ArticleImplementation science communications2024
Bundling implementation strategies supports outcome measure adoption in stroke rehabilitation: preliminary findings.
Article in Implementation science communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04888416 (Strategies to Promote the Implementation of Outcome Measures in Stroke Rehabilitation), which is not on this map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Strategies to Promote the Implementation of Outcome Measures in Stroke Rehabilitation
Who cites it
3 citing papers in PubMed.
- Advancing the Implementation of Patient-Centered Outcomes in Rehabilitation Learning Health Systems: Insights From the 2024 LeaRRn Summit.Archives of physical medicine and rehabilitation · 2026Article
- Exploring factors influencing the consistent adoption of a post-stroke upper extremity outcome measure using Normalisation Process Theory.BMC health services research · 2025Article
- The use of implementation mapping in healthcare settings: a scoping review.Frontiers in public health · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundOver 80% of people who experience a stroke present with residual impairment of the upper extremity, such as the shoulder, elbow, wrist, and hand. However, rarely do stroke rehabilitation practitioners (e.g., occupational therapists) use standardized outcome measures to objectively evaluate upper extremity function. Accordingly, the purpose of this project was to develop a bundle of implementation strategies that supports practitioners' adoption of the Fugl-Meyer Assessment of the Upper Extremity in stroke rehabilitation practice.
methodsWe used tenets of Implementation Mapping to guide the development of our implementation strategy bundle. We partnered with one, large academic health system serving over 200 stroke patients annually through intensive rehabilitation care. Strategies were selected and developed through a multi-method process that included a review of the literature, qualitative input from our health system's practitioners and managers, and expert consultation. We also specified the hypothesized implementation "mechanisms" our strategies intended to change. Practitioners' adoption (yes/no) of the Fugl-Meyer Assessment was calculated by analyzing electronic health record documentation of the 6-month time frame before strategies were deployed compared to the 6-month time frame after deployment.
resultsPractitioners were exposed to the following implementation strategies to support Fugl-Meyer adoption: conduct educational meetings, prepare outcome measure champions, provide equipment, develop training materials, and adapt documentation systems. In the 6-months before deployment of our implementation strategies, practitioners implemented the Fugl-Meyer with 14.8% of stroke patients. In the six months after deployment, adoption of the Fugl-Meyer increased to 73.8% (p < .001).
conclusionsWhen systematically developed in collaboration with health system partners, a bundle of implementation strategies may support outcome measure adoption in stroke rehabilitation. Improving the use of standardized outcome measures is of paramount importance in stroke rehabilitation to objectively monitor patients' progress or decline, to demonstrate the value of rehabilitation services for enhancing patients' recovery, and to advocate for continued reimbursement for rehabilitation care. Future opportunities lie in further specifying the mechanisms through which implementation strategies are intended to work and how those mechanisms contribute to strategy effectiveness.
trial registrationNCT registration: NCT04888416; May 06, 2021.
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