Deans' stroke musings: Experiences of physical therapists and professional leaders with implementing a toolkit to advance walking assessment poststroke: A realist evaluation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, June 23, 2022

Experiences of physical therapists and professional leaders with implementing a toolkit to advance walking assessment poststroke: A realist evaluation

Toolkits do little to help recovery. You need EXACT STROKE PROTOCOLS. GET THERE!

Experiences of physical therapists and professional leaders with implementing a toolkit to advance walking assessment poststroke: A realist evaluation

Physical Therapy , Volume 101(12)

NARIC Accession Number: J88997. What's this?
ISSN: 0031-9023.
Author(s): Salbach, Nancy M.; McDonald, Alison; MacKay-Lyons, Marilyn; Bulmer, Beverly; Howe, Jo-Anne; Bayley, Mark T.; McEwen, Sara; Nelson, Michelle; Solomon, Patricia.
Publication Year: 2021.
Number of Pages: 11.

Abstract:

Study examined the influence of contextual circumstances on use of a toolkit and implementation strategy across acute care and inpatient and outpatient rehabilitation settings. The iWalk toolkit and implementation strategy was designed to guide physical therapists in using the 10-Meter Walk Test (10MWT) and 6-Minute Walk Test (6MWT) for evaluation of walking, education, goal setting and treatment selection post stroke. The toolkit comprised a mobile app, video, and educational guide outlining instructions for 3 learning sessions. After completing learning sessions, 33 physical therapists and 7 professional leaders participated in focus groups or interviews. As part of a realist evaluation, the study compared and synthesized site-specific context-mechanism-outcome descriptions across sites to refine an initial theory of how the toolkit would influence practice. Analysis revealed 3 context-mechanism-outcomes: (1) No onsite facilitator? No practice change in acute care: Without an onsite facilitator, participants lacked authority to facilitate and coordinate the implementation strategy; (2) Onsite facilitation fostered integration of select practices in acute care: When onsite facilitation occurred in acute care, walk test administration and use of reference values for patient education were adopted variably with high functioning patients; (3) Onsite facilitation fostered integration of most practices in rehabilitation settings: When onsite facilitation occurred, many participants incorporated 1 or both tests to evaluate and monitor walking capacity, and reference values were applied for inpatient and outpatient education and goal setting. Participants preferentially implemented the 10MWT over the 6MWT because set-up and administration were easier, and a greater proportion of patients could walk 10 meters.
Descriptor Terms: ACUTE CARE, AMBULATION, CLINICAL MANAGEMENT, MEASUREMENTS, OUTCOMES, PHYSICAL THERAPY, REHABILITATION, SERVICE UTILIZATION, STROKE.

Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Salbach, Nancy M., McDonald, Alison, MacKay-Lyons, Marilyn, Bulmer, Beverly, Howe, Jo-Anne, Bayley, Mark T., McEwen, Sara, Nelson, Michelle, Solomon, Patricia. (2021). Experiences of physical therapists and professional leaders with implementing a toolkit to advance walking assessment poststroke: A realist evaluation. Physical Therapy , 101(12) Retrieved 6/23/2022, from REHABDATA database.