Details of HTA project
Last updated: 1 July 2008 - Next update due: 8 July 2008
Research type: |
Secondary Research (e.g. systematic review) |
Project title: |
A systematic review of repetitive task training with modelling of resource use, costs and effectiveness |
Project ref: |
05/17/04 |
Cost: |
£68,683 |
Chief Investigator : |
Professor Caroline Watkins, Professor of Stroke & Older People's Care, Department of Nursing, University of Central Lancashire |
Start Date: |
November 2005. |
Publication date: |
August 2008. This project is at the editorial review stage. Delays in the review process can cause the forecast publication date to be delayed. |
Plain English Summary |
Half of the people who survive a stroke are left with problems moving and using their arms and legs. Some research studies have shown that if stroke patients repeat a series of movements over and over again, then this may help them to use their arms and legs to do activities such as walking or dressing. Our proposal plans to find all the research studies that have looked at whether training stroke patients to repeat a series of movements over and over again has helped them to recover use of their arms and legs. We plan to review all the research studies that have examined this repetitive training and then put the results of the studies together. By combining the results we will find which kinds of repeated movements help patients the most. We will then be able to advise patients of the movements to repeat that will be most likely to help them to recover the use of their arms and legs. We also want to identify what effect, if any, training stroke patients to repeat movements has on NHS costs. To do this, we will initially use existing data to calculate the current cost of stroke. Then we will use the results of the review to estimate how this cost of stroke might change if repetitive training helps people to recover use of their arms and legs. Our study will be done with the Cochrane Collaboration, an international not-for-profit organisation, providing up-to-date information about the effects of health care. The project will be based at the University of Central Lancashire. We will not need to contact any patients to perform this project. However, we may use existing anonymised patient data to help us examine the cost of stroke. We will seek approval to use such data from an Ethics Committee. Our study team has a lot of experience of doing research with stroke patients and of doing similar studies for the Cochrane Collaboration. To help us do this study, we would like a full-time research assistant to help find research studies to include, to help take important information from studies, including cost information, and to see if studies are good quality and what the costs would be if applied in practice. Money is also requested for obtaining studies from other libraries, searching for and translating studies from other languages and buying some databases of research studies. We would like the research team to meet three times and for three members of the research team to attend the HTA Programme introductory meeting in Southampton. |
Abstract: |
Stroke is a leading cause of disability, and contributes to 4% of all NHS costs. If disability and subsequently the need for institutional care can be reduced, there is a potential to reduce costs. Reviews of treatment interventions suggest that patients benefit from exercise programmes where they are trained in functional tasks. Repetitive Task Training (RTT) is defined as the repeated use of active sequences of functional movement. Repeated motor practice has been hypothesised to reduce muscle weakness and spasticity, and to form the physiological basis of motor learning. No systematic review has yet considered the effectiveness of RTT. In order to assimilate the existing evidence a comprehensive Cochrane review of randomised or quasi-randomised controlled trials of RTT will be undertaken. The review will use the stroke specific search strategies developed for the Cochrane Stroke Group. For a trial to be included in the review, one arm must include RTT, with a primary focus on repetitive movement practice of a functional goal and must be compared with usual practice or another intervention. The primary outcomes will be upper and lower limb-specific ADL scores. Secondary outcomes will include: global functional measures, quality of life, and resource use. Following the review, and using existing data, an economic model of current stroke resource use will be developed. The costing will take the perspective of the NHS and PSS, and will estimate costs over a five year period post-stroke. The economic model will then be applied to the estimates of effectiveness obtained from the systematic review. The costs of a RTT programme for each of the trials identified in the systematic review will be estimated and compared with the difference in outcomes between the groups. From this, an incremental cost per unit change of outcome measure will be calculated. |
MeSH* index primary terms: |
DECISION-MAKING; WORK; TEACHING |
MeSH* index secondary terms: |
HUMANS; COST-BENEFIT-ANALYSIS; REVIEW |
NRR* number, if applicable: |
N0484171030 (*National Research Register) |
Project Protocol: |
Project protocol not available |
URL of this page: |
http://www.hta.ac.uk/1488 |
News feeds