Critical Review of Journal Article

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This critical review of the quantitative study “Evaluation of a multiprofessional community stroke team: a randomised controlled trial. Clinical Rehabilitation; 18 pp 40-47

The study aims to conclusively evaluate how effective it is to employ a specialist community stroke team for the rehabilitation of stroke victims in a community based setting. This is clearly established at within the opening lines of the article. In the summary at the beginning of the article the author claims that the available evidence is inconclusive and his aim is to provide conclusive proof with regards to evidence based practise for the patient. A research article should state its’ aims clearly and should assume the audience has no previous background knowledge (Greenhalg, 2006).

The literature reviewed in this article was from a variety of sources such as the Cochrane database and a selection of journal articles. On this basis the authors were able to deduce that previous research carried out provided contradicting reports. For example Roderick et al (2001) as cited by Lincoln et al (2004) found no significant difference in the effectiveness of rehabilitation which had taken place in the home to that which had occurred in a hospital setting. On the contrary Gladman et al (1993) as cited by Lincoln et al (2004) found a significant difference in a small group of younger patients. It was also suggested that there was a shift of focus from mainly hospital based rehabilitation to community based rehabilitation of stroke patients. According to Polger and Thomas (2008) a literature review should provide appropriate background information. That is, it should show the current knowledge level in that area of study. The author appears to have utilised much of his own previous work in the study and some are more than ten years old. This could possibly be an indication that indeed, there is a large gap in knowledge of this subject area. On the other hand it may indicate that the author has done a selective search of the literature.

A quantitative approach was utilised in this study and the method used was a Randomised Controlled Trial (RCT). The articles’ methodology was well documented. According to Sim and Wright (2000) an analytic study attempts to quantify the relationship between two factors, that is, the effect of an intervention or exposure on an outcome. A term used to describe the design randomized controlled trial according to Greenhalgh (2006) is Parallel group comparison. This is when each group receives a different treatment and both are entered into the experiment at the same time. By comparing the groups an analysis is provided. In the Lincoln et al (2004) study Participants were divided into two groups, A and B with the former receiving routine care while the latter received the intervention – rehabilitation with the multi-professional community stroke team. The question posed by the authors could have been answered using a qualitative approach. The question could possible state; Evaluation of a multiprofessional community stroke team: a phenomenological study.

Altman (1991) states that a study should have enough participants recruited in order to detect a significant effect if one exists. The sample group consisted of patients referred to the Nottingham Community Stroke Team who had suffered a stroke within the last two years, who were over sixteen years old and needed intervention from more than one multidisciplinary team member. Patients who lived outside the geographical area and/or had been treated by the community stroke team in the preceding two years were excluded. Four hundred and twenty eight patients were randomly selected at the start of the trial and randomly allocated to either Group A or Group B. An error resulted in seven people being recruited twice. This error was corrected by including only the outcome of their initial recruitment when the...
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