Real-World Experiences of Therapy Staff Implementing an Intensive Rehabilitation Protocol in Canadian Stroke Inpatient Rehabilitation Settings: A Multi-Site Survey Study.
Importance While best practice guidelines recommend intensive rehabilitation for post-stroke walking recovery, knowledge of real-world implementation factors is limited. Objective The aim was to understand the implementation factors for intensive rehabilitation within real-world inpatient stroke reh...
| Published in: | PTJ: Physical Therapy & Rehabilitation Journal Vol. 105; no. 10; pp. 1 - 10 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | research tables/charts Journal Article |
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Oxford University Press / USA
Oct2025
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188960803&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188960803 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15386724 MZW0 jtl: PTJ: Physical Therapy & Rehabilitation Journal issn: 15386724 maglogo: N pubinfo: dt: Oct2025 vid: 105 iid: 10 pid: 622 pub: Oxford University Press / USA artinfo: ui: 188960803 188960803 188960803 10.1093/ptj/pzaf111 188960803 ppf: 1 ppct: 9 formats: tig: atl: Real-World Experiences of Therapy Staff Implementing an Intensive Rehabilitation Protocol in Canadian Stroke Inpatient Rehabilitation Settings: A Multi-Site Survey Study. aug: au: Hung, Stanley H Ackerley, Suzanne Connell, Louise A Bayley, Mark T Best, Krista L Donkers, Sarah J Dukelow, Sean P Ezeugwu, Victor E Milot, Marie-Hélène Peters, Sue Sakakibara, Brodie M Sheehy, Lisa Yao, Jennifer Eng, Janice J affil: Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada sug: subj: Physical Therapists Psychosocial Factors Work Experiences Evaluation Physical Therapist Attitudes Evaluation Stroke Rehabilitation Walking Protocols Hospitalization Program Implementation Psychosocial Factors Rehabilitation Centers Canada Physical Therapist Assistants Psychosocial Factors Attitude of Health Personnel Rehabilitation Methods Human Surveys Inpatients Stroke Patients Rehabilitation Patients Adult Middle Age Canada Step Heart Rate Organizational Structure Thematic Analysis Open-Ended Questionnaires Structured Questionnaires Male Female Time Wearable Sensors Cross Sectional Studies Multicenter Studies Self Report Weight-Bearing Physical Therapists Rehabilitation Personnel Seminars and Workshops Implementation Science Physical Therapy Practice Descriptive Statistics Data Analysis Software Funding Source Clinical Assessment Tools Summated Rating Scaling Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Importance While best practice guidelines recommend intensive rehabilitation for post-stroke walking recovery, knowledge of real-world implementation factors is limited. Objective The aim was to understand the implementation factors for intensive rehabilitation within real-world inpatient stroke rehabilitation settings. Design This was a cross-sectional, online survey study. Setting Twelve inpatient rehabilitation units (7 Canadian provinces) were included. Participants Eighty-five therapy staff who delivered an intensive rehabilitation protocol within the Walk 'n Watch implementation trial (NCT04238260) were invited. Intervention A structured intensive walking rehabilitation protocol was implemented as usual care (>2000 steps, 40%-60% heart rate reserve, >30 minutes/session). Step counters and heart rate monitors were provided. Main Outcomes and Measures An online survey was used, including close-ended and open-ended questions regarding the protocol practicalities, workplace structure, and training. Open-ended responses were thematically analyzed using the Consolidated Framework for Implementation Research (CFIR). Results Forty-seven participants (85% women) completed the survey. Most agreed they successfully delivered the protocol (87%) and found the step and heart rate targets helpful (72%). However, few participants agreed they had enough time to deliver the protocol (36%); 26% and 47% agreed they achieved the step count and heart rate targets, respectively. The major time-related factor was insufficient therapy time to accommodate the protocol and prescribed step targets (CFIR: Work Infrastructure); discharge planning often took priority. Most agreed to future protocol use (87%). However, only about half agreed to future use of the trial-assigned devices (49% step counters; 64% heart rate monitors), likely due to perceived device inaccuracies (CFIR: Materials and Equipment). Conclusions Therapy staff reported successfully delivering an intensive rehabilitation protocol as usual care under real-world conditions. Strategies to facilitate implementation included incorporating discharge planning considerations, system-level changes, and acquiring more accurate monitoring devices. Relevance This study enhanced the understanding of real-world implementation factors and potential strategies for future implementation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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