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Workshop:How to use the Cohrane evidence in the field of spinal cord injury: The Cochrane Rehabilitation strategy.

Track 1
Friday, September 4, 2020
11:00 AM - 12:30 PM
Auditorium - Track 1


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Dr Carlotte Kiekens
Spinal Unit Director
Montecatone Rehabilitation Institute

How to use the Cochrane Evidence in the field of Spinal Cord Injury: The Cochrane Rehabilitation strategy


Outline of the 90-minute session:
• Cochrane Rehabilitation knowledge translation activities. Carlotte Kiekens (15 minutes)
• What is a Cochrane Review and how to use it in Spinal Cord Injury rehabilitation practice. Julia Patrick Engkasan (15 minutes)
• Overview of Cochrane Reviews in Spinal Cord Injury rehabilitation. Chiara Arienti (15 minutes)
• Cochrane Rehabilitation special projects: the rehabilitation definition for research purposes and RCT Rehabilitation Checklist (RCTRACK) for reporting. Stefano Negrini (15 minutes)
• Discussion (30 minutes)

The creation of the Cochrane Knowledge Translation Strategy came from the difficulty to apply scientific knowledge in clinical practice: in the field of Evidence Based Medicine, high quality evidence in not consistently applied in practice. The aim is to shortly present what Knowledge Translation is and its relevance for Spinal Cord Injury rehabilitation.
Cochrane Rehabilitation (CR) is organized to provide the best possible Knowledge Translation (KT) in both directions (bridging function), toward the world of rehabilitation (e.g. spreading reviews), and to the Cochrane community (e.g. production of reviews significant for rehabilitation).
Most of the work of CR has been performed following the KT strategy: for example, CR has finished the “tagging” process of Cochrane Systematic Reviews (CSRs) relevant for rehabilitation published until August 2019. Four CSRs were related to Spinal Cord Injury rehabilitation on the following topics: the effectiveness of pharmacological interventions on spasticity, locomotor training on walking ability respiratory muscle training and non-pharmacological interventions on chronic neuropathic and nociceptive pain. The results highlighted the low quality of evidence and consequently, any conclusion about the effectiveness of rehabilitation in spinal cord injury management was not addressed. This issue is related to the complexity of rehabilitation characteristics that make difficult to keep the standard of high quality of evidence. To face this important challenge, CR started two important projects to improve the quality of evidence in rehabilitation field. The first is the rehabilitation definition for research purposes with the aim to specify a definition of rehabilitation suitable for research purposes that also defines inclusion and exclusion criteria. The second is the RCT Rehabilitation Checklist (RCTRACK) project to improve designing, conducting, reporting, implementing, and assessing the Risk of Bias in rehabilitation.
A proposal of rehabilitation definition and RCTARCK checklist have been presented to dedicated Consensus Meetings in Milan and in Orlando, respectively. The next step is to finalize and approve them after a Delphi round consensus procedure.
These KT activities of CR represent a new strategy to disseminate and improve the evidence more meaningful for the world of Spinal Cord Injury rehabilitation. The vision of CR is that all rehabilitation professionals apply Evidence Based Clinical Practice, combining the best available evidence as gathered by high quality Cochrane systematic reviews, with their own clinical expertise and the values of patients and to take decisions according to the best and most appropriate evidence in this specific field.


Carlotte Kiekens is a Physical and Rehabilitation (PRM) physician (MD). She is since January 2020 Director of the Spinal Unit at the Montecatone Rehabilitation Institute in Imola (Bologna, Italy). Before she was head of clinic at the PRM department of the University Hospitals Leuven and she is currently still affiliated with UZ Leuven and KU Leuven. She is Co-Director of Cochrane Rehabilitation which she cofounded in 2016. She is the chair of the International Society of PRM-WHO Liaison committee and a member of the European Academy of Rehabilitation Medicine. She published more than 100 papers, 19 book chapters and gave many lectures at national and international conferences. She was a co-editor of the 3rd Edition of the White Book on PRM in Europe.