Chapter 3: Critically Appraise the Applicability and Quality of an Intervention Research Study

Pre-Test

Read the clinical questions and abstract below¹:

Abstract

Background and Purpose: This single-blinded randomized controlled trial compared the efficacy of a reimbursable, outpatient, modified constraint-induced therapy (mCIT) protocol (half-hour therapy sessions occurring 3 days per week in which subjects used the more affected arm combined with less affected arm restriction 5 days per week for 5 hours; both of these regimens were administered during a 10-week period) with that of a time-matched exercise program for the more affected arm or a no-treatment control regimen.

Subjects: Thirty-five subjects with chronic stroke participated in the study.

Methods: The Action Research Arm Test (ARAT), Fugl-Meyer Assessment of Motor Recovery After Stroke (FM), and Motor Activity Log (MAL) were administered to the subjects.

Results: After intervention, significant differences were observed on the ARAT and MAL Amount of Use and Quality of Movement scales, all in favor of the mCIT group.

Discussion and Conclusion: The data affirm previous findings suggesting that this reimbursable, outpatient protocol increases more affected arm use and function. Magnitude of changes was consistent with those reported in more intense protocols, such as constraint-induced therapy.

Page, S., Levine, P., Leonard, A., Szaflarski, J., Kissela, B. Modified Constraint-Induced Therapy in Chronic Stroke: Results of a Single-Blinded Randomized Controlled Trial

PHYS THER March 2008 88:333-340

1. How will you determine if this study is applicable to your patient?

2. State one major threat to the quality of this study.

Introduction: The Process of Study Appraisal

This chapter and Chapter 4 support your knowledge and skill development for the third step of evidence based practice (EBP):

Step 3: Critically appraise the research evidence for applicability and quality

Step 3 in the EBP process is study appraisal. The appraisal process is summarized in the four parts in Figure 3.1. The first two parts are detailed in this chapter including appraising the:

1. Applicability and

2. Quality of a research study.

The third part, appraising study results, and fourth part, formulating a clinical bottom line, are detailed in Chapter 4. High-quality studies produce valid results. Chapters 3 and 4 focus on the appraisal of intervention studies. When results of an intervention study are valid, they can more confidently be applied to inform patient care.

Part A: Determining Applicability of an Intervention Study

Using Research Evidence to Inform Care for ...