Welcome to the PEDro World-Wide Journal Club. The purpose of the PEDro World-Wide Journal Club is to encourage the global physiotherapy community to read trials, reviews and guidelines that have important implications for clinical practice. We hope that facilitating discussion of this research will help physiotherapists to implement the results into their clinical practice.
Journal clubs are a great way to translate research into practice. In March 2020 PEDro published a blog that outlined some key features of running a successful journal club. We are going to use this framework to run three or four journal clubs during 2020. The idea is for physiotherapists to use resources provided by PEDro as the basis for running a local journal club with their peers. The resources provided by PEDro will include: a research article that addresses an important evidence-practice gap; a video summary of the article; a panel discussion about the article that explores applying the results into practice; and, links to resources to support ongoing discussion and implementation.
The following journal clubs are now available:
- Constraint induced movement therapy after stroke
- Exercise for falls prevention in community dwelling older people
- Exercise for rotator cuff related shoulder pain
- Advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease
- Decreasing frailty in older people
- Exercise for injury prevention in football (soccer)
- Understanding comparisons in trials
- Understanding blinding in trials
- Intention-to-treat analysis
- Confidence intervals
- Training bicycle riding in ambulant children with cerebral palsy
- Preoperative exercise training for people with non-small cell lung cancer
- Ballistic resistance training for people with traumatic brain injury
1. Constraint induced movement therapy after stroke
This first PEDro World-Wide Journal Club is about constraint induced movement therapy for people with neurological conditions (particularly stroke). If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
3. watch (or listen to) the video summarising the EXCITE trial (3 minutes)
4. watch (or listen to) the video of the panel discussing the EXCITE trial (41.5 minutes)
5. meet with your colleagues to have your own discussion about the EXCITE trial
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the EXCITE trial:
- To find other trials evaluating the effects of constraint induced movement therapy after stroke we suggest you look at the Cochrane review on this treatment:
Corbetta D, et al. Constraint-induced movement therapy for upper extremities in people with stroke. Cochrane Database Systematic Reviews 2015;Issue 10. - The Taub Therapy Clinic
- The ACTIveARM project evaluates a multimodal implementation package to change clinician behaviour and increase the delivery of constraint induced movement therapy programs to stroke survivors and people with traumatic brain injury. The protocol for the project has been registered. Links to project results and resources will be added when they are available.
- Lauren Christie has made six videos about contraint induced movement therapy for the ACTIveARM project:
– An introduction to constraint induced movement therapy (CIMT)
– CIMT: an introduction to shaping 1
– CIMT: an introduction to shaping 2
– An introduction to the Motor Activity Log (MAL)
– Constraint induced movement therapy from a person with traumatic brain injury: Wassim
– Stroke survivor experience of a constraint induced movement therapy program: Khee - Systematic review led by Ted Stevenson from Canada that compared constraint induced movement therapy to dose-matched interventions after stroke:
Stevenson T, et al. Constraint-induced movement therapy compared to dose-matched interventions for upper-limb dysfunction in adult survivors of stroke: a systematic review with meta-analysis. Physiother Can 2012;64(4):397-413 - Publication from the EXCITE trial that compared early (3-9 months post-stroke) to late (15-21 months post-stroke) delivery of constraint induced movement therapy:
Lang KC, et al. The EXCITE trial: reacquiring upper-extremity task performance with early versus late delivery of constraint therapy. Neurorehabil Neural Repair 2013;27(7):654-63 - StrokeEd resource book on constraint induced movement therapy
If you have run a local journal club on constraint induced movement therapy using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Simone Dorsch and Leanne Hassett for coordinating this journal club. We would also like to thank Lauren Christie, Reem Rendell, Scott Wade, Emma Fanayan, Roland Qiu, and Jenny Yun Jia Qian for participating in the panel discussion video.
2. Exercise for falls prevention in community dwelling older people
The second PEDro World-Wide Journal Club is about exercise for falls prevention in community dwelling older people. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
2. read the abridged version of the review
Sherrington C, Fairhall N, Wallbank G, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb S. Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review. Br J Sports Med 2020;54(15):885-91
or the full version of the review
Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE. Exercise for preventing falls in older people living in the community (Cochrane review). Cochrane Database Syst Rev 2019;Issue 1
3. watch (or listen to) the video summarising the abridged version of the exercise for falls prevention review (5 minutes)
4. watch (or listen to) the video of the panel discussing the abridged version of the exercise for falls prevention review (29 minutes)
5. meet with your colleagues to have your own discussion about the exercise for falls prevention review
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the exercise for falls prevention review:
- The citation for the observation made by Terry Haines that some older people think that the risk of falls and messages to exercise apply to other older people is:
Haines TP, Day L, Hill KD, Clemson L, Finch C. “Better for others than for me”: a belief that should shape our efforts to promote participation in falls prevention strategies. Arch Gerontol Geriatr 2014;59(1):136-44 - Definition of a fall included in the fact sheets produced by the World Health Organization:
https://www.who.int/news-room/fact-sheets/detail/falls - Otago exercise program
https://www.livestronger.org.nz/assets/Uploads/acc1162-otago-exercise-manual.pdf - Prevention of Falls Network Europe (ProFaNE) web-site:
http://www.profane.eu.org/ - In the first trial to evaluate the Otago Exercise Program the intervention was delivered by physiotherapists. The citation is:
Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ 1997;315(7115):1065-9 - In subsequent trials evaluating the Otago Exercise Program the intervention is delivered by nurses who were trained and supervised by physiotherapists. One citation is:
Robertson MC, Devlin N, Gardner MM, Campbell AJ. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: randomised controlled trial. BMJ 2001;322(7288):697-701 - The citation for the previous Gillespie review is:
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012;Issue 9 - The citation for the Stepping On trial lead by Lindy Clemson is:
Clemson L, Cumming RG, Kendig H, Swann M, Heard R, Taylor K. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial. J Am Geriatr Soc 2004;52(9):1487-94 - The citation for the previous non-Cochrane version of the review that investigated exercise dosage is:
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JCT, Lord SR. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med 2017;51(24):1750-8 - The citation for the companion paper that describes the trial and participant characteristics in more detail is:
Ng CACM, Fairhall N, Wallbank G, Tiedemann A, Michaleff ZA, Sherrington C. Exercise for falls prevention in community-dwelling older adults: trial and participant characteristics, interventions and bias in clinical trials from a systematic review. BMJ Open Sport Exerc Med 2019;5(1):e000663 - The citation for the Brazilian trial evaluating the effect of dance on falls risk factors is:
Franco MR, Sherrington C, Tiedemann A, Pereira LS, Perracini MR, Faria CSG, Negrão-Filho RF, Pinto RZ, Pastre CM. Effect of senior dance (DanSE) on fall risk factors in older adults: a randomized controlled trial. Phys Ther 2020;100(4):600-8
If you have run a local journal club on exercise for falls prevention in community dwelling older adults using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Emre Ilhan for coordinating this journal club. We would also like to thank Cathie Sherrington, Jamie Hallen and Nadeem Mousad for participating in the panel discussion video.
3. Exercise for rotator cuff related shoulder pain
This PEDro World-Wide Journal Club is about exercise for rotator cuff related shoulder pain. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
2. read the abridged version of the review
Naunton J, Street G, Littlewood C, Haines T, Malliaras P. Effectiveness of progressive and resisted and non-progressive or non-resisted exercise in rotator cuff related shoulder pain: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2020;34(9):1198-216
3. watch (or listen to) the video summarising the exercise for rotator cuff related shoulder pain review (5.5 minutes)
4. watch (or listen to) the video of the panel discussing the exercise for rotator cuff related shoulder pain review (28 minutes)
5. meet with your colleagues to have your own discussion about the exercise for rotator cuff related shoulder pain review
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the exercise for rotator cuff related shoulder pain review:
- Debate in the literature about how much pain should be experienced during shoulder rehabilitation:
Klintberg IH, et al. Consensus for physiotherapy for shoulder pain. Int Orthop 2015;39(4):715-20
Smith BE, et al. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. Br J Sports Med 2017;51(23):1679-87 - Continuum model of tendon pathology:
Cook JL, et al. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med 2016;50(19):1187-91 - Cohort studies evaluating prognosis after rotator cuff tears:
Boorman RS, et al. What happens to patients when we do not repair their cuff tears? Five-year rotator cuff quality-of-life index outcomes following nonoperative treatment of patients with full-thickness rotator cuff tears. J Shoulder Elbow Surg 2018;27(3):444-8
Kuhn JE, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg 2013;22(10):1371-9 - Study applying resistance training for full thickness tears:
Kuhn JE, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg 2013;22(10):1371-9 - Back pain literature on reduction in symptoms while strength does not change:
Steiger F, et al. Is a positive clinical outcome after exercise therapy for chronic non-specific low back pain contingent upon a corresponding improvement in the targeted aspect(s) of performance? A systematic review. Eur Spine J 2012;21(4):575-98
If you have run a local journal club on exercise for rotator cuff related shoulder pain using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Joshua Zadro for coordinating this journal club. We would also like to thank Peter Malliaras, Laura Crowe-Owen and Dominique Murphy for participating in the panel discussion video.
4. Advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease
This PEDro World-Wide Journal Club is about using advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
2. read the systematic review review
Bonnevie T, et al. Advanced telehealth technology improves home-based exercise therapy for people with stable chronic obstructive pulmonary disease: a systematic review. J Physiother 2021;67(1):27-40
3. watch (or listen to) the video summarising the advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease review (6 minutes)
4. watch (or listen to) the video of the panel discussing the advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease review (30 minutes)
5. meet with your colleagues to have your own discussion about the advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease review
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease review:
- Articles on estimating the size of the treatment effect and the uncertainty around that estimate (rather than focusing on the presence or absence of statistical significance):
Herbert RD. How to estimate treatment effects from reports of clinical trials. I: Continuous outcomes. Aust J Physiother 2000;46(3):229-35
Herbert RD. How to estimate treatment effects from reports of clinical trials. II: Dichotomous outcomes. Aust J Physiother 2000;46(4):309-13
Herbert R. Research note: significance testing and hypothesis testing: meaningless, misleading and mostly unnecessary. J Physiother 2019;65(3):178-81
Kamper SJ. Showing confidence (intervals). Braz J Phys Ther 2019;23(4):277-8 - myCOPD app-based program from the United Kingdom used in the Bourne (2017) trial: https://mymhealth.com/mycopd
- The primary reference for the Liu (2008) trial that used an app-based program to pace walking is:
Liu W-T, et al. Efficacy of a cell phone-based exercise programme for COPD. Eur Respir J 2008;32(3):651-9 - A study that investigates satisfaction with advanced telehealth technologies in people with chronic obstructive pulmonary disease is:
Tsai LLY, et al. Satisfaction and experience with a supervised home-based real-time videoconferencing telerehabilitation exercise program in people with chronic obstructive pulmonary disease (COPD). Int J Telerehabil 2016;8(2):27-38 - The primary reference for the Nguyen (2013) trial that used a web-based tool to self-manage dyspnoea is:
Nguyen HQ, et al. Internet-based dyspnea self-management support for patients with chronic obstructive pulmonary disease. J Pain Symptom Manage 2013;46(1):43-55 - The Cochrane review on a similar question to the Bonnevie review is:
Cox NS, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database Syst Rev 2021;Issue 1
If you have run a local journal club on advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Mark Elkins for coordinating this journal club. We would also like to thank Lissa Spencer, Sally Wootton and Joshua Hain for participating in the panel discussion video.
5. Decreasing frailty in older people
This PEDro World-Wide Journal Club is about a frailty intervention for frail older people. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
3. watch (or listen to) the video summarising the frailty intervention trial (8 minutes)
4. watch (or listen to) the video of the panel discussing the frailty intervention trial (32 minutes)
5. meet with your colleagues to have your own discussion about the frailty intervention trial.
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the frailty intervention trial:
- the citation to the original trial paper describing the frailty intervention:
Cameron ID, et al. A multifactorial interdisciplinary intervention reduces frailty in older people: randomized trial. BMC Medicine 2013;11(65) - the citation for adherence to the program Niki referred to:
Fairhall N, et al. A multifactorial intervention for frail older people is more than twice as effective among those who are compliant: complier average causal effect analysis of a randomised trial. Journal of Physiotherapy 2017;63(1):40-44 - the citation for the ‘Weight Bearing Exercises for Better Balance program (WEBB)’ to improve mobility and balance is:
https://www.webb.org.au/attachments/File/WEBB_draft_19.pdf - the citation for clinical practice guidelines for the management of frailty:
Dent E, et al. The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty. Braz Journal of the American Medical Directors Association 2017;18(7): 564–575 - British Geriatrics Society web-site with resources for frailty:
https://www.bgs.org.uk/resources/resource-series/fit-for-frailty - citations for frailty assessments to identify frail persons at risk of developing disability as well as decline in health functioning and mortality. The FRAIL scale which includes 5 components, Fatigue, Resistance, Ambulation, Illness, and Loss of weight:
Woo J, Leung J, Morley JE. Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. Journal of the American Geriatrics Society. 2012 Aug;60(8):1478-1486 - citation for the Clinical Frailty Scale, a global clinical measure of fitness and frailty in elderly people:
Rockwood K, et al. A global clinical measure of fitness and frailty in elderly people. Canadian Medical Association Journal. 2005;173:489-195 - citation for the Cardiovascular Health Study article for the Fried Phenotype, discussed in the video summary and panel discussion:
Fried LP, et al. Frailty in older adults: evidence for a phenotype. The Journals of Gerontology. Series A, Biological sciences and medical sciences. 2001;56(3):M146–M156 - citation for the management of frailty:
Dent E, et al. Management of frailty: opportunities, challenges, and future directions. Lancet 2019; 394(10206):1376–1386 - the citation for implications of frailty for clinical practice and public health:
Hoogendijk EO, et al. Frailty: implications for clinical practice and public health. Lancet 2019; 394(10206):1365–1375
If you have run a local journal club on decreasing frailty in older people using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Simone Dorsch and Sandeep Gupta for coordinating this journal club. We would also like to thank Niki Fairhall, Vanessa Jessop and Adam Wilkes for participating in the panel discussion video.
6. Exercise for injury prevention in football (soccer)
This PEDro World-Wide Journal Club is about exercise-based programs for preventing non-contact musculoskeletal injuries in football (soccer). If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
3. watch (or listen to) the video summarising the exercise for injury prevention in football (soccer) review (7 minutes)
4. watch (or listen to) the video of the panel discussing the exercise for injury prevention in football (soccer) review (48 minutes)
5. meet with your colleagues to have your own discussion about the exercise for injury prevention in football (soccer) review
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the exercise for injury prevention in football (soccer) review:
- citations for epidemiology of injuries in football:
López-Valenciano A et al. Epidemiology of injuries in professional football: a systematic review and meta-analysis. Br J Sports Med 2020;54(12):711–8
Ekstrand J et al. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med 2011;45(7):553–8
Ekstrand J et al. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med 2011;39(6):1226–32 - citation for injury risk in amateur and professional players:
van Beijsterveldt AMCA-M et al. Differences in injury risk and characteristics between Dutch amateur and professional soccer players. J Sci Med Sport 2015;18(2):145–9 - citations for effects of injuries on athletes and teams:
Psychological issues related to illness and injury in athletes and the team physician: a consensus Statement-2016 update. Med Sci Sport Exerc 2017;49(5):1043–54
Hägglund M et al. Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA champions League injury study. Br J Sports Med 2013;47(12):738–42 - citation for editorial about injury reviews and randomised controlled trials:
Bricca A, et al. There are more football injury prevention reviews than randomised controlled trials. Time for more RCT action! Br J Sports Med 2018;52(22):1477 - citation for review about hamstring injury:
Green B et al. Recalibrating the risk of hamstring strain injury (HSI): a 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport. Br J Sports Med 2020;54(18):1081–8 - citations for implementation and adherence to injury prevention programs:
Steffen K et al. Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11+) impact team adherence and injury risk in Canadian female youth football players: a cluster-randomised trial. Br J Sports Med 2013;47(8):480–7
van der Horst N et al. Effective but not adhered to: how can we improve adherence to evidence-based hamstring injury prevention in amateur football? Clin J Sport Med 2021;31(1):42–8
McCall A et al. Injury prevention strategies, coach compliance and player adherence of 33 of the UEFA elite Club injury study teams: a survey of teams’ head medical officers. Br J Sports Med 2016;50(12):725–30 - exercise programs resource:
https://www.f-marc.com/files/downloads/posters_generic/english.pdf
If you have run a local journal club on exercise for injury prevention in football (soccer) using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Marina De Barros Pinheiro and Giovanni Esteves Ferreira for coordinating this journal club. We would also like to thank Ítalo Ribeiro Lemes, Natalia Bittencourt, Thales Lopasso, Ariane Lopes, Eduester Lopes, Thales Rezende Souza for participating in the panel discussion video.
7. Understanding comparisons in trials
This PEDro World-Wide Journal Club is the first to focus on a research topic. It discusses issues raised in two short papers that explain why it is important to focus on the between-group difference as the estimate of the effect on an intervention in randomised controlled trials. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
2. read the article
Kamper SJ. Interpreting Outcomes 1 – Change and Difference: Linking Evidence to Practice. J Orthop Sports Phys Ther 2019;49(5):357-358.
3. read the article
Bland JM, Altman DG. Comparisons within randomised groups can be very misleading. BMJ 2011;342:d561.
4. watch (or listen to) the video of the panel discussing the topic (12 minutes)
5. meet with your colleagues to have your own discussion about interpreting comparative effects in trials
This discussion should focus on the implications of the papers’ demonstration that it is the between-group difference that measures the effect of an intervention in a controlled trial, and the difference in the effect of two interventions in a comparative trial. Consider the implications of that, which include that we cannot estimate the effect of an intervention from the within-group change in a randomised trial nor from the results of an uncontrolled trial.
If you have run a local journal club on interpreting comparative effects in trials using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Aidan Cashin, Kate Scrivener and Mark Elkins for coordinating this journal club and participating in the panel discussion video.
8. Understanding blinding in trials
This PEDro World-Wide Journal Club is another that focuses on a research topic. It discusses issues raised in two short papers that explain why it is important to consider the possible influence of blinding or lack of blinding on the estimate of the effect on an intervention in randomised controlled trials. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
2. read the article
Kamper SJ. Blinding: Linking Evidence to Practice. J Orthop Sports Phys Ther 2018;48(10):825-826.
3. read the article
Devereux PJ, et al. Physician interpretations and textbook definitions of blinding terminology in randomized controlled trials. JAMA 2001;285(15):2000-2003.
4. watch (or listen to) the video of the panel discussing the topic (12 minutes)
5. meet with your colleagues to have your own discussion about blinding in trials
This discussion should focus on the implications of the papers’ demonstration of the importance of blinding in reducing bias from affecting the results of randomised trials. You should consider the areas of clinical practice of the members of the group, and consider how blinding or lack of blinding might affect a trial’s outcomes. In particular, consider which common interventions in your subdiscipline that it might be possible to blind. Where such blinding is not possible, consider which typical outcome measures might be particularly exposed to bias due to lack of blinding.
If you have run a local journal club on blinding in trials using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Aidan Cashin, Kate Scrivener and Mark Elkins for coordinating this journal club and participating in the panel discussion video.
9. Intention-to-treat analysis in trials
This PEDro World-Wide Journal Club is the third to focus on a research topic. It discusses issues raised in a short paper about intention-to-treat analysis. These issues include the value of intention-to-treat analysis, the limitations of other approaches to data analysis, and how to discern whether intention-to-treat analysis has been achieved from the published report of a trial. If you are interested in being involved, please follow these four steps.
1. invite your colleagues to be involved
2. read the article
Elkins MR, Moseley AM. Intention-to-treat analysis. J Physiother 2015;61(3):165-167.
3. watch (or listen to) the video of the panel discussing the topic (10 minutes)
4. meet with your colleagues to have your own discussion about intention-to-treat analysis in trials
This discussion should focus on the implications of the paper’s demonstration of the importance of intention-to-treat analysis. You should consider the areas of clinical practice of the members of the group, the typical causes of loss to follow-up in those clinical areas and the typical causes of deviation from the intended intervention, such as poor adherence, poor tolerance, and use of other interventions. Then consider how other forms of analysis (eg, per protocol analysis or as treated analysis) might bias a trial’s outcomes.
If you have run a local journal club on blinding in trials using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Aidan Cashin, Kate Scrivener and Mark Elkins for coordinating this journal club and participating in the panel discussion video.
10. Confidence intervals
This PEDro World-Wide Journal Club is the fourth to focus on a research topic. It discusses issues raised in two short papers that explain what confidence intervals are and how they should be interpreted. The need for confidence intervals is introduced with an explanation that all estimates derived from clinical studies come with some uncertainty, and confidence intervals help us to quantify that uncertainty. The journal club also discusses some common misconceptions about confidence intervals and how they can be interpreted in relation to the smallest worthwhile effect, when such a threshold is available. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
2. read the article
Kamper SJ. Showing confidence (intervals). Braz J Ther. 2019;23(4):277-278.
3. read the article
Elkins MR, et al. Statistical inference through estimation: recommendations from the International Society of Physiotherapy Journal Editors. J Physiother. 2022;68:1–4.
4. watch (or listen to) the video of the panel discussing the topic (13 minutes)
4. meet with your colleagues to have your own discussion about interpreting confidence intervals in trials
This discussion should focus on the papers’ description of what confidence intervals signify in a controlled trial. Discuss the implications of that, which include that we should consider the practical implications of all values inside the confidence interval. Where confidence intervals have not been reported in a published trial, consider how you might need to interpret the results of the trial.
If you have run a local journal club on blinding in trials using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Aidan Cashin, Kate Scrivener and Mark Elkins for coordinating this journal club and participating in the panel discussion video.
11. Training bicycle riding in ambulant children with cerebral palsy
This PEDro World-Wide Journal Club is about training bicycle riding in ambulant children with cerebral palsy. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
3. watch (or listen to) the video summarising the training bicycle riding in ambulant children with cerebral palsy trial (7 minutes)
4. watch (or listen to) the video of the panel discussing the training bicycle riding in ambulant children with cerebral palsy trial (44 minutes)
5. meet with your colleagues to have your own discussion about the training bicycle riding in ambulant children with cerebral palsy trial.
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the training bicycle riding in ambulant children with cerebral palsy trial:
- I can shine program, based in the U.S. mentioned in the panel discussion.
- Bike skills training for children with cerebral palsy: protocol for a randomised controlled trial
If you have run a local journal club on training bicycle riding in ambulant children with cerebral palsy using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Nicholas Draheim and Emre Ilhan for coordinating this journal club. We would also like to thank Rachel Toovey, Melissa Locke, and Claire for participating in the panel discussion video.
12. Preoperative exercise training for people with non-small cell lung cancer
This PEDro World-Wide Journal Club is about preoperative exercise training for people with non-small cell lung cancer. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
2. read the article
Granger C, et al. Preoperative exercise training for people with non-small cell lung cancer. Cochrane Database of Systematic Reviews 2022, Issue 9
3. watch (or listen to) the video summarising the preoperative exercise training for people with non-small cell lung cancer review (5 minutes)
4. watch (or listen to) the video of the panel discussing the preoperative exercise training for people with non-small cell lung cancer review (57 minutes)
5. meet with your colleagues to have your own discussion about the preoperative exercise training for people with non-small cell lung cancer review.
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the preoperative exercise training for people with non-small cell lung cancer review:
- Greater Manchester Prehab4Cancer program
- Prehab4Cancer YouTube channel
- Cancer Research UK prehabilitation resources
- Moving Medicine
- The Pulmonary Rehabilitation Toolkit
- MacMillan Cancer Support
- Bradley P, Merchant Z, Rowlinson-Groves K, Taylor M, Moore J, Evison M. Feasibility and outcomes of a real-world regional lung cancer prehabilitation programme in the UK. Br J Anaesth. 2023 Jan;130(1):e47-e55.
If you have run a local journal club on preoperative exercise training for people with non-small cell lung cancer using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Lara Edbrooke for coordinating this journal club. We would also like to thank Catherine Granger, Zoe Merchant, Matt Evison and Nicola Burgess for participating in the panel discussion video.
13. Ballistic resistance training for people with traumatic brain injury
This PEDro World-Wide Journal Club is about ballistic resistance training for people with traumatic brain injury. If you are interested in being involved, please follow these five steps.
1. invite your colleagues to be involved
3. watch (or listen to) the video summarising the ballistic resistance training for people with traumatic brain injury trial (10 minutes)
4. watch (or listen to) the video of the panel discussing the ballistic resistance training for people with traumatic brain injury trial (37 minutes)
5. meet with your colleagues to have your own discussion about the ballistic resistance training for people with traumatic brain injury trial.
This discussion should focus on the implications of the results, including exploring possible barriers and facilitators to implementation. Devising strategies to implement the evidence into practice in your clinical environment is critical. For example, making plans for audit and feedback to quantify current and future practice.
Resources and articles mentioned in the video discussion about the ballistic resistance training for people with traumatic brain injury trial:
- Williams G, et al. Ballistic resistance training has a similar or better effect on mobility than non-ballistic exercise rehabilitation in people with a traumatic brain injury: a randomised trial. Journal of Physiotherapy 2022, 68(4): 262-268
- Williams G, et al. Ballistic strength training compared with usual care for improving mobility following traumatic brain injury: protocol for a randomised, controlled trial. Journal of Physiotherapy 2016, 62(3): 164
- Williams G, et al. Improving walking ability in people with neurological conditions: a theoretical framework for biomechanics-driven exercise prescription. Archives of Physical Medicine and Rehabilitation 2019, 100(6): 1184-1190
- Progression Models in Resistance Training for Healthy Adults. Medicine & Science in Sports & Exercise 2009; 41 (3): 687-708
- Williams G, et al. Internal validity of the revised HiMAT for people with neurological conditions neurological conditions. Clinical Rehabilitation 2012; 26(8): 741-747
- Williams G, et al. The high-level mobility assessment tool (HiMAT) for traumatic brain injury. Part 2: content validity and discriminability. Brain Injury 2005; 19(10): 833-843
If you have run a local journal club on ballistic resistance training for people with traumatic brain injury using this material, please let PEDro know. We’d like to know what your local journal club experience was like and any feedback you may have about the materials provided by PEDro.
PEDro acknowledges Leanne Hassett and Jayden Smileski for coordinating this journal club. We would also like to thank Gavin Williams, Chris Byrne, and Thommo for participating in the panel discussion video.