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实施功能性电刺激临床实践指南以支持行动能力:利益相关者咨询。

Implementing functional electrical stimulation clinical practice guidelines to support mobility: A stakeholder consultation.

作者信息

Brown Lisa, Street Tamsyn, Adonis Adine, Johnston Therese E, Ferrante Simona, Burridge Jane H, Bulley Catherine

机构信息

Department of Physical Therapy, Boston University, Boston, MA, United States.

Salisbury NHS Foundation Trust, Salisbury, United Kingdom.

出版信息

Front Rehabil Sci. 2023 Jan 26;4:1062356. doi: 10.3389/fresc.2023.1062356. eCollection 2023.

Abstract

Functional Electrical Stimulation (FES) has been used to support mobility for people with upper motor neuron conditions such as stroke and multiple sclerosis for over 25 years. Recent development and publication of clinical practice guidelines (CPGs) provide evidence to guide clinical decision making for application of FES to improve mobility. Understanding key barriers to the implementation of these CPGs is a critical initial step necessary to create tailored knowledge translation strategies. A public involvement and engagement consultation was conducted with international stakeholders including researchers, clinicians and engineers working with FES to inform implementation strategies for CPG use internationally. Reflexive thematic analysis of the consultation transcripts revealed themes including inconsistent use of CPGs, barriers to implementation such as limited access to FES and low clinician confidence, and the need for a tiered education approach with ongoing support. Insights derived from this consultation will inform the development of knowledge translation strategies to support the next steps to implementing FES use for mobility.

摘要

超过25年来,功能性电刺激(FES)一直被用于帮助患有上运动神经元疾病(如中风和多发性硬化症)的患者实现行动能力。近期临床实践指南(CPG)的制定和发布为指导FES应用以改善行动能力的临床决策提供了证据。了解这些CPG实施的关键障碍是制定针对性知识转化策略的关键初始步骤。我们与包括从事FES研究的研究人员、临床医生和工程师在内的国际利益相关者进行了公众参与和咨询,以了解CPG在国际上的实施策略。对咨询记录的反思性主题分析揭示了一些主题,包括CPG使用不一致、实施障碍(如FES获取有限和临床医生信心不足)以及需要采用分层教育方法并提供持续支持。此次咨询得出的见解将为知识转化策略的制定提供参考,以支持FES用于行动能力的后续实施步骤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e820/9909018/3cf7dafc4791/fresc-04-1062356-g001.jpg

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