased)

Less accurate

(more biased)


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More accurate

(less biased)

Less accurate

(more biased)


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More accurate

(less biased)

Less accurate

(more biased)


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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

enquiry 1 - oral presentation (1)

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