a very quick update on research in amputees. process search of amed, medline, embase, cochrane...
TRANSCRIPT
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A Very Quick Update on Research in
Amputees
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Process
Search of AMED, Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of SR, Cochrane Database of Abstracts of Reviews and Effects 22150 Entries
2010 87 entries
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Process
Cochrane Reviews 4 (3 complete, 1 protocol)
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Cochrane Reviews
At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses which summarise and interpret the results of medical research.
The Cochrane Library aims to make the results of well-conducted controlled trials readily available and is a key resource in evidence-based medicine.
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Pharmacological interventions for treating phantom limb pain (2009)
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Phantom Pain
Do pharmacological agents given post operatively when phantom pain occurs provide : Short term pain relief
Improved sleep Changes in sleep Changes in function Changes in QOL
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Transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults (2010)
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TENS for Phantom and Stump Pain
Criteria All RCT’s Adults with phantom limb or stump
pain TENS vs comparison group (ie no Rx,
sham, a pharmacological intervention, a non-pharmacological intervention)
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TENS for Phantom and Stump Pain
Outcome measures Primary (Pain validated scale – VAS,
NRS) Secondary (lots)
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TENS for Phantom and Stump Pain
72 published studies initially identified
14 considered relevant
Nil meet criteria
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TENS for Phantom and Stump Pain
Insufficient evidence for practice
10 of the 14 studies reported benefits from using TENS
1 reported no benefit 2 were inconclusive 1 did not provide sufficient
information
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Prosthetic rehabilitation for older dysvascular people following a unilateral transfemoral review (2009)
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Prosthetic Training
To summarise the evidence evaluating prosthetic rehabilitation interventions post TFA in older dysvascular patients
Criteria RCT’s Male or female over 60 years old Living in the community or in institutional care Dysvascular A TFA or through knee amputation and
provided a prosthesis for mobilising
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Prosthetic Training
Interventions Education on Don/doff Education on skin care Therapeutic interventions Balance and mobility training Functional training General advice
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Prosthetic Training
Primary measure User satisfaction Level of function Amputee specific functional tests
Secondary measures General quality of life measures
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Prosthetic Training
38 published studies initially identified
5 considered relevant
1 suitable for inclusion
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Prosthetic Training
Prosthetic weight effect on gait speed and preference
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Prescription of prosthetic ankle-foot mechanisms after lower limb amputation(2009)
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Ankle-foot prescription
To establish precise criteria for the prescription of prosthetic ankle-foot mechanisms in individuals with lower limb amputations
Criteria RCT’s and Quasi RCT’s Comparing different types of feet
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Ankle-foot mechanisms
Outcomes Subjective findings Energy expenditure Stride characteristics Kinetic and kinematic parameters
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Ankle-foot Prescription
348 references initially identified
37 studies considered relevant
26 suitable for inclusion
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Ankle-foot Prescription
Insufficient evidence from high quality comparative studies for the overall superiority of any type of prosthetic foot ankle mechanism
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Take Home message
A lack of high quality comparative studies
Lack of randomisation
Poor description of procedures