Nicoline Otterman1, Janne Veerbeek2, Sven Schiemanck3, Philip van der Wees4, Frans Nollet1,5, Gert Kwakkel2,5,6,7,8. 1. a Department of Rehabilitation , Academic Medical Center, University of Amsterdam , The Netherlands. 2. b Department of Rehabilitation Medicine , VU University Medical Center , Amsterdam , The Netherlands. 3. c Department of Rehabilitation , Leiden University Medical Center , The Netherlands. 4. d Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare , The Netherlands. 5. e MOVE Research Institute Amsterdam , Amsterdam , The Netherlands. 6. f Department of Neurorehabilitation , Reade Centre for Rehabilitation and Rheumatology , Amsterdam , The Netherlands. 7. g Neuroscience Campus Amsterdam , VU University Medical Center , Amsterdam , The Netherlands. 8. h Department of Physical Therapy and Human Movement Sciences , Northwestern University , Evanston , IL , USA.
Abstract
PURPOSE: To select relevant and feasible instruments for the revision of the Dutch clinical practice guideline for physical therapy in patients with stroke. METHODS: In this implementation study a comprehensive proposal for ICF categories and matching instruments was developed, based on reliability and validity. Relevant instruments were then selected in a consensus round by 11 knowledge brokers who were responsible for the implementation of the selected instruments. The feasibility of the selected instruments was tested by 36 physical therapists at different work settings within stroke services. Finally, instruments that were deemed relevant and feasible were included in the revised guideline. RESULTS: A total of 28 instruments were recommended for inclusion in the revised guideline. Nineteen instruments were retained from the previous guideline. Ten new instruments were tested in clinical practice, seven of which were found feasible. Two more instruments were added after critical appraisal of the set of the measurement instruments. CONCLUSIONS: The revised guideline contains 28 relevant and feasible instrument selected and tested in clinical practice by physical therapists. Further education and implementation is needed to integrate instruments in clinical practice. Further research is proposed for developing and implementing a core set of measurement instruments to be used at fixed time points to establish data registries that allow for continuous improvement of rehabilitation for stroke patients. Implications for Rehabilitation The revised Dutch Stroke Physical Therapy Guideline recommends a total of 28 instruments, that are relevant and feasible for clinical practice of physical therapist in the different settings of stroke rehabilitation. The selection of instrument in daily practice should be part of the clinical reasoning process of PTs and be tailored to individual patients' needs and the degree of priority of the affected ICF category. Suggested education strategies for further integration of instruments in of the daily practice of PTs in Stroke Rehabilitation are: 'Training on the job' and 'peer assessment in clinical situations'.
PURPOSE: To select relevant and feasible instruments for the revision of the Dutch clinical practice guideline for physical therapy in patients with stroke. METHODS: In this implementation study a comprehensive proposal for ICF categories and matching instruments was developed, based on reliability and validity. Relevant instruments were then selected in a consensus round by 11 knowledge brokers who were responsible for the implementation of the selected instruments. The feasibility of the selected instruments was tested by 36 physical therapists at different work settings within stroke services. Finally, instruments that were deemed relevant and feasible were included in the revised guideline. RESULTS: A total of 28 instruments were recommended for inclusion in the revised guideline. Nineteen instruments were retained from the previous guideline. Ten new instruments were tested in clinical practice, seven of which were found feasible. Two more instruments were added after critical appraisal of the set of the measurement instruments. CONCLUSIONS: The revised guideline contains 28 relevant and feasible instrument selected and tested in clinical practice by physical therapists. Further education and implementation is needed to integrate instruments in clinical practice. Further research is proposed for developing and implementing a core set of measurement instruments to be used at fixed time points to establish data registries that allow for continuous improvement of rehabilitation for strokepatients. Implications for Rehabilitation The revised Dutch Stroke Physical Therapy Guideline recommends a total of 28 instruments, that are relevant and feasible for clinical practice of physical therapist in the different settings of stroke rehabilitation. The selection of instrument in daily practice should be part of the clinical reasoning process of PTs and be tailored to individual patients' needs and the degree of priority of the affected ICF category. Suggested education strategies for further integration of instruments in of the daily practice of PTs in Stroke Rehabilitation are: 'Training on the job' and 'peer assessment in clinical situations'.
Entities:
Keywords:
Assessment; outcome; physical therapy; practice guideline; stroke
Authors: Ruud van der Veen; Jaap Oosterlaan; Mike Bos; Mara van Dooren; Işıl Düdükçü; Andries van Iperen; Linda Kooiman; Karel Nicolas; Saskia Peerdeman; Marsh Königs Journal: J Med Syst Date: 2022-04-04 Impact factor: 4.920