To select evidence for critical appraisal by the group for the development of this guideline, Pubmed, OVID (Medline, Cinahl, All EBM Reviews - Cochrane DSR, ACP Journal Club, DARE and CCTR), Pedro, OT Seeker and OT CATS databases were searched to generate an unrefined, "combined evidence" database using a search strategy focused on answering clinical questions relevant to this Loss of Elbow Motion Following Surgery or Trauma (see Appendix 'Initial Clinical Questions used to guide search and selection of evidence' in the original guideline document) and employing a combination of Boolean searching on human-indexed thesaurus terms (MeSH headings using an OVID Medline interface) and "natural language" searching on searching on human-indexed thesaurus terms (MeSH headings using an OVID Medline interface) and "natural language" searching on words in the title, abstract, and indexing terms. Additionally a search was done on the on the web including the website www.googlescholar.com. Many search terms were used as seven therapists did the searching. The search was done from February to May of 2006. Terms that were used to search relating to the anatomy of the elbow were as follows: elbow, distal humerus, supracondylar, radial head, olecranon, upper extremity. These terms were combined with terms describing the pathology: injury, fracture, dislocation, trauma, adhesions, contracture. Other terms used include: immobilization, complications, therapy, splint, pediatric, rehabilitation, range of motion, stretching, goniometer, modalities, reliability and validity. The citations were reduced by eliminating duplicates, non-English articles, and articles deemed inappropriate for the purpose of this project. Various combinations of these terms were used of the above named databases and the appropriate articles were retrieved, read, reviewed and appraised by members of the team. There were approximately 55 articles pulled from these searches that were culled by team members to find those that best aligned with this guideline's clinical questions (see Appendix in the original guideline document). After the database search was exhausted, the team found other appropriate articles and book chapters by scanning the reference lists of the reviewed articles. The team decided that all levels of evidence would be appropriate as there was not much evidence relating to the specific population at the time of the search. During the course of the guideline development, additional clinical questions were generated and subjected to the search process, and some relevant review articles and adult literature were utilized.