Kristin E Musselman1,2, Jean-François Lemay1,3, Kristen Walden4, Anne Harris4, Dany H Gagnon3,5, Molly C Verrier1,2,6. 1. KITE, Toronto Rehabilitation Institute-University Health Network , Toronto , Ontario , Canada. 2. Department of Physical Therapy and Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto , Toronto , Ontario , Canada. 3. Centre de recherche interdisciplinaire en réadaptation du Montréal , Montreal , Québec , Canada. 4. Rick Hansen Institute , Vancouver , British Columbia , Canada. 5. École de réadaptation, Faculté de médecine, Université de Montréal , Montreal , Québec , Canada. 6. Institute of Medical Science, Faculty of Medicine, University of Toronto , Toronto , Ontario , Canada.
Abstract
Context/Objective: The Spinal Cord Injury (SCI) Standing and Walking Assessment Tool (SWAT) combines stages of walking recovery with measures of balance and walking. It standardizes the timing and content of walking assessment in inpatient rehabilitation. The study aims were: (1) Evaluate the content validity of the SWAT stages of walking recovery, and (2) Understand physical therapists' (PTs) experiences using the SWAT to gauge acceptance, implementation and impact. Design: Qualitative, exploratory study. Setting: Nine Canadian rehabilitation hospitals. Participants: Thirty-four PTs who had used the SWAT ≥10 times. Interventions: Seven focus group meetings were completed. Semi-structured questions queried the content, order and spacing of SWAT stages, and current SWAT use (i.e. processes, challenges, facilitators, impact on practice). Meetings were audio-recorded and transcribed. Themes and categories were derived through a conventional content analysis. Outcome Measure: Not applicable. Results: PTs agreed with the ordering and content of the SWAT stages, but reported unequal spacing between stages. Three themes related to PTs' use of the SWAT were identified: (1) Variable process: SWAT implementation varied across sites, PTs and patients. (2) Implementation challenges: unfamiliarity of the SWAT, lack of time, not required by place of work, and patients who are outliers or have poor gait quality. (3) Potential to influence clinical decision-making: the SWAT did not influence clinical decisions, but PTs recognized the potential of the tool to do so. Conclusions: Content validity of the SWAT stages was supported and implementation challenges identified. Variability in SWAT implementation may reflect the heterogeneity and person-centeredness of SCI rehabilitation.
Context/Objective: The Spinal Cord Injury (SCI) Standing and Walking Assessment Tool (SWAT) combines stages of walking recovery with measures of balance and walking. It standardizes the timing and content of walking assessment in inpatient rehabilitation. The study aims were: (1) Evaluate the content validity of the SWAT stages of walking recovery, and (2) Understand physical therapists' (PTs) experiences using the SWAT to gauge acceptance, implementation and impact. Design: Qualitative, exploratory study. Setting: Nine Canadian rehabilitation hospitals. Participants: Thirty-four PTs who had used the SWAT ≥10 times. Interventions: Seven focus group meetings were completed. Semi-structured questions queried the content, order and spacing of SWAT stages, and current SWAT use (i.e. processes, challenges, facilitators, impact on practice). Meetings were audio-recorded and transcribed. Themes and categories were derived through a conventional content analysis. Outcome Measure: Not applicable. Results: PTs agreed with the ordering and content of the SWAT stages, but reported unequal spacing between stages. Three themes related to PTs' use of the SWAT were identified: (1) Variable process: SWAT implementation varied across sites, PTs and patients. (2) Implementation challenges: unfamiliarity of the SWAT, lack of time, not required by place of work, and patients who are outliers or have poor gait quality. (3) Potential to influence clinical decision-making: the SWAT did not influence clinical decisions, but PTs recognized the potential of the tool to do so. Conclusions: Content validity of the SWAT stages was supported and implementation challenges identified. Variability in SWAT implementation may reflect the heterogeneity and person-centeredness of SCI rehabilitation.
Authors: Garima Shah; Alison R Oates; Tarun Arora; Joel L Lanovaz; Kristin E Musselman Journal: J Spinal Cord Med Date: 2017-09-06 Impact factor: 1.985
Authors: V K Noonan; B K Kwon; L Soril; M G Fehlings; R J Hurlbert; A Townson; M Johnson; M F Dvorak Journal: Spinal Cord Date: 2011-11-01 Impact factor: 2.772
Authors: Joost J van Middendorp; Allard J F Hosman; A Rogier T Donders; Martin H Pouw; John F Ditunno; Armin Curt; Alexander C H Geurts; Hendrik Van de Meent Journal: Lancet Date: 2011-03-04 Impact factor: 79.321
Authors: Edward J Miech; Nicholas A Rattray; Mindy E Flanagan; Laura Damschroder; Arlene A Schmid; Teresa M Damush Journal: SAGE Open Med Date: 2018-05-17
Authors: B Catharine Craven; S Mohammad Alavinia; Matheus J Wiest; Farnoosh Farahani; Sander L Hitzig; Heather Flett; Gaya Jeyathevan; Maryam Omidvar; Mark T Bayley Journal: J Spinal Cord Med Date: 2019-10 Impact factor: 1.985