Designs for Clinical Research

Gonnella, Carmella

doi:10.1093/ptj/53.12.1276

Cited by 11 publications

(4 citation statements)

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“…Sequential medical trials (SMT) were chosen to be the method of experimental design and statistical analysis. 14,15 This sequential design was considered ideal because 1) sub jects could be admitted to the study as they became available, 2) comparisons could be made within the same subject, 3) no statistical computations were necessary, and 4) the experiment could be terminated as soon as statistical significance was achieved (ie, a predetermined number of subjects was not required).…”

Section: Discussionmentioning

confidence: 99%

Low-Load Prolonged Stretch vs. High-Load Brief Stretch in Treating Knee Contractures

et al. 1984

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This study was designed to compare the results of a traditional method of stretching knee flexion contractures by high-load brief stretch (HLBS) with the results of an experimental method of prolonged knee extension by skin traction, low-load prolonged stretch (LLPS). End range of passive knee extension was measured by standard goniometry. Subjects were 11 nonambulatory residents of a nursing home who had demonstrated gradually progressive bilateral knee contractures. Each subject served as his or her own control with one lower limb receiving LLPS and the other limb receiving HLBS and passive range of motion (PROM). Sequential medical trials were used as the clinical research design. Whether comparing the LLPS limb PROM measurements pretreatment and posttreatment (p less than or equal to .05) or the HLBS to the LLPS limb PROM recordings posttreatment (p less than or equal to .05), the results demonstrated a preference for LLPS in the treatment of knee contractures in the immobile nursing home resident.

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Section: Discussionmentioning

confidence: 99%

Low-Load Prolonged Stretch vs. High-Load Brief Stretch in Treating Knee Contractures

et al. 1984

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“…When there are large differences in patient characteristics and individual recovery patterns within both the experimental and control groups, it becomes difficult to demonstrate differences between groups, in particular, when these effects of treatment are small compared to the extent and heterogeneous nature of developing spontaneous recovery. For this reason, a number of researchers advocate the inclusion of a large number of patients in stroke rehabilitation trials, whereas others prefer controlled single subject experimental designs or interrupted time series experiments [40,41,42]. A major advantage to this latter design is its control for subject homogeneity.…”

Section: Methodological Quality Of Stroke Rehabilitation Researchmentioning

confidence: 99%

Functional Recovery After Stroke: A Review of Current Developments in Stroke Rehabilitation Research

Kollen

Kwakkel

Lindeman

2006

RRCT

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This review article discusses current research developments in functional recovery after stroke. With the institutionalization of stroke services across health care facilities, a reduction in mortality rates, length of inpatient stay and improved independence in activities of daily living has been reported. Several systematic reviews show that traditional treatment approaches induce improvements that are confined to impairment level only and do not generalize to a functional improvement level. More recently developed treatment strategies that incorporate compensation strategies with a strong emphasis on functional training, may hold the key to optimal stroke rehabilitation. Intensity and task-specific exercise therapy are important components of such an approach. Guidelines may assist the clinician in this responsibility. However, due to marked heterogeneity of the stroke population and poor methodological quality of many studies, results are uncertain. Several options are discussed to overcome the problem of stroke heterogeneity in research designs. Longitudinal repeated measurements designs are required to study the effects of non-linearity and time dependency of functional recovery in stroke. Furthermore, prognostic research based on sound clinimetric data generates relevant information that may guide the clinician in clinical decision making and in determining optimal treatment strategies.

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“…Because of this phenomenon, until the early diagnostic process achieves a level of sophistication such that professionals may distinguish reliably between those infants likely and not likely to exhibit spontaneous recovery, research into the effectiveness of therapeutic intervention with this population, using control group methodology, will continue to generate spurious findings. In response to this, continued research in this area will use such alternatives as non parametric research designs (I) and increasingly sophisticated single-subjecl methodologies (51,52).…”

Section: Summary and Recommendationsmentioning

confidence: 99%

A Review of Therapeutic Intervention Research on Gross and Fine Motor Progress in Young Children with Cerebral Palsy

Parette

Hourcade

1984

The American Journal of Occupational Therapy

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Recently, perhaps due to increased societal demands for accountability, early intervention programming for handicapped infants and young children has been questioned. Therapeutic intervention provided through occupational and/or physical therapy has been increasingly implemented in habilitation settings for children diagnosed as having cerebral palsy, although research justifying this increase is inconclusive. This review presents a comprehensive evaluation of 18 studies that evaluated early occupational and/or physical therapy intervention for children with cerebral palsy. An analysis of these studies revealed that as research paradigms become more rigorous, support for therapeutic intervention effectiveness decreases. This finding was explained in light of the currently inadequate levels of technology relating to instrumentation and the manipulation of the many variables that have been suggested to affect therapeutic intervention effectiveness.

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Designs for Clinical Research

Cited by 11 publications

References 0 publications

Low-Load Prolonged Stretch vs. High-Load Brief Stretch in Treating Knee Contractures

Low-Load Prolonged Stretch vs. High-Load Brief Stretch in Treating Knee Contractures

Functional Recovery After Stroke: A Review of Current Developments in Stroke Rehabilitation Research

A Review of Therapeutic Intervention Research on Gross and Fine Motor Progress in Young Children with Cerebral Palsy

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