ArticleBMJ open quality2020
What is the feasibility and observed effect of two implementation packages for stroke rehabilitation therapists implementing upper limb guidelines? A cluster controlled feasibility study.
Article in BMJ open quality, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Healthcare professionals' perceived barriers and facilitators of implementing clinical practice guidelines for stroke rehabilitation: A systematic review.Clinical rehabilitation · 2023Pooled it
- Article
- Determinants and strategies for implementing guideline-adherent physiotherapy: a scoping review.BMJ open · 2026Article
- Implementation science promotes clinical practice of guidelines: a scoping review.BMC health services research · 2025Article
- Evaluation of a Theoretical and Experiential Training Programme for Allied Healthcare Providers to Prescribe Exercise Among Persons with Multiple Sclerosis: A Co-Designed Effectiveness-Implementation Study.Journal of clinical medicine · 2025Article
- Implementing modified constraint-induced movement therapy after stroke in an early-supported discharge rehabilitation service: a process evaluation using RE-AIM QuEST.BMC health services research · 2025Article
- Exploring Therapists' Experiences of an Educational Website to Support Telehealth Delivery of Constraint-Induced Movement Therapy.Healthcare (Basel, Switzerland) · 2025Article
- Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care.Implementation science : IS · 2025Article
- Audit as a Tool for Improving the Quality of Stroke Care: A Review.International journal of environmental research and public health · 2023Review
- Tailored GuideLine Implementation in STrokE Rehabilitation (GLISTER) in Germany. Protocol of a Mixed Methods Study Using the Behavior Change Wheel and the Theoretical Domains Framework.Frontiers in neurology · 2022Article
- Implementation of evidence-based assessment of upper extremity in stroke rehabilitation: From evidence to clinical practice.Journal of rehabilitation medicine · 2021Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHand and arm activity after stroke improves with evidence-based rehabilitation. Therapists face known barriers when providing evidence-based rehabilitation and require support to implement guidelines. The aim of this study was to investigate the feasibility of two implementation packages on guideline adherence by occupational therapists and physiotherapists, and explore effect on patient upper limb outcomes.
methodThis was a non-randomised clustered feasibility study of occupational and physiotherapy rehabilitation services (n=3 inpatient and n=3 outpatient services). Services were allocated to one of three groups: (group A) facilitator-mediated implementation package, (group B) self-directed implementation package or (group C) usual care (control); we recruited n=1 inpatient and n=1 outpatient service per group. Outcomes of feasibility, adherence to guidelines (medical file audits) and patient upper limb impairment (Fugl-Meyer Upper Extremity Assessment), activity (Box and Block Test) and practice (minutes/week) were collected at baseline and after 3 months of intervention.
results29 therapists (8 in group A, 13 in groups B and 8 in group C) and 55 patients participated. Both the facilitator-mediated and the self-directed implementation packages were feasible to deliver in the rehabilitation setting. Therapists in group A improved with respect to guideline adherence (medical file audits; median within-group proportion difference of 0.29 (95% CI 0.22 to 0.36, p<0.0001) preintervention to postintervention). No significant within-group differences from baseline to postintervention were found in group B or group C, and no between-group differences were found for upper limb outcomes.
conclusionA facilitator-mediated package was acceptable to therapists working in stroke rehabilitation, and feasibility data suggest increased guideline uptake following implementation. An adequately powered study is planned to understand how to support therapists to provide evidence-based upper limb rehabilitation after stroke. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12619000596101).
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