Cerebral Palsy (CP)
Conditions
Keywords
functional electrical stimulation, implementation intervention, physical therapist, occupational therapist
Brief summary
Physical rehabilitation interventions that promote activity-dependent neuroplasticity are desired for children with CP as this will result in improved motor skill and function. In adult neurological populations, such as stroke and spinal cord injury, FES is a recommended, evidence-based intervention that addresses motor and sensory impairments and promotes neuroplasticity. The evidence base supporting the safety, feasibility and efficacy of FES for youth with CP is rapidly growing, yet FES is not commonly used in Canadian pediatric rehabilitation. Through interviews with Canadian pediatric physical and occupational therapists, we identified numerous barriers to FES implementation, including a lack of knowledge and training in FES, difficulty accessing FES equipment, and a perceived lack of time to deliver FES within a treatment session. To address these barriers, we have developed an implementation intervention for FES that consists of an online course and toolkit for physical and occupational therapists. As a next step, we will evaluate the effects of the implementation intervention on pediatric therapists' knowledge, confidence and use of FES.
Interventions
The intervention employs four established implementation strategies according to the Expert Recommendations for Implementing Change: conduct educational meetings, provide ongoing consultation, provide technical assistance, and change physical structure and equipment. The first component is a six-week online course led by the PI that combines weekly pre-recorded lectures, hands-on activities, group mentoring sessions and a reflective assignment. The second component of the intervention is ensuring access to the equipment needed for FES. The third component of the intervention is access to the FES Toolkit.
Sponsors
University Health Network, Toronto
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
1. Licensed to practice physical or occupational therapy in Canada. 2. Report that CP comprises ≥20% of their caseload over the past year. 3. Has not previously taken a continuing education course in FES. 4. Reports never (0% of treatment sessions) or rarely (1-20% of treatment sessions) using neuromuscular electrical stimulation (NMES) or FES in their clinical practice. 5. Report being able to participate in a six-week online FES course from October 18 2024 - November 28 2024. 6. Able to complete the course and interview in English.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| FES knowledge quiz | From pre-intervention to immediately post-intervention and six months post-intervention | — |
| FES Confidence Questionnaire | From pre-intervention to immediately post-intervention and six months post-intervention | — |
| FES Use Survey | From pre-intervention to immediately post-intervention and six months post-intervention | — |
| Technology Assistance Model 2 Questionnaire | From pre-intervention to immediately post-intervention and six months post-intervention | — |
| Semi-structured Interview | Six months post-intervention | Guided by the RE-AIM Framework |
Countries
Canada
Outcome results
None listed