REVIEWS: Departments: Reviews
Purpose/Audience: Spinal Cord Injury Rehabilitation Evidence (SCIRE) is a Canadian project sponsored by the Rick Hansen Institute and developed in 2006 with collaboration among scientists, clinicians, consumers at International Collaboration on Repair Discoveries (ICORD), Ontario Neurotrauma Foundation, Lawson Health Research Institute, Parkwood Hospital, G. F. Strong Rehab Centre, and the University of British Columbia. The website provides reviews, evaluations, and translations of existing research to inform allied health professionals and physicians, as well as other stakeholders of best rehabilitation practices following spinal cord injury (SCI). SCIRE currently offers summaries of evidence and recommendations regarding best practices for 30 different topics related to SCI, has published more than 25 peer-reviewed manuscripts in various journals (mainly systematic reviews), and has hosted more than 100 informational presentations and workshops around the world.
Outcome Measures Section: SCIRE reviews common outcome measures used in SCI rehabilitation and describes their clinical utility and properties to assist clinicians in selecting appropriate measures to monitor progress and evaluate treatment effectiveness. Only outcome measures that have had their psychometric properties assessed for persons with SCI are included. The standards used by SCIRE were adapted from McDowell and Newell's (1996), as well as Andresen's (2000) recent overview of Criteria for Outcome Measures. The included tools are either “familiar and of interest to clinicians” or “commonly known and used internationally.” Thus far there have been 3 iterations of SCIRE's list of outcome measures. There are a total of 91 tools in the present version; 45 pertain to body function and structure, 36 to activity, 6 to participation, 11 to quality of life, and 2 outcome measures related to the environment. The procedures, scoring, acceptability, interpretability, usability, language, time to administer, training requirements, psychometric properties, and availability of the tests are all reported for each outcome tool. An SCI outcome measure toolkit is also currently under construction by SCIRE.
Rehabilitation Evidence Section: The SCIRE project began with a systematic review of publications pertaining to SCI rehabilitation that were published between 1980 and 2005 in MEDLINE/PubMed, CINAHL, EMBASE, or PsycINFO. Approximately 8400 titles and abstracts were reviewed for the first version of SCIRE. Methodological quality of individual randomized controlled trials was assessed using the Physiotherapy Evidence Database (PEDro) tool. All other studies were assessed with the Downs and Black Tool for methodological quality. The levels of evidence were determined using the work of Sackett and colleagues (Evidence-Based Medicine: How to Practice and Teach EBM, 2000). This information was then used to generate summaries of evidence and lists of references, as well as recommendations for practice. This method of review was repeated in 2008 and 2009.
Case Studies Section and Education Sections: These sections of the website are currently under construction, but in the future will include scenarios and modules designed to facilitate translation of evidence to practice for various audiences (specialist and nonspecialist clinicians, residents, and students).
The website was last updated May 5, 2010; last accessed April 4, 2011.
Joy A. Bruce, MSPT, NCS
Shepherd Center, Atlanta, Georgia