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Support for PEDro comes from the American Physical Therapy Association, Deutscher Verband für Physiotherapie, Physio Austria, Physio Swiss and Associação Portuguesa de Fisioterapeutas
We thank the American Physical Therapy Association, Deutscher Verband für Physiotherapie, Physio Austria, Physio Swiss and Associação Portuguesa de Fisioterapeutas who have just renewed their partnership with PEDro for another year.
#MyPTArticleOfTheMonth – what is Marcelo Rieder reading?
Marcelo Rieder is physiotherapy team leader in the trauma intensive care unit at the Grupo Hospitalar Conceição and professor in cardiorespiratory physiotherapy at the Centro Universitário Metodista in Rio Grande do Sul, Brazil. He is recognised by the Conselho Federal de Fisioterapia e Terapia Ocupacionala as a specialist respiratory physiotherapist.
One way Marcelo keeps up-to-date with developments in early mobilisation and other physiotherapy interventions used in intensive care is by subscribing to the cardiothoracics feed of PEDro’s Evidence in your inbox. Two recent papers have caught Marcelo’s eye.
Arias-Fernandez P, et al. Rehabilitation and early mobilization in the critical patient: systematic review. J Phys Ther Sci 2018;30(9):1193-1201
This systematic review evaluated the effects of rehabilitation and early mobilisation for adults admitted to intensive care for more than 2 days. The authors searched five databases (Bibliotheca Virtual en Salud, CINAHL, PubMed, Scopus, and Web of Science) in order to identify randomized controlled trials, crossover trials, and case-control studies. Unfortunately there was no quantitative synthesis of the 11 included studies. The results of individual studies indicate that, compared to usual care, rehabilitation and early mobilisation increases the total distance walked at discharge. Marcelo says: “Rehabilitation and early mobilisation in intensive care looks promising, but more research is necessary to quantify the size of the treatment effect”.
Nydahl P, et al. Safety of patient mobilization and rehabilitation in the intensive care unit: systematic review with meta-analysis. Ann Am Thorac Soc 2017;14(5):766-777
Safety concerns are a barrier to the widespread use of rehabilitation and early mobilisation in intensive care units. This systematic review synthesised safety events, including falls, removal of endotracheal tubes, removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, haemodynamic changes, and desaturation. 48 eligible studies evaluating 7,546 patients in 22,351 early mobilisation or rehabilitation sessions were included. Potential safety events occurred in 2.6% of sessions. Marcelo says: “This review reassures me that rehabilitation and early mobilisation in intensive care is safe. It would be really useful if future trials recorded safety events in a consistent way”.
#MyPTArticleOfTheMonth #PhysicalTherapy #physio
#MyPTArticleOfTheMonth resource – how to search PEDro
PEDro is an excellent source of high-quality clinical research to answer clinical questions about the effects of physiotherapy interventions. We have put together 10 tips to help you get started or enhance your skills with PEDro searching.
- Think about (and record) your clinical question before you start searching. The ‘PICO’ memory aid will help ensure that all key elements are included in your question: the Patient, Intervention, Comparator, and Outcome.
- For each element of your PICO question, jot down a couple of words that capture the concept and can potentially be used as search terms. For example, the word ‘cue’ could be used to summarise an intervention involving gait training using visual or auditory cues. Entering search terms for two PICO elements is a good starting point for performing your search.
- Use the PEDro Advanced Search interface. This contains 13 search fields that can be used to specify the elements of your clinical question. Six fields contain drop-down lists (Therapy, Problem, Body Part, Subdiscipline, Topic, Method). The terms in these lists are applied to all articles indexed in PEDro by trained raters. For example, the term ‘Gerontology’ in the Subdiscipline field could be used for the patient group of older people. You can type words into four free-text fields (Abstract & Title, Author/Association, Title Only, Source).
- Use advanced search features in free-text fields (eg, Abstract & Title). Truncation allows you to search for words that start (or end) with the same string of text. For example, cue* will return articles that contain the words cue, cueing and cues, and *feedback will return articles that contain the words feedback, biofeedback and myofeedback. Words that occur together can be searched for as a single term using inverted commas. For example, “blood pressure”.
- Only enter English words in the Abstract & Title and Title Only fields.
- Don’t use Boolean Operators (AND, OR, NOT) in free-text fields.
- If your search returns too many articles, click on the “Continue Searching (Advanced)” hyperlink and add more terms to make your search more precise.
- If your search returns too few (or no) articles, click on the “Continue Searching (Advanced)” hyperlink and remove or change your search terms.
- If you are new to PEDro searching, watch the “How to perform a PEDro Advanced Search” video. This video is available in English, Simplified Chinese, Traditional Chinese, Portuguese, German, French, Spanish, Italian, Japanese, Korean, Tamil, and Dutch.
- If you have performed a PEDro Advance Search before, watch the “How to optimise PEDro searching” video. This video is available in English, Portuguese, German, French, Spanish, Italian, Japanese, and Tamil.
Introducing the new PEDro logo
PEDro celebrates its 20th birthday in October 2019. To mark this important milestone we have decided to refresh the PEDro logo and web-site. The new logo is now being used, and we will launch the new-look web-site later in the year. You can watch the PEDro logo transform from old to new in the video above.
PEDro update (6 May 2019)
PEDro contains 43,384 records. In the 6 May 2019 update you will find:
- 33,928 reports of randomised controlled trials (33,065 of these trials have confirmed ratings of methodological quality using the PEDro scale)
- 8,783 reports of systematic reviews, and
- 673 reports of evidence-based clinical practice guidelines.
PEDro update (May 2019)
PEDro was updated on 6 May 2019. For latest guidelines, reviews and trials in physiotherapy visit Evidence in your inbox.
Next PEDro update (May 2019)
The next PEDro update is on Monday 6 May 2019.
An overview of PEDro
A short article providing an overview of the Physiotherapy Evidence Database (PEDro) has recently been published. PEDro is a free, searchable online resource that can be used by physiotherapists to assist their efforts to undertake evidence-based practice. In February 2019 PEDro indexed the details of over 42,000 pieces of published evidence about the effects of physiotherapy interventions, and the number of articles is growing exponentially. PEDro is searched millions of times each year by users worldwide. In addition to searching PEDro to answer clinical questions, physiotherapists can browse the latest evidence in their area of practice using the PEDro Evidence in your inbox service. Training for using the search interface and to develop skills in evidence-based practice is provided in 12 languages. The article concludes by outlining the collaboration between the Societá Italiana de Fisioterapia (SIF) and PEDro. In addition to providing financial support, about 40 SIF members have completed the PEDro scale training program and have rated over 400 of the trials indexed on PEDro.
Elkins M, et al. Societá Italiana de Fisioterapia and the Physiotherapy Evidence Database (PEDro). Archives of Physiotherapy 2019 Mar 14;9(5):Epub
Systematic review found that spinal manipulative therapy for chronic low back pain produces similar effects to therapies recommended by clinical guidelines
This systematic review evaluated the benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain. Randomised controlled trials conducted in adults 18 years and older with more than 50% of participants reporting pain lasting more than 3 months were included. Spinal manipulative therapy was compared against guideline-recommended interventions, non-guideline-recommended interventions, sham spinal manipulation, and combined therapies. Risk of bias was assessed using the criteria described by Cochrane Back and Neck Review group. Primary outcomes were pain intensity (0-100 scale) and back specific functional status. Treatment effects were reported at 1, 3, 6 and 12 months post-randomisation.
47 trials were included (n = 9,211 participants). Several health professionals were involved in providing treatment, with most being chiropractors (16 studies) or physiotherapists (14 studies).
Compared to guideline-recommended interventions, moderate quality evidence suggests that spinal manipulative therapy was not better for pain at 1 month (mean difference -3.17, 95% confidence interval (CI) -7.85 to 1.51) and 12 months (mean difference -1.86, 95% CI -4.79 to 1.07). A statistically significant difference was found at 6 months (mean difference -3.09, 95% CI -5.42 to -0.77) but this was not considered to be clinically relevant. Compared to interventions not recommended by guidelines, spinal manipulative therapy was significantly better at reducing pain at 1 month (mean difference -7.48, 95% CI -11.50 to -3.47, high quality evidence), 6 months (mean difference -7.54, 95% CI -13.29 to -1.79, moderate quality evidence), and 12 months (mean difference -7.80, 95% CI-14.19 to -1.41). Compared to sham spinal manipulation, there was low quality evidence that spinal manipulative therapy did not reduce pain at 1 month (mean difference -7.55, 95% CI -19.86 to 4.76), and very low quality evidence that it did not reduce pain at 6 months (mean difference 0.96, 95% CI -6.34 to 8.26) and 12 months (mean difference 0.20, 95% CI -5.33 to 5.37).
For back specific functional status, there was moderate quality evidence that spinal manipulative therapy was statistically better to guideline-recommended treatments at 1 month, but not at 6 and 12 months. Compared to interventions not recommended by guidelines, there was high quality evidence that spinal manipulative therapy was significantly better at 1 month, and these effects were clinically relevant, with moderate and low quality evidence that spinal manipulative therapy was statistically and clinically better than interventions not recommended by guidelines at 6 and 12 months, respectively. Compared to sham spinal manipulation, there was low quality evidence that spinal manipulation improved functional status at 1 month, and this improvement was clinically relevant.
Spinal manipulative therapy produces similar effects to guideline-recommended therapies for chronic low back pain, and it appears to be better than non-guideline-recommended interventions for improvement in function in the short-term.
Rubinstein SM, et al. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ 2019;364:l689
Read more on PEDro.
WCPT Congress 2019
The World Confederation for Physical Therapy (WCPT) Congress 2019 will be held in Geneva, Switzerland on 10-13 May 2019. As a WCPT Professional Partner, PEDro will be participating in the Congress scientific program and exhibition.
At 16:00-17:30 on Sunday 12 May 2019 a seminar entitled “Consumption of research reports: how to find reports of reliable clinical research” will be conducted in Room E. Lead by Mark Elkins, Rob Herbert, Mark Kaizik and Carsten Juhl, this seminar will update conference delegates on strategies that can be used to find reports of high-quality clinical research.
The “Application of evidence: strategies to improve the application of evidence to individual patients” focused symposia will run in Room A at 8:30-10:00 on Sunday 12 May 2019. Featuring Mark Elkins, Philip van der Wees, Leonardo Costa, Rebecca Craik and Sallie Lamb, this symposia will provide participants with strategies to overcome challenges to evidence-based practice.
Four “Rapid 5” style papers relating to PEDro will be presented on Monday 13 May 2109. The session times and rooms are listed below, but please consult the Congress iPlanner for more information.
Monday, 13 May 2019 10:45-12:15, Room P
Research methodology & knowledge translation session (PLR5-11)
- PEDro searching has improved over time: a comparison of search commands from two 6-month periods 3 years apart (PLR5-722)
- The number of randomised controlled trials of physiotherapy interventions doubles every 6 years: a survey of the Physiotherapy Evidence Database (PLR5-3351)
- Meet PEDro's partner, DiTA, a database of studies of diagnostic test accuracy relevant to physiotherapy (PLR5-1109)
Professional issues session (PLR5-12)
- PEDro: tackling the language barrier to translating research into practice (PLR5-2119)
Please come and visit PEDro at stand T12 in the Exhibition Hall. The PEDro team will be available during the Welcome Networking Reception plus the morning tea, lunch and afternoon tea breaks to give guided tours of PEDro and answer any questions you may have.
#WCPT2019 #PhysicalTherapy #physio