Research Report
Population: Adult
Amber Maureen Devers, PT, DPT, NCS, Physical Therapist, Sheltering Arms Physical Rehabilitation Centers amdevers@shelteringarms.com
Matt Wilks, PT, NCS, Associate Vice President of Rehabilitation and Wellness, Sheltering Arms Physical Rehabilitation Centers, Virginia Commonwealth University mwilks@shelteringarms.com
Melissa Banta, PT, DPT, Manager Hanover and Midtown Therapy, Sheltering Arms Physical Rehabilitation Centers, Virginia Commonwealth University mbanta@shelteringarms.com
Joana Moore, PT, DPT, Manager South and Bon Air Therapy, Sheltering Arms Physical Rehabilitation Centers, Virginia Commonwealth University jbmoore@shelteringarms.com
Peter Pidcoe, PT, DPT, PhD, Associate Professor and Assistant Chair Director of the Engineering and Biomechanics Lab,, Virginia Commonwealth University pepidcoe@vcu.edu
Keywords: Plasticity, Implementation Science, Knowledge Translation, Gait Rehabilitation
Purpose : Knowledge translation (KT) is gaining popularity as a concept for approaching evidence-based care in rehabilitation practice. For example, the number of clinical practice guidelines (CPG) related to rehabilitation practice is growing tremendously, but difficulty remains in CPG implementation. KT is proposed as a set of processes to close the gap between evidence and action. Creating a clinical culture that enhances appropriate standardization and limits unwarranted variability is difficult but meaningful. Current literature suggests ways to implement KT strategies in a variety of clinical settings from acute care to outpatient; however, there remains a gap in the current research with regard to evaluating the impact of KT on patient outcomes.
Description : The knowledge to action process by Graham and Tetroe can be used as a framework to assess barriers to implementation of best practice and develop interventions. Examples of KT interventions are use of opinion leaders, formal education, audit and feedback tools, and informatics. A multi-faceted KT strategy was implemented in an inpatient rehabilitation setting to improve use of CPG for advanced gait technology with stroke survivors. Examples of specific techniques were self-assessment, online tutorial and testing, and weekly discussion with management.
Summary of Use: Outcome data from twelve stroke survivor subjects treated by therapists participating in the knowledge translation strategies (experimental group) were compared to data from subjects treated by other therapists (control group) . The control group received care from therapists trained in the CPG but without the structured KT strategy. Subjects were matched for age, comorbidity, and initial function. Significant changes were found favoring the experimental group for outcome measures related to gait speed, balance, gait capacity, motor function, and stair climbing.
Importance to Members : Although literature exists supporting the use of strategies to improve knowledge to action, the connection to patient outcomes has been infrequently reported. This report shows evidence that the KT interventions utilized can produce benefits to stroke survivors relative to gait recovery. A standardized clinician training methodology for adopting guidelines is essential, and suggestions are offered.
Citation:
Devers, Amber Maureen, PT, DPT, NCS; Wilks, Matt , PT, NCS; Banta, Melissa , PT, DPT; Moore, Joana , PT, DPT; Pidcoe, Peter , PT, DPT, PhD. Connecting Knowledge Translation Strategies to Impact on Clinical Outcomes. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online. https://u.osu.edu/ivstep/poster/abstracts/035_devers-et-al/