A Survey of Perceived Implementation Gaps for a Clinical Practice Guideline for the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury

Lamontagne, Marie-Ève; Gargaro, Judith; Marier-Deschênes, Pascale; Truchon, Catherine; Bayley, Mark; Kagan, Corinne; Brière, Anabèle; Swaine, Bonnie

doi:10.1097/htr.0000000000000430

Cited by 10 publications

(8 citation statements)

References 13 publications

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“…Journal of Head Trauma Rehabilitation/May-June 2021 not identified explicitly in the guidelines. 11,12 More importantly, the best PA approaches and exercise parameters to prescribe (eg, frequency, duration, intensity, intervention length, mode, timing to initiate, and progression of exercise) to facilitate recovery remain unclear. 2,6,13 For example, Howell et al 13 noted that important exercise dosage parameters were only reported in 5 of 11 studies comprising the review about PA interventions for individuals with mTBI.…”

mentioning

confidence: 99%

Physical Activity Interventions for Individuals With a Mild Traumatic Brain Injury:

Alarie¹,

Gagnon²,

Quilico³

et al. 2021

Journal of Head Trauma Rehabilitation

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Objective: To document the characteristics, measured outcomes, and effectiveness of physical activity (PA) interventions designed to improve health-related outcomes in individuals with a mild traumatic brain injury (mTBI) to assist in rehabilitation quality improvement efforts of a TBI rehabilitation program. Methods: A scoping review following a 6-step iterative framework search across 5 databases (MEDLINE, CINAHL, PsycINFO, SPORTDiscuss, and EMBASE) and the gray literature (Google) was performed. Selected PA interventions were designed for individuals of all ages and any mechanism of injury (eg, sports-related and falls). Data were charted, collated, and summarized according to the Consensus on Exercise Reporting Template checklist and domains of the International Classification of Functioning, Disability and Health. Involvement of clinical experts ensured tailoring of the knowledge synthesis to meet clinical needs. Results: Thirty-five articles and 14 gray literature records were retained. Five types of PA interventions were identified with the majority being multimodal. Reporting of PA intervention characteristics was highly variable across studies; many details necessary for intervention replication are missing. Study outcomes focused primarily on improving body functions and symptoms of mTBI, and less frequently on activities, participation, and health-related quality of life. The methodological quality of studies varies. Conclusions: Identified PA intervention types offer various management options for healthcare providers. PA interventions may improve a wide range of health-related outcomes supporting the inclusion of PA in the management of individuals of all ages with mTBI. Higher-quality research and better reporting about intervention characteristics is however needed.

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mentioning

confidence: 99%

Physical Activity Interventions for Individuals With a Mild Traumatic Brain Injury:

Alarie¹,

Gagnon²,

Quilico³

et al. 2021

Journal of Head Trauma Rehabilitation

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“…Adherence to the indicators was reported as percentages of facilities that reported the structure or process to be present. “Hard to meet” indicators were defined as those met by less than two-thirds of facilities [ 16 ]. Percentages of indicators met by each facility were also calculated to assess performance level.…”

Section: Methodsmentioning

confidence: 99%

“…15 Spinal Unit and Spinal Rehabilitation (SpiRe) Lab, IRCCS Fondazione S. Lucia, Rome, Italy. 16 University of Sydney, Sydney, NSW, Australia. 17 Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.…”

Section: Acknowledgementsmentioning

confidence: 99%

An international survey of the structure and process of care for traumatic spinal cord injury in acute and rehabilitation facilities: lessons learned from a pilot study

Abedi

Biering‐Sørensen

Chhabra

et al. 2022

BMC Health Serv Res

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Background To describe the key findings and lessons learned from an international pilot study that surveyed spinal cord injury programs in acute and rehabilitation facilities to understand the status of spinal cord injury care. Methods An online survey with two questionnaires, a 74-item for acute care and a 51-item for rehabilitation, was used. A subset of survey items relevant to the themes of specialized care, timeliness, patient-centeredness, and evidence-based care were operationalized as structure or process indicators. Percentages of facilities reporting the structure or process to be present, and percentages of indicators met by each facility were calculated and reported separately for facilities from high-income countries (HIC) and from low and middle-income countries (LMIC) to identify “hard to meet” indicators defined as those met by less than two-thirds of facilities and to describe performance level. Results A total of 26 acute and 26 rehabilitation facilities from 25 countries participated in the study. The comparison of the facilities based on the country income level revealed three general observations: 1) some indicators were met equally well by both HIC and LMIC, such as 24-hour access to CT scanners in acute care and out-patient services at rehabilitation facilities; 2) some indicators were hard to meet for LMIC but not for HIC, such as having a multidisciplinary team for both acute and rehabilitation settings; and 3) some indicators were hard to meet by both HIC and LMIC, including having peer counselling programs. Variability was also observed for the same indicator between acute and rehabilitation facilities, and a wide range in the total number of indicators met among HIC facilities (acute 59–100%; rehabilitation 36–100%) and among LMIC facilities (acute: 41–82%; rehabilitation: 36–93%) was reported. Conclusions Results from this international pilot study found that the participating acute and rehabilitation facilities on average adhered to 74% of the selected indicators, suggesting that the structure and processes to provide ideal traumatic spinal cord injury care were broadly available. Recruiting a representative sample of SCI facilities and incorporating regional attributes in future surveys will be helpful to examine factors affecting adherence to indicators.

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“…A number of guidelines have been published to promote best practices in care of persons with TBI, 32,33 but implementation is highly variable. 34 Sometimes erroneous services are applied because of lack of expertise and sometimes even those with expertise may apply improper or unnecessary services. Inaccurate diagnosis, inappropriate application of treatment at a particular stage of recovery, use of unproven or ineffective treatments, and application of effective treatment to those for whom it would not be of benefi t are examples.…”

Section: Realities Of the Marketplacementioning

confidence: 99%

Systems of Care and Natural History of Traumatic Brain Injury

Katz¹,

Zasler²,

Zafonte³

2021

Brain Injury Medicine

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A Survey of Perceived Implementation Gaps for a Clinical Practice Guideline for the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury

Abstract: Assessment of clinician perception provides a helpful perspective for implementation. Exploring perceived implementation gaps based on users' needs and expectation should be a part of an implementation process.

Cited by 10 publications

References 13 publications

Physical Activity Interventions for Individuals With a Mild Traumatic Brain Injury:

Physical Activity Interventions for Individuals With a Mild Traumatic Brain Injury:

An international survey of the structure and process of care for traumatic spinal cord injury in acute and rehabilitation facilities: lessons learned from a pilot study

Systems of Care and Natural History of Traumatic Brain Injury

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