Development of a Theory-Based Intervention to Increase Clinical Measurement of Reactive Balance in Adults at Risk of Falls

Sibley, Kathryn M.; Brooks, Dina; Gardner, Paula; Janaudis-Ferreira, Tânia; McGlynn, Mandy; O’Hoski, Sachi; McEwen, Sara; Salbach, Nancy M.; Shaffer, Jennifer; Shing, Paula; Straus, Sharon E.; Jaglal, Susan

doi:10.1097/npt.0000000000000121

Cited by 14 publications

(14 citation statements)

References 35 publications

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“…All of these studies found that this type of training lowered fall risk, but they also all included sophisticated laboratory equipment that is not accessible or practical for most clinicians. This reason, along with the fact that many studies utilized kinematics and spatiotemporal characteristics as outcomes rather than standardized, functional, outcome measures, support previous research that has determined that effective balance reactions are 23 not regularly measured or utilized in interventions by physical therapists.…”

Section: Introductionmentioning

confidence: 62%

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

Drake¹,

Mowder-Tinney²

2017

Phys Med Rehabil

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Section: Introductionmentioning

confidence: 62%

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

Drake¹,

Mowder-Tinney²

2017

Phys Med Rehabil

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“…Initial published intervention components [ 28 ] included using regular health record audits as an additional feedback strategy to participants. However, this component was not delivered due to feasibility challenges extracting participant-linked data in real-time during the intervention.…”

Section: Resultsmentioning

confidence: 99%

“…This study is among the first to use a determinant framework, and more specifically, the TDF, to directly link barriers and facilitators to rehabilitation intervention components, strategies and outcomes. The hands-on practice meeting – the most positively rated component by participants – suggests that rehearsal of relevant skills, feedback, problem solving, decision making, goal setting, and modeling/demonstration of behaviors by others [ 28 , 32 ] may be related to intervention effects. However, this cannot be confirmed in the absence of an appropriate comparator for this intervention.…”

Section: Discussionmentioning

confidence: 99%

“…A 12-month intervention was administered at each site. Details of intervention development have been reported elsewhere [ 28 ] and are described briefly here. Previously-identified factors influencing reactive balance assessment informed the selection of the reactive balance measure [ 29 ] and were mapped to the Theoretical Domains Framework (TDF) [ 30 , 31 ].…”

Section: Methodsmentioning

confidence: 99%

“…With regards to the intervention components, the local champions worked actively to engage participants and foster adoption of the reactive balance measure through a variety of activities as needed throughout the study [ 28 ]. These included scheduling and coordinating group meetings, communicating study goals and objectives, co-facilitating group meeting discussions to tailor activities to each site, modeling use of the reactive balance measure in their caseload and encouraging use among participants, providing ongoing mentorship and problem solving with participants between meetings, answering questions and brokering interactions between participants and the larger offsite research team, as well as co-developing and customizing the reactive measure administration forms, and assisting with study administrative coordination as needed.…”

Section: Methodsmentioning

confidence: 99%

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A theory-based multi-component intervention to increase reactive balance measurement by physiotherapists in three rehabilitation hospitals: an uncontrolled single group study

Sibley

Bentley

Salbach

et al. 2018

BMC Health Serv Res

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BackgroundMost implementation interventions in rehabilitation, including physiotherapy, have used passive, non-theoretical approaches without demonstrated effectiveness. The goal of this study was to improve an important domain of physiotherapy practice – reactive balance measurement – with a targeted theory-based multi-component intervention developed using the Theoretical Domains Framework. The primary objective was to determine documented reactive balance measure use in a 12-month baseline, during, and for three months post- intervention.MethodsAn uncontrolled before-and-after study was completed with physiotherapists at three urban adult rehabilitation hospitals in Ontario, Canada. The 12-month intervention included group meetings, local champions, and health record modifications for a validated reactive balance measure. The primary outcome was the proportion of records with a documented reactive balance measure when balance was assessed pre-, during- and post-intervention. Secondary outcomes were changes in use, knowledge, and confidence post-intervention, differences across sites, and intervention satisfaction.ResultsReactive balance was not measured in any of 211 eligible pre-intervention records. Thirty-three physiotherapists enrolled and 28 completed the study. Reactive balance was measured in 31% of 300 eligible records during-intervention, and in 19% of 90 eligible records post-intervention (p < 0.04). Knowledge and confidence significantly increased post-intervention (all p < 0.05). There were significant site differences in use during- and post-intervention (all p < 0.05). Most participants reported satisfaction with intervention content (71%) and delivery (68%).ConclusionsReactive balance measurement was greater among participants during-intervention relative to the baseline, and use was partially sustained post-intervention. Continued study of intervention influences on clinical reasoning and exploration of site differences is warranted.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3533-8) contains supplementary material, which is available to authorized users.

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Knowledge translation theories in fall prevention and balance control: A scoping review

Aloraini

Alothaim

Alsalamah

et al. 2022

PM&R

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Falls are a major problem all over the world. Falls may result in bone fractures, fear of falling, and reduced participation in activities of daily living and in social activities, thus, an increased cost of health care to the individual and the society. Falls occur as a result of compounding factors that combine and overwhelm an individual's ability to maintain or regain his or her balance. However, fall rates are often reported as high, suggesting the presence of a gap between clinical practices related to fall prevention and the knowledge of the best available evidence related to fall prevention. The science of knowledge translation (KT) offers a variety of theories that can facilitate the implementation of up‐to‐date knowledge among clinicians. Therefore, the aim of this study was to identify and review the use of knowledge translation theories, namely the Knowledge to Action Framework (KTA), Promoting Action on Research Implementation in Health Services framework (PARIHS), Consolidated Framework for Implementation Research (CFIR), and the Theoretical Domains Framework (TDF), in studies related to fall prevention and balance control. A scoping review was conducted to identify studies related to fall prevention and balance control that used one of these four KT theories. An extensive literature search was performed up to January 2021. Two independent reviewers conducted a study selection process followed by data extraction of the search results. Our results identified 16 studies that were related to the scope of our review, with three studies utilizing KTA, two studies using PARIHS, four studies using CFIR, and seven studies using the TDF. Overall, it appears that the use of KT theories is helpful to guide interventions for fall prevention and improve balance control. Future efforts are needed to facilitate the use of KT theories for guiding clinical practices related to fall prevention and balance control.

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Development of a Theory-Based Intervention to Increase Clinical Measurement of Reactive Balance in Adults at Risk of Falls

Cited by 14 publications

References 35 publications

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

Impact of Perturbation-Based Balance Training on Functional Outcomes in a Patient with Chronic Incomplete Spinal Cord Injury: A Case Report

A theory-based multi-component intervention to increase reactive balance measurement by physiotherapists in three rehabilitation hospitals: an uncontrolled single group study

Knowledge translation theories in fall prevention and balance control: A scoping review

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