Applying the knowledge-to-action framework to implement gait and balance assessments in inpatient stroke rehabilitation

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 Applying the knowledge-to-action framework to implement gait and balance assessments in inpatient stroke rehabilitation

Archives of Physical Medicine and Rehabilitation , Volume 103(7, Supplement) , Pgs. S230-S245.

NARIC Accession Number: J89466.  What's this?
ISSN: 0003-9993.
Author(s): Moore, Jennifer L.; Virva, Roberta; Henderson, Chris; Lenca, Lauren; Butzer, John F.; Lovell, Linda; Roth, Elliot; Graham, Ian D.; Hornby, T. George.
Project Number: 90RT5027 (formerly H133B140012).
Publication Year: 2022.
Number of Pages: 16.

Abstract: 

 Study implemented an evidence-based gait assessment battery (GAB) implemented during inpatient stroke rehabilitation and assessed the effect of the intervention on clinician adherence to the recommendations and its effect on clinician perceptions and the organization. The GAB recommendations included the Berg Balance Scale, 10-Meter Walk Test, and 6-Minute Walk Test. The multicomponent implementation plan was based on the Knowledge-to-Action Framework and included implementation facilitation, implementation leadership, and a bundle of knowledge translation interventions that targeted barriers. Implementation was an iterative process in which results from one implementation phase informed planning of the next phase. Online surveys were administered before implementation, and 1 and 3 years after implementation to assess perceptions, barriers, and current use of outcome measures in clinical practice. Eight clinicians on the stroke unit (6 physical therapists and 2 physical therapist assistants) participated in the survey in 2015, 2016, and 2018. Results indicated that initial adherence to the GAB was 46 percent and increased to more than 85 percent after 6 months. These adherence levels remained consistent 48 months after implementation. Clinician perceptions of measure use were initially high (>63 percent), with significant improvements in knowledge and use of one measure after implementation. The assessment battery was successfully implemented with high levels of adherence to recommendations, likely because of using the bundle of knowledge translation activities, facilitation, and use of a framework to codevelop the plan. These changes in practice were sustainable, as determined by a 4-year follow-up.
Descriptor Terms: AMBULATION, BARRIERS, CLINICAL MANAGEMENT, COMPLIANCE, EQUILIBRIUM, EVALUATION TECHNIQUES, KNOWLEDGE TRANSLATION, MEASUREMENTS, MOBILITY AIDS, OUTCOMES, PHYSICAL THERAPY, POSTURE, REHABILITATION, RESEARCH UTILIZATION, SERVICE UTILIZATION, STROKE.


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Citation: Moore, Jennifer L., Virva, Roberta, Henderson, Chris, Lenca, Lauren, Butzer, John F., Lovell, Linda, Roth, Elliot, Graham, Ian D., Hornby, T. George. (2022). Applying the knowledge-to-action framework to implement gait and balance assessments in inpatient stroke rehabilitation.  Archives of Physical Medicine and Rehabilitation , 103(7, Supplement), Pgs. S230-S245. Retrieved 8/22/2022, from REHABDATA database.