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. 2018 Jan 23;18(1):34.
doi: 10.1186/s12913-018-2829-z.

Changing practice in the assessment and treatment of somatosensory loss in stroke survivors: protocol for a knowledge translation study

Liana S Cahill  1   2   3 , Natasha A Lannin  4   5 , Yvonne Y K Mak-Yuen  4   6 , Megan L Turville  4   6 , Leeanne M Carey  4   6
Affiliations

Changing practice in the assessment and treatment of somatosensory loss in stroke survivors: protocol for a knowledge translation study

Liana S Cahill et al. BMC Health Serv Res. .

Abstract

Background: The treatment of somatosensory loss in the upper limb after stroke has been historically overshadowed by therapy focused on motor recovery. A double-blind randomized controlled trial has demonstrated the effectiveness of SENSe (Study of the Effectiveness of Neurorehabilitation on Sensation) therapy to retrain somatosensory discrimination after stroke. Given the acknowledged prevalence of upper limb sensory loss after stroke and the evidence-practice gap that exists in this area, effort is required to translate the published research to clinical practice. The aim of this study is to determine whether evidence-based knowledge translation strategies change the practice of occupational therapists and physiotherapists in the assessment and treatment of sensory loss of the upper limb after stroke to improve patient outcomes.

Method/design: A pragmatic, before-after study design involving eight (n = 8) Australian health organizations, specifically sub-acute and community rehabilitation facilities. Stroke survivors (n = 144) and occupational therapists and physiotherapists (~10 per site, ~n = 80) will be involved in the study. Stroke survivors will be provided with SENSe therapy or usual care. Occupational therapists and physiotherapists will be provided with a multi-component approach to knowledge translation including i) tailoring of the implementation intervention to site-specific barriers and enablers, ii) interactive group training workshops, iii) establishing and fostering champion therapists and iv) provision of written educational materials and online resources. Outcome measures for occupational therapists and physiotherapists will be pre- and post-implementation questionnaires and audits of medical records. The primary outcome for stroke survivors will be change in upper limb somatosensory function, measured using a standardized composite measure.

Discussion: This study will provide evidence and a template for knowledge translation in clinical, organizational and policy contexts in stroke rehabilitation.

Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) retrospective registration ACTRN12615000933550 .

Keywords: Clinician behavior change; Complex intervention; Occupational therapy; Physiotherapy; Rehabilitation; Somatosensory disorders; Translational medical research.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval for this study has been granted from the Austin Health Human Research Ethics Committee (Reference: H2013/04956 HREC/13/Austin/8) and La Trobe University (Reference FHEC 14/243). Given this is a multi-site study, site-specific ethical approval has been sought and obtained from each participating health organization. Written consent to participate in this study will be sought from all participants, following provision of written information in a participant information and consent form.

Consent for publication

Not applicable.

Competing interests

LMC is the lead originator of the SENSe approach to sensory rehabilitation and the measures used in the quantitative SENSe Assess© measure. A SENSe training package (manual and DVD) has been developed and is available for purchase. SENSe assessment and training equipment are also available for purchase. LMC has no personal financial interest in sale of these resources. There is no patent or intended application for any patent associated with these resources. LMC has conducted workshops on the SENSe approach and has been invited to give lectures and conference presentations on the approach. LMC conceptualized the study but will not be directly involved in data collection. All other authors declare that they have no competing interests.

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