Prof. Leeanne Carey1,2, Ms Liana Cahill1,2,3, Mr Brendon Haslam1,2, Ms Yvonne Mak-Yuen1,2, Dr Megan Turville1,2, Ms Cheryl Neilson1, A/Professor Natasha Lannin1,4, Professor Vincent Thijs2,5, Professor Susan Hillier6, Professor Michael Nilsson2,7
1La Trobe University, Occupational Therapy, Bundoora, Melbourne, Australia, 2Florey Institute of Neuroscience and Mental Health, Heidelberg, Melbourne, Australia, 3Australian Catholic University, Melbourne, Australia, 4Alfred Health, Prahran, Melbourne, Australia, 5Austin Health, Heidelberg, Melbourne, Australia, 6University of South Australia, Adelaide, Australia, 7The University of Newcastle, Newcastle, Australia
Aim: Effective therapies are available to improve hand function. However, our national survey found that stroke survivors with impaired touch sensation are not receiving recommended best-practice therapy. We aim, through our partnership of clinicians, health providers, consumers, researchers and academics, to increase access to best-practice upper-limb rehabilitation and thus achieve better outcomes for stroke survivors.
Method: We developed a ‘knowledge transfer’ intervention, guided by the Theoretical Domain Framework and Behaviour Change Wheel, to change clinician behaviour and increase access. A network of 12 sites and approximately 100 ‘upskilled’ therapists will participate in the implementation intervention, delivering best-practice upper-limb therapy to 336 stroke survivors. This pragmatic before-after study design involves 8 Australian health organisations and 4 specialist therapy centres. Outcomes will be analysed in relation to generalist and specialist sites of delivery and skill level of therapists.
Results: 87 therapists from 8 health organisations reported low confidence in their skill level to assess (mean 4.5/10 on visual analogue scale) and treat (mean 3.8/10) sensory loss, supporting the need for upskilling. Therapists identified competing workload demands and priorities as organisational barriers within the current system.
Significance of the findings to allied health: Findings support a role for upskilling of therapists and complementary services to help increase access to best-practice stroke rehabilitation. This partnership project will deliver a knowledge translation hub, specialist therapy centres, a community of upskilled therapists and an exemplar implementation intervention for translating recommended best-practice interventions into the clinic and community environment.
Professor Leeanne Carey is Professor of Occupational Therapy and Discipline Lead, School of Allied Health, La Trobe University and Clinical Research Lead and Head of the Neurorehabilitation and Recovery research group in the Stroke Division, Florey Institute of Neuroscience and Mental Health in Australia. Dr Carey’s research program focuses on stroke rehabilitation and recovery: in particular how the brain adapts and how we might harness that potential in rehabilitation. She has developed successful neuroscience and learning-based sensorimotor interventions and evidence-based assessments. An important focus has been to translate these discoveries into clinical practice and better outcomes for stroke survivors.