World-Wide Journal Club

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:

  1. Constraint induced movement therapy after stroke
  2. Exercise for falls prevention in community dwelling older people
  3. Exercise for rotator cuff related shoulder pain
  4. Advanced telehealth technology to deliver exercise therapy for chronic obstructive pulmonary disease
  5. Decreasing frailty in older people
  6. Exercise for injury prevention in football (soccer)
  7. Understanding comparisons in trials
  8. Understanding blinding in trials
  9. Intention-to-treat analysis
  10. Confidence intervals
  11. Training bicycle riding in ambulant children with cerebral palsy
  12. Preoperative exercise training for people with non-small cell lung cancer

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

2. read the article
Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D, Giuliani C, Light KE, Nichols-Larsen D, for the EXCITE Investigators. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA 2006;296(17):2095-104

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:

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:

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:

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:

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

2. read the article
Fairhall N, et al. Effect of a multifactorial interdisciplinary intervention on mobility-related disability in frail older people: randomised controlled trial. BMC Med 2012;10(120):1-13

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:

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

2. read the systematic review
Lemes IR, et al. Do exercise-based prevention programmes reduce non-contact musculoskeletal injuries in football (soccer)? A systematic review and meta-analysis with 13,355 athletes and more than 1 million exposure hours. British Journal of Sports Medicine 2021;55(20):1170-1178

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:

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

2. read the article
Toovey RAM, et al. Task-specific training for bicycle-riding goals in ambulant children with cerebral palsy: a randomized controlled trial. Developmental Medicine and Child Neurology 2022 Feb;64(2):243-252

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:

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:

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.

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