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Table 8 Effect of substitution of allied health professional therapy with AHA therapy on patient outcomes

From: The effect of delegation of therapy to allied health assistants on patient and organisational outcomes: a systematic review and meta-analysis

Study Outcome MD (95%CI) SMD (95%CI)
Impairment
 Boyle 2007 [46] Individual   
  CELF-R (units) −1.76 (− 6.43 to 2.91) − 0.18 (− 0.66 to 0.30)
  CELF- E (units) − 1.35 (− 5.28 to 2.58) − 0.17 (− 0.65 to 0.31)
  Group   
  CELF-R (units) −1.33 (− 6.19 to 3.53) − 0.14 (− 0.63 to 0.35)
  CELF-E (units) 0.47 (− 3.11 to 4.05) 0.07 (− 0.42 to 0.56)
 Cox 2014 [50] AusTOMs impairment: UL (units) 0.45 (− 0.03 to 0.93) 0.44 (− 0.03 to 0.93)
  AusTOMs impairment: Daily tasks (units) 0.22 (− 0.19 to 0.63) 0.25 (− 0.21 to 0.73)
  AusTOMs impairment: Domestic life (units) 0.27 (−0.12 to 0.66) 0.32 (− 0.15 to 0.80)
 Lincoln 1999 [33] Handgrip strength
(% max unaffected hand)
8 (−2.06 to 18.06) 0.24 (− 0.06 to 0.54)
Activity limitation
 Cannel 2018 [49] Functional reach (cm) (change score) 0.9 (−3.1 to 5.0)a N/A
  Lateral reach (cm) (change score) 2.4 (−0.9 to 5.7)a N/A
  Sitting balance (units) (change score) 0.2 (−0.17 to 0.6)a N/A
  MMAS-upper arm (units) (change score) −0.1 (− 0.17 to 0.6)a N/A
  Box and block test (units) (change score) −2.2 (− 7.8 to 3.0)a N/A
  Step test (number) (change score) −0.5 (−2.3 to 1.4)a N/A
  TUGT (sec) (change score) 4.9 (− 5.3 to 15.4)a N/A
  Walking speed (m/sec) (change score) 0.05 (−0.09 to 0.19)a N/A
 Cox 2014 [50] AusTOMs activity limitation: UL (units) 0.35 (−0.09 to 0.79) 0.37 (− 0.10 to 0.85)
  AusTOMs activity limitation: Daily tasks (units) −0.18 (− 0.51 to 0.15) −0.26 (− 0.74 to 0.21)
  AusTOMs domestic life: Domestic life (units) 0 (−0.38 to 0.38) 0 (− 0.47 to 0.47)
  FIM (units) −1.76 (− 6.43 to 2.91) − 0.18 (− 0.66 to 0.30)
 Lincoln 1999 [33] Rivermead arm (units) 0.66 (− 1.16 to 2.48)b 0.11 (− 0.19 to 0.41)b
  ARAT (units) 3.33 (− 5.88 to 12.54)b 0.11 (− 0.19 to 0.41)b
  Barthel index (units) 0 (−2.07 to 2.07)b 0 (− 0.30 to 0.30)b
  Rivermead gross motor (units) 0 (−1.49 to 1.49)b 0 (− 0.30 to 0.30)b
  Ten hole peg test (units) 6.33 (−2.10 to 14.76)b 0.23 (−0.07 to 0.53)b
 Parry 1999 [34] Rivermead arm (units) 0.66 (− 0.45 to 1.77)b 0.33 (− 0.22 to 0.88)b
  ARAT (units) 7.66 (0.61 to 14.71)b 0.57 (0.01 to 1.13)b
  Barthel Index (units) 3.00 (0.36 to 5.64)b 0.63 (0.07 to 1.19)b
Activity limitation
 Lord 2008 [51] Walking speed (m/min) −2.6 (− 15.2 to 10.0)a N/A
  6-min walk test (m) − 1.1 (− 60.2 to 58)a N/A
  ABCS (units) −0.6 (− 14.8 to 13.5)a N/A
 Wenke 2014 [52] CAT spoken language (units) −3.72 (− 32.84 to 25.40) −0.14 (− 1.13 to 0.86)
  CAT disability (units) − 16.87 (− 34.10 to 0.36) −1.06 (− 2.12 to 0.01)
Participation restriction
 Cox 2014 [50] AusTOMs: Participation restriction (units) 0.15 (− 0.18 to 0.48) 0.21 (− 0.26 to 0.69)
Lord 2008 [51] SIPSO (units) 0.3 (− 3.9 to 4.5)a N/A
Other
 Cox 2014 [50] AusTOMs: Distress / wellbeing (units) 0.03 (− 0.30 to 0.36) 0.04 (− 0.43 to 0.51)
  1. ABCS Activities-specific balance confidence scale, ADL Activities of daily living, AHA Allied health assistant, ARAT Action research arm test, AUS Australia, AusTOMs Australian therapy outcome measures for Occupational Therapy, CAT Comprehensive aphasia test, CELF-E Clinical evaluation of language fundamentals expressive sub-scale, CELF-R Clinical evaluation of language fundamentals receptive sub-scale, FIM Functional independent measure, MD Mean difference, MMAS Modified motor assessment scale, N/A Not available or unable to be calculated, SMD Standardised mean difference SIPSO: subjective index of physical and social outcome. Bold text* indicates statistically significant difference between groups favouring allied health assistant group
  2. Positive MD favours allied health assistant group
  3. aMD reported in study
  4. bMD calculated from converted medians