Incorporating Self-Management in Prosthetic Rehabilitation: Case Report of an Integrated Knowledge-to-Action Process

Abstract

Background. In improvement of clinical practice, unidirectional approaches of translating evidence into clinical practice have been pinpointed as main obstacles. The concept of engaged scholarship has been introduced to guide knowledge-toaction (KTA) processes, in which research knowledge and practical knowledge derived from therapists, patients, and organizational structures mutually inform each other. Accordingly, KTA experts should engage end-users earlier in knowledge translation and work in concert with them on both knowledge creation and knowledge implementation.Purpose. The purposes of this case report are: (1) to provide an illustrative example of an evidence-informed improvement process in prosthetic rehabilitation in a local setting and (2) to articulate the bidirectional translation work incorporated into an integrated KTA process.Case Description. A KTA expert translated research knowledge on selfmanagement and task-and context-specific training into a functional prosthetic training program for patients with a lower limb amputation. Therapists contributed as co-creators to the translation process with practical knowledge of the specificities of the target group and local organizational context. The KTA expert moved the co-created knowledge into action in iterative and interactive steps with local therapists, patients, and managers.Outcome. This bidirectional KTA translation process led to shared ownership of the functional prosthetic training program, in which self-management and task-and context-specific training principles and practices were integrated.Discussion. Bidirectional knowledge translation builds on explicating and integrating the different knowledge practices of researchers, therapists, and their patients. Knowledge-to-action experts and end-users have their own roles and activities in such knowledge translation processes. Appreciating these different roles in genuine partnerships and acknowledging the distinct but equally valued knowledge practices can help in effectively translating evidence into action.

Self-Management in Persons With Limb Loss: A Systematic Review

“…One of the included studies looked at the benefits of group training when learning to self-manage and use a prosthesis. 30 This practice demonstrated both benefits and drawbacks. The benefits include the ability to socialize, learn from each other, and share in the experience.…”

Revisión sistemática sobre modelos de rehabilitación con víctimas de Minas Antipersonal (MAP), en el marco de conflictos armados y el enfoque comunitario

“…Una forma de optimizar la intervención del equipo interdisciplinario que participa en la rehabilitación consiste en el aprendizaje para la acción, con el cual se busca que un experto en entrenamiento protésico funcional capacite al personal médico y terapéutico que interviene en el proceso; por consiguiente, se requiere una estrategia de educación autogestionada y una capacitación específica por tareas, abordados en el contexto local concerniente. En este orden de ideas, es indispensable que el experto como observador e integrador de conocimientos, realice constantes retroalimentaciones sobre la pertinencia de la terapia y los avances en el paciente; en consecuencia, los investigadores encontraron que el ejercicio aportó a la comunicación del grupo profesional, el aprendizaje por pares y la integración de teoría-práctica (van Twillert, Postema, Geertzen, y Lettinga, 2015). Esta alternativa puede contribuir a un mejor desempeño de los profesionales tratantes y, por ende, al desarrollo de una rehabilitación sobresaliente que según Barker et.al (2016), requiere la concentración de todos los recursos necesarios para lograr un buen resultado.…”