Research Report Abstracts - Gesundheit

eS866
Analysis: We analysed the outcome data using weighted
mean difference for identical outcome measures and the standardised
mean difference when different measurement scales
were used. We applied a random-effects meta-analysis model
throughout. Where it was not possible to perform a metaanalysis
due either to significant heterogeneity or a lack of
evidence, we provide a narrative summary of the data for each
study. The analysis was performed using RevMan5 ® .
Results: Overall the meta-analysis found no evidence for the
effectiveness of CBR as compared with IBR with respect to
functional outcome (Standardised Mean Difference (SMD)
0.09; 95% Confidence Interval (CI) −0.08 to 0.26) or quality
of life (Mean Difference (MD) 1.32; 95% CI −4.30 to
6.93) or carer strain (MD 0.76; 95% CI −0.19 to 1.77). Subgroup
analyses at three months showed a significant effect
for community-based rehabilitation over hospital/institution
based rehabilitation on quality of life (MD 5.00; 95% CI
0.82–9.18); however, this effect was not maintained at six
months. Cost-effectiveness tended towards a cost reduction
associated with community-based rehabilitation.
Conclusions: Use of community-based rehabilitation may
be associated with positive and negative effects. However,
there is currently insufficient supporting evidence to justify
the implementation of community-based rehabilitation for
stroke rehabilitation. A stronger evidence base is required to
adequately inform health policy decisions and guide methods
of service delivery to effective improve stroke patient
outcomes.
Implications: RCT’s provided insufficient data to support
evidence-based recommendations regarding the use of CBR
over IBR on improving functional independence, quality
of life, carer strain and cost effectiveness for patients with
stroke. Currently inadequate evidence to support the routine
implementation of CBR for the management of stroke
patients with functional limitations and participation restrictions.
Keywords: Community-based rehabilitation; Stroke; Systematic
review
Funding acknowledgements: The work was unfunded.
Ethics approval: Ethics approval was not needed as it is
secondary research.
Research Report Platform Presentation
Number: RR-PL-1438 Tuesday 21 June 16:30
RAI: E106-107
IS IONTOPHORESIS OF VALUE IN
PHYSIOTHERAPY?
Naidoo N. 1 , Naidoo R. 2
1University of Cape Town, Physiotherapy, Cape Town, South
Africa, 2Clairwood Hospital, Physiotherapy, Durban, South
Africa
Purpose: Iontophoresis is a therapeutic, non-invasive method
of transdermal drug delivery which may be used to stimulate
wound healing and could provide physiotherapists with
an effective adjuvant treatment modality to facilitate wound
care. The main aim was to investigate the effectiveness of
antibiotic iontophoresis on open burn injuries of the hand on
wound healing, pain inhibition and wound infection control.
Relevance: Physiotherapists treat open wounds in general
practice and are a vital member of the multidisciplinary
wound care team. There is evidence, although dated, to support
the use of iontophoresis to accelerate wound healing.
Iontophoresis could enhance rehabilitation and function and
provide effective adjuvant treatment for open wound injuries.
Participants: 22 subjects between the ages 18 and 55 years
with partial thickness open burn wounds to the hands sustained
within a week of injury were included in this study.
Methods: Eleven subjects were randomly assigned to the
experimental group and 11 subjects were included in the
control group, All participants were assessed initially and
subsequently at weekly intervals where measurements of
pain, bacteriology, wound size and range of motion were
taken. Outcome measures included a visual analogue scale
to measure pain; wound swabs were subjected to microbiology
analysis, wound surface area was calculated and the
range of motion at the associated joints was measured using a
goniometer. All participants received mobilization exercises
and standardized wound lavage and dressings. Additionally,
those participants in the experimental group received antibiotic
iontophoresis and those in the control group received
topical antibiotic application in the wound dressings.
Analysis: Descriptive statistics were used to describe the
participants. Chi squared and t tests were done to compare
the independent variable. A repeated measures ANOVA was
used to compare the two groups over time with respect to the
outcome variables.
Results: There were no significant differences between the
two groups at the initiation of the study. There was a trend
using the ANOVA towards decreased pain in the iontophoresis
group, however, this was not significant (p = 0.11). t tests
calculating the wound surface area showed no significant difference
(p = 0.29). Although the distribution was the same in
both groups on initiation of the study, the Chi squared test
showed that there were a greater number in the experimental
group that had no growth of organisms (p = 0.01).