Implementation of Focused Intensive Repeated Stepping Training (FIRST) During Inpatient Rehabilitation Poststroke - A Quality Improvement Project
Indiana University
Summary
The purpose of this quality improvement project was first to monitor usual physical therapy care (types \& cardiovascular intensity of interventions and amount of stepping practice provided) and outcomes. Following which educational training and support was provided to treating physical therapists to encourage implementation of evidence-based practices. Specifically, therapists were encouraged to prioritize the practice of walking, particularly at higher cardiovascular intensities during scheduled therapy sessions. Fidelity metrics in the form of chart audits and pedometer-based step counts were utilized to determine compliance with the evidence-based intervention and ultimately investigated for potential effects on patient outcome measures.
Description
Converging data over the past 20 years suggest that the provision of large amounts of walking practice can improve walking function for individuals poststroke with greater improvements observed when the walking training is performed at moderate to high aerobic intensities. Despite this, current physical therapy practice during inpatient rehabilitation suggests limited walking practice is provided and low cardiovascular intensities achieved. The purpose of this current quality improvement project is to evaluate the feasibility of implementing Focused, Intensive, Repeated Stepping Training (FIR…
Eligibility
- Age range
- 18–89 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * \< 2 months poststroke Exclusion Criteria: * restrictions in lower extremity weightbearing (e.g., amputation or lower limb fracture) * unable to ambulate \> 50 m prior to their most recent stroke * discharged to home from inpatient rehabilitation after \< 1 week
Interventions
- Otherinpatient physical therapy poststroke
routine care
Location
- Rehabilitation Hospital of IndianaIndianapolis, Indiana