Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation

Louise A Connell, Naoimh E McMahon, Sarah F Tyson, Caroline L Watkins, Janice J Eng

Research output: Contribution to journalArticlepeer-review

82 Downloads (Pure)

Abstract

BACKGROUND AND PURPOSE: Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members' and patients' perceptions of the utility of the developed intervention.

CASE DESCRIPTIONS: A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff.

OUTCOMES: Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and caregivers and monitoring and progressing exercises were not performed consistently.

CONCLUSIONS: This case series is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcomes.

Original languageEnglish
JournalPhysical Therapy
Early online date23 Jun 2016
DOIs
Publication statusPublished - 8 Sept 2016

Fingerprint

Dive into the research topics of 'Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation'. Together they form a unique fingerprint.

Cite this