Motor impairment affects around 80% of stroke survivors, affecting the control of movement of one side of the body. A common goal of stroke rehabilitation is to improve function and walking/mobility. Identification of effective rehabilitation treatments to improve walking is an identified (James Lind Alliance) research priority of stroke survivors, carers and health professionals. The goal of this project is to identify best evidence for interventions aimed at improving walking after stroke.
Yet, current clinical practice often does not reflect the available evidence-base and the growing number of systematic reviews can be overwhelming for decision makers, who do not have time to keep up-to-date. Overviews of systematic reviews can play an important role in the promotion of efficient evidence based practice by signposting clinical decision makers to the most useful and high quality evidence. For example, a Cochrane Overview of interventions to improve arm function after stroke published in 2014 is the most accessed Cochrane stroke review per year (2015-2018) and is widely cited in national guidelines.
There are a large number of Cochrane stroke reviews focussed on interventions to improve walking/mobility and bringing these together into an overview has the potential for considerable impact.
However, while overviews of reviews have the potential for impact, this is a new and developing field and there is a need for methodological development and innovation to ensure optimal translation of evidence into practice.
The aims of this PhD are therefore to: 1. Conduct a Cochrane overview of interventions to improve walking/mobility after stroke. 2. Develop innovative ways of presenting summaries of evidence to clinical decision makers, including production of visual maps, aimed at supporting knowledge translation. 3. Explore the information needs of clinical decision makers, and their preferences for different ways of receiving information in order to inform practice.