Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

does the use of e-stim on the lower extremity for foot drop have any effect on tonus (brain connection) with people who have had brain injury(TBI,CVA)?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Compare subtle somatic education to help nervous system learn/improve movement strategies with high tech approaches such as e-stim and the effect on tonus for improving ambulation

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

CVA, TBI OTHER CENTRAL NERVOUS SYSTEM DISORDERS

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Probably within 5 years of onset would make the most sense

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Improving tonus

Describe any health-related risks, side effects, or harms that you are concerned about.

overstimulation, ressulting in increased tonus and decreased coordination, having an effect on safety/fall risk

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Functional limitations and disability

AHRQ Priority Populations

Federal Health Care Program

• Medicare
• Other

Importance

Describe why this topic is important.

Fall prevention Reaching maximum potential with lasting results

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

clinical practice dilemma

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

New ideas sometimes appear, to desperate people, to try high tech approaches which might not be any better or perhaps more harmful than slow tech approaches

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

Selection of interventions

Describe the timeframe in which an answer to your question is needed.

Now and later

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

Selection of interventions

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program