Using functional electrical stimulation with stroke survivors: A survey of Victorian occupational therapists and physiotherapists

Howlett, Owen; McKinstry, Carol; Lannin, Natasha A.

doi:10.1111/1440-1630.12482

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…Multiple barriers to effective implementation of FES were documented including inconsistent access to FES devices, decreased awareness of the evidence supporting FES use, and variability of FES education and supports contributing to a lack of confidence and overall use of FES. These barriers are similar to those identified in current research on barriers in FES use, which highlights the need for improved educational and implementation strategies with considerations for behaviour change ( 6 , 10 , 11 , 18 ). The behaviour change research documents a lack of access or awareness of current research and a lack of clinician efficacy interpreting the research as barriers to evidence-based practice ( 19 ).…”

Section: Discussionsupporting

confidence: 74%

“…For successful translation of CPGs on FES into clinical practice, development of multimodal knowledge translation strategies is required to improve practice and change clinician behaviour ( 18 – 20 ). A systematic review by Berube et al (2018) provides guidance that may assist in the implementation of CPGs related to FES ( 10 ). Successful increases in physiotherapists’ knowledge and awareness of musculoskeletal guidelines were achieved using a variety of techniques, such as professional educational materials, presentations, and marketing materials.…”

Section: Discussionmentioning

confidence: 99%

“…Public engagement and involvement consultations play an important role in the dissemination of research and can improve the quality, relevance, and ultimately the usefulness of the knowledge to action products ( 9 ). Publications on this topic by Howlett et al, 2018, Auchstaetter et al 2016, and Tedesco Triccas et al 2021 identified barriers to FES use including gaps of education or training for FES use and lack of resources ( 10 – 12 ). Each of these surveys were completed prior to the publication of the recent evidenced based CPG in 2021, and were online surveys only distributed to one specific region, potentially limiting the global application of the results.…”

Section: Introductionmentioning

confidence: 99%

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

Brown

Street

Adonis

et al. 2023

Front. Rehabil. Sci.

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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.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Brown

Street

Adonis

et al. 2023

Front. Rehabil. Sci.

View full text Add to dashboard Cite

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“…The FES content provided in Canadian PT and OT entry-to-practice programs was perceived as insufficient to prepare clinicians to apply FES. Similarly, Australian PTs and OTs reported gaining skills in FES application through post-graduate education and mentoring rather than entry-level education ( 22 ). A lack of knowledge, training, and expertise in FES is known to be the main barriers PTs and OTs face when applying FES ( 3 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluating the validity of a functional electrical stimulation clinical decision making tool: A qualitative study

et al. 2022

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IntroductionFollowing central nervous system damage, the recovery of motor function is a priority. For some neurological populations, functional electrical stimulation (FES) is recommended in best practice guidelines for neurorehabilitation. However, limited resources exist to guide FES application, despite clinicians reporting that a lack of FES knowledge prevents use in clinical practice. The FES Clinical Decision Making Tool was developed to assist clinicians with FES application and translation into clinical practice. The purpose of this study was to evaluate the content validity of the Tool from the perspectives of Canadian physical and occupational therapists using FES in neurorehabilitation.MethodsThirteen participants (twelve women, one man), aged 40.5 ± 10.3 years, participated in individual semi-structured interviews to explore their clinical decision making experiences when applying FES and to evaluate the content validity (i.e., appropriateness, comprehensibility, and comprehensiveness) of the Tool. Interviews were analyzed using a qualitative conventional content analysis following the DEPICT model.ResultsThree themes were identified. 1) Clinician context influences FES usage. Participants' experiences with FES use varied and application was influenced by treatment goals. 2) Parameter selection in clinical practice. Participants identified decision-making strategies and the challenges of parameter selection. 3) With modifications, the Tool is a valid resource to inform FES applications. Participants discussed its strengths, limitations, and suggested changes. While the Tool is useful, a more extensive resource (e.g., appendix) for the Tool is warranted.DiscussionA revised Tool was created to improve its comprehensiveness and comprehensibility. Thus, the Tool is a valid resource for applying FES in neurorehabilitation.

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Physical and occupational therapists' learning needs and preferences for education on functional electrical stimulation: A qualitative descriptive study

Musselman,

Mayhew,

Somal

et al. 2024

Artificial Organs

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BackgroundFunctional electrical stimulation (FES) is an evidence‐based intervention that is rarely used by Canadian physical therapists (PTs) and occupational therapists (OTs). A common barrier to FES implementation is a lack of knowledge and training. FES learning resources that meet therapists' learning needs and preferences may address this barrier.ObjectiveTo explore OTs' and PTs' perspectives on the utility of FES e‐learning resources, including whether the resources met their learning needs and preferences.MethodsThrough this qualitative descriptive study, feedback on FES e‐learning resources was solicited from 5 PTs and 18 OTs who work clinically, but do not use FES. Participants reviewed ≥3 prerecorded lectures on FES topics and then completed a semi‐structured interview. Participants were asked about the lectures' content, delivery, ease of use and comprehensibility, and were asked to suggest modifications to facilitate self‐directed learning about FES. Interviews were analyzed using conventional content analysis.ResultsThree themes were identified. (1) Feedback on FES e‐learning: the content and delivery of the prerecorded lectures facilitated participants' learning, although opportunities to improve content and delivery were identified. (2) Factors influencing FES learning needs and preferences: Participants identified internal (i.e., baseline knowledge, learning style) and external (i.e., learning with colleagues, practice setting) factors that affected learning. Themes 1 and 2 impacted (3) the effects of FES e‐learning: Participants described the outcomes of their FES e‐learning, including increases in FES knowledge, confidence, and use in clinical practice.ConclusionTherapists' perceived the FES e‐learning resources to be useful and to address their learning needs and preferences.

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Using functional electrical stimulation with stroke survivors: A survey of Victorian occupational therapists and physiotherapists

Cited by 5 publications

References 22 publications

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

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

Evaluating the validity of a functional electrical stimulation clinical decision making tool: A qualitative study

Physical and occupational therapists' learning needs and preferences for education on functional electrical stimulation: A qualitative descriptive study

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