You'll have to ask your doctor what the difference is between what Margaret Yekutiel wrote a whole book about this in 2001, 'Sensory Re-Education of the Hand After Stroke' and this latest. Assuming your doctor has the competency to even know about the 2001 book. Was the book not good enough to just write and distribute stroke protocols from?
Changing practice in the assessment and treatment of somatosensory loss in stroke survivors: protocol for a knowledge translation study
Liana S. Cahill1,2,3*
, Natasha A. Lannin
1,4
, Yvonne Y. K. Mak-Yuen
1,2
, Megan L. Turville
1,2
and Leeanne M. Carey
1,2
Abstract
Background:
The treatment of somatosensory loss in the upper limb after stroke has been historically overshadowed by therapy focused on motor recovery. A double-blind randomized controlled trial has demonstrated the effectiveness of SENSe (Study of the Effectiveness of
Neurorehabilitation on Sensation) therapy to retrain somatosensory discrimination after stroke. Given the acknowledged prevalence of upper limb sensory loss after stroke and the evidence-practice gap
that exists in this area, effort is required to translate the published research to clinical practice. The aim of this study is to determine whether evidence-based knowledge translation strategies change the practice of occupational therapists and physiotherapists in the assessment and treatment of sensory loss of the upper limb after stroke to improve patient outcomes.
Method/design:
A pragmatic, before-after study design involving eight (n= 8) Australian health organizations, specifically sub-acute and community rehabilitation facilities. Stroke survivors (n= 144) and occupational therapists and physiotherapists (~10 per site, ~ n= 80) will be involved in the study. Stroke survivors will be provided with SENSe therapy or usual care. Occupational therapists and ph
ysiotherapists will be provided with a multi-component approach to knowledge translation including i) tailoring of the implementation intervention to site-specific barriers and enablers, ii) interactive group training workshops, iii) establishing and fostering champion therapists and iv) provision of
written educational materials and online resources. Outcome measures for occupational therapists and physiotherapists will be pre- and post-implementation questionnaires and audits of medical records. The primary outcome for stroke survivors will be change in upper limb somatosensory function, measured using a standardized composite measure.
Discussion:
This study will provide evidence and a template for knowledge translation in clinical, organizational and policy contexts in stroke rehabilitation.
Trial registration:
Australian New Zealand Clinical Trials Regi
stry (ANZCTR) retrospective registration
ACTRN12615000933550.
Keywords:
Somatosensory disorders, Translational medical resear
ch, Clinician behavior change, Occupational therapy,
Physiotherapy, Rehabilita
tion, Complex intervention
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