Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 4 appraisals
Physiotherapy theory and practice
Physical therapists' perspectives on a large language model-powered knowledge translation tool for guideline adherence: A qualitative focus group study.
BACKGROUND: Clinical practice guidelines support healthcare professionals in making evidence-based decisions, yet guideline adherence among physical therapists remains inconsistent. To address this gap, a prototype digital knowledge translation tool powered by a large language model (LLM) was developed, with content based on two exemplary high-quality German national guidelines. OBJECTIVE: To (1) explore the experiences of German physical therapists using the tool, (2) assess their perspectives on its utilization in clinical practice, and (3) compare perceptions between outpatient and inpatient settings. METHODS: Six focus group interviews were conducted: three in a university hospital inpatient setting and three in outpatient physical therapy practices. Discussions were analyzed using qualitative content analysis with inductive and deductive coding. RESULTS: Twenty physical therapists (11 inpatient, 9 outpatient) participated. Overall experiences were positive, though prolonged response times were criticized. Utilization was thought to depend on time availability and workplace digitization. The tool's potential assisting with clinical questions was highlighted. No considerable differences in experiences across settings were noted. Inpatient therapists envisioned using the tool between sessions for personal knowledge enhancement, whereas outpatient therapists anticipated utilization during sessions for patient education. CONCLUSION: LLM-based knowledge translation tools may contribute to improving guideline adherence among physical therapists. Successful implementation requires assessment of digital infrastructure, relevance to clinical needs, and users' digital literacy. Further research should evaluate the quality of LLM-generated summaries to ensure validity and trustworthiness, and optimize the tools' usability regarding speed and content. Development should also prompt ethical considerations about their role in clinical decision-making and patient care.
2 July 2026
Read appraisal →Brain impairment : a multidisciplinary journal of the Australian Society for the Study of Brain Impairment
Rehabilitation technologies perceived positively by patients and facilitated intensive therapy within sessions.
BACKGROUND: Australian inpatient rehabilitation facilities are increasingly integrating rehabilitation technologies to support patient recovery. However, little is known about patient perceptions of rehabilitation technologies and the intensity of therapy able to be facilitated. This study aimed to quantify the amount of practice being achieved by patients in an Australian inpatient rehabilitation setting and explore their perceptions of upper limb rehabilitation technologies. METHODS: A multimethod study design was used to investigate the perceptions and use of rehabilitation technologies (i.e. InMotion, Fourier ArmMotus, SaeboReJoyce and Touch Accessible Platform for Interactive Technology) by adult inpatients. Semi-structured interviews and the System Usability Scale were completed. Observations of routine therapy sessions were undertaken to quantify the amount and intensity of technology-based practice. RESULTS: Ten participants were recruited (50% male, mean age 62 years). A total of 15 sessions were observed across all participants using robot-assisted therapy and Touch Accessible Platform for Interactive Technology at an average duration of 35 min/session; of which 29 min was active therapy. Most participants described their experiences with rehabilitation technologies positively, highlighting benefits for recovery, enjoyability and easy usability. Participants rated the technologies highly on the System Usability Scale, with total scores ranging between 65 and 100 for usability, and a minimum rating of 'good' for user-friendliness. CONCLUSION: Rehabilitation technologies were well received by adults undergoing inpatient rehabilitation and with application for a range of impairments. The technologies facilitated enjoyment of daily therapy, and participants were comfortable with limited therapist input when using the devices. Additionally, participants were able to engage in highly intensive practice using the technologies.
27 June 2026
Read appraisal →American journal of speech-language pathology
Parental Roles in Language Intervention: A Systematic Review
BACKGROUND: Children with language delays (LDs) or language disorders face persistent challenges in their development. Speech and language therapy is vital, and within it, parental involvement is recognized as a key factor in therapeutic success. Although many parent-implemented interventions exist, little is known about the specific roles parents assume, particularly across different diagnostic groups: LD, developmental language disorder (DLD), and language disorder associated with other conditions (LD + X). OBJECTIVE: The aim of this study was to review and synthesize evidence on parental roles in language interventions for children with LD, DLD, and LD + X. METHOD: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in PROSPERO (CRD42023452616), this systematic review analyzed studies from four databases. Eligible studies involved parent participatory language interventions reporting child language outcomes. Two independent reviewers conducted screening, quality appraisal, and data extraction. RESULTS: Across 37 studies, parents most frequently assumed the roles of Learner, Implementer, and Informer, highlighting their functions in acquiring knowledge, applying strategies, and providing feedback on children's progress. Less common roles included Adaptor and Collaborative Decision-Maker, suggesting that although caregivers are increasingly active, their engagement rarely extends to shared decision making with professionals. The studies reviewed here demonstrated considerable variability in intervention dosage, total duration, delivery format, and strategies taught. In contrast, less variability was observed in the identity of the parents/caregivers (most often the mother) and the trainer (typically a speech-language therapist) as well as in the type and mode of delivery. CONCLUSIONS: Parental engagement in language interventions continues to be largely determined by professional guidance, positioning parents as learners and implementers rather than full collaborators. Strengthening adaptive roles and promoting shared decision making can enhance family-centered practice. Future programs could consider the specific needs of each context, encourage parental involvement, and explore telepractice to expand access. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.32060328.
11 May 2026
Read appraisal →Journal of speech, language, and hearing research : JSLHR
Rhotic Generalization Is More Rapid in Biofeedback Than Motor-Based Treatment for Residual Speech Sound Disorder: Secondary Outcomes of a Randomized Controlled Trial
PURPOSE: This study examined the effects of visual biofeedback approaches and nonbiofeedback motor-based treatment on generalization outcomes following speech therapy for children with residual speech sound disorders (RSSDs). METHOD: A total of 108 children aged 9-15 years with RSSD affecting American English /ɹ/ were randomly assigned to receive 19 motor-based speech treatment sessions, with or without visual biofeedback (divided into ultrasound or visual-acoustic biofeedback). The treatment included practice designed to implement several motor learning principles, with task difficulty systematically adjusted based on the child's performance. Children's /ɹ/ accuracy on untreated words before and after treatment was rated as correct or incorrect by lay listeners who were blinded to participant characteristics, treatment conditions, and time points. RESULTS: The mixed-effects regression model revealed a statistically significant interaction between treatment type and time point. Specifically, both the biofeedback and nonbiofeedback motor-based treatment groups made progress over time, but the amount of generalization to untreated words was significantly greater in the biofeedback condition than in the motor-based treatment. In a subanalysis comparing biofeedback types, greater generalization was observed following ultrasound biofeedback than visual-acoustic biofeedback, although this effect was strongest at one treatment site. DISCUSSION: This randomized controlled trial found that adding biofeedback to motor-based treatment can increase the rate of accurate production of the American English /ɹ/ in untreated words.
12 Apr 2026
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