Assessing the Use of Standardized Outcome Measures for Stroke Rehabilitation among Physiotherapists in Ghana

Agyenkwa, Seth Kwame; Yarfi, Cosmos; Banson, Adjoa Nkrumah; Kofi-Bediako, Woyram Abla; Abonie, Ulric S.; Angmorterh, Seth Kwadjo; Ofori, Eric Kwasi

doi:10.1155/2020/9259017

Cited by 11 publications

(20 citation statements)

References 15 publications

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“…Previous systematic reviews have identified multiple measures of sitting balance used for people after stroke ( 90 ), with over 60 different measures of standing balance in the adult population ( 69 ), and over 30 measures of mobility for older adults ( 91 ). We found that the assessment tools included in at least 70% of CPGs (i.e., BBS, 6MWT, TUG, and 10mWT) are consistent with the tools most frequently used in clinical practice as indicated by clinician surveys conducted in Canada ( 92 – 94 ), Colombia ( 95 ), Ghana ( 27 ), and Germany ( 32 ). Moreover, our analyses considering CPGs by country income level showed that the BBS, 6MWT, TUG, and 10mWT, are currently recommended by CPGs from middle- and high-income countries.…”

Section: Discussionsupporting

confidence: 67%

“…The use of standardized assessment tools in physical therapy practice is inconsistent ( 27 – 32 ). Common barriers to the use of standardized assessment tools are lack of time, insufficient knowledge, lack of description of how to administer standardized assessment tools, and low perceived value of some instruments ( 24 , 28 , 29 , 31 – 36 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Standardized tools for assessing balance and mobility in stroke clinical practice guidelines worldwide: A scoping review

Santos

Fiedler²,

Badwal³

et al. 2023

Front. Rehabil. Sci.

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BackgroundUse of standardized tools to assess balance and mobility limitations is a recommended practice in stroke rehabilitation. The extent to which clinical practice guidelines (CPGs) for stroke rehabilitation recommend specific tools and provide resources to support their implementation is unknown.PurposeTo identify and describe standardized, performance-based tools for assessing balance and/or mobility and describe postural control components challenged, the approach used to select tools, and resources provided for clinical implementation, in CPGs for stroke.MethodsA scoping review was conducted. We included CPGs with recommendations on the delivery of stroke rehabilitation to address balance and mobility limitations. We searched seven electronic databases and grey literature. Pairs of reviewers reviewed abstracts and full texts in duplicate. We abstracted data about CPGs, standardized assessment tools, the approach for tool selection, and resources. Experts identified postural control components challenged by each tool.ResultsOf the 19 CPGs included in the review, 7 (37%) and 12 (63%) were from middle- and high-income countries, respectively. Ten CPGs (53%) recommended or suggested 27 unique tools. Across 10 CPGs, the most commonly cited tools were the Berg Balance Scale (BBS) (90%), 6-Minute Walk Test (6MWT) (80%), Timed Up and Go Test (80%) and 10-Meter Walk Test (70%). The tool most frequently cited in middle- and high-income countries was the BBS (3/3 CPGs), and 6MWT (7/7 CPGs), respectively. Across 27 tools, the three components of postural control most frequently challenged were underlying motor systems (100%), anticipatory postural control (96%), and dynamic stability (85%). Five CPGs provided information in varying detail on how tools were selected; only 1 CPG provided a level of recommendation. Seven CPGs provided resources to support clinical implementation; one CPG from a middle-income country included a resource available in a CPG from a high-income country.ConclusionCPGs for stroke rehabilitation do not consistently provide recommendations for standardized tools to assess balance and mobility or resources to facilitate clinical application. Reporting of processes for tool selection and recommendation is inadequate. Review findings can be used to inform global efforts to develop and translate recommendations and resources for using standardized tools to assess balance and mobility post-stroke.Systematic Review Registrationhttps://osf.io/, identifier: 10.17605/OSF.IO/6RBDV.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Standardized tools for assessing balance and mobility in stroke clinical practice guidelines worldwide: A scoping review

Santos

Fiedler²,

Badwal³

et al. 2023

Front. Rehabil. Sci.

View full text Add to dashboard Cite

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“…The rest (36.8%) used them occasionally or rarely. In Ghana, Agyenkwa et al ( 2020 ) also showed that 21% of physiotherapists working in stroke care used standardised outcome measures all the time (5/5 patients) and 21% often (3-4/5 patients) (Agyenkwa et al 2020 ). Our results are similar to those of Demers et al ( 2019 ) who compared the use of outcome measures between India and Canada.…”

Section: Discussionmentioning

confidence: 99%

“…However, later in 2019, Odole et al ( 2019 ) reported contrasting results with a 68% use of knee osteoarthritis outcome measures among Nigerian physiotherapists (Odole et al 2019 ). Agyenkwa et al ( 2020 ) found that Ghanaian physiotherapists (47.6%) had low use of standardised outcome measures (Agyenkwa et al 2020 ). One study from Nigeria dealt with harvesting perceived barriers and facilitators to the use of outcome measures (Obembe et al 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Use of standardised outcome measures among physiotherapists in French-speaking sub-Saharan Africa

Sawadogo,

Sogbossi,

Everard

et al. 2024

South African Journal of Physiotherapy

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Background: The use of standardised assessment tools is a fundamental aspect of good clinical practice. However, to our knowledge, no study has documented the use of standardised assessment tools in physiotherapy in French-speaking sub-Saharan Africa.Objectives: Documenting the use of standardised outcome measures in physiotherapy in French-speaking sub-Saharan Africa.Method: Our cross-sectional survey used an online self-questionnaire on facilitators and barriers to the use of standardised outcome measures, distributed to physiotherapists in French-speaking sub-Saharan Africa.Results: A total of 241 physiotherapists working in French-speaking sub-Saharan Africa responded to the survey. The most represented countries were Benin (36.9%), Cameroon (14.1%), and Burkina Faso (10.8%). Although 99% of participants reported using standardised outcome measures, only 27% of the respondents used them systematically (all the time). The most reported facilitators included the recognition that standardised outcome measures help to determine whether treatment is effective, help to guide care, and improve communication with patients. The most significant barriers were the lack of time, unavailability of the standardised outcome measures, and non-sensitivity of measures to patients’ cultural and ethnic concerns. There was a higher proportion of use in the middle age group (30–40) (p = 0.02) and a lower proportion of use in physiotherapists simultaneously working in public and private sectors (p = 0.05).Conclusion: Standardised outcome measures are still not widely used by physiotherapists in French-speaking sub-Saharan Africa.Clinical implications: The perceived barriers and facilitators could help to develop strategies to improve the systematic use of outcome measures in French-speaking sub-Saharan Africa.

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“…These few studies revealed that the standardised assessments of somatosensation are underutilised. Evidence regarding the use of validated and reliable instruments by therapists in stroke rehabilitation varies across countries [48][49][50][51]. For example, the use of standardised assessments was notably high in the United Kingdom but relatively low in Canada, likely due to lack of time and knowledge about outcome measures.…”

Section: Discussionmentioning

confidence: 99%

Current clinical practice in managing somatosensory impairments and the use of technology in stroke rehabilitation

et al. 2022

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Stroke-induced somatosensory impairments seem to be clinically overlooked, despite their prevalence and influence on motor recovery post-stroke. Interest in technology has been gaining traction over the past few decades as a promising method to facilitate stroke rehabilitation. This questionnaire-based cross-sectional study aimed to identify current clinical practice and perspectives on the management of somatosensory impairments post-stroke and the use of technology in assessing outcome measures and providing intervention. Participants were 132 physiotherapists and occupational therapists currently working with stroke patients in public hospitals and rehabilitation centres in Singapore. It was found that the majority (64.4%) of the therapists spent no more than half of the time per week on somatosensory interventions. Functional or task-specific training was the primary form of intervention applied to retrain somatosensory functions in stroke survivors. Standardised assessments (43.2%) were used less frequently than non-standardised assessments (97.7%) in clinical practice, with the sensory subscale of the Fugl-Meyer Assessment being the most popular outcome measure, followed by the Nottingham Sensory Assessment. While the adoption of technology for assessment was relatively scarce, most therapists (87.1%) reported that they have integrated technology into intervention. There was a common agreement that proprioception is an essential component in stroke rehabilitation, and that robotic technology combined with conventional therapy is effective in enhancing stroke rehabilitation, particularly for retraining proprioception. Most therapists identified price, technology usability, and lack of available space as some of the biggest barriers to integrating robotic technology in stroke rehabilitation. Standardised assessments and interventions targeting somatosensory functions should be more clearly delineated in clinical guidelines. Although therapists were positive about technology-based rehabilitation, obstacles that make technology integration challenging ought to be addressed.

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Assessing the Use of Standardized Outcome Measures for Stroke Rehabilitation among Physiotherapists in Ghana

Cited by 11 publications

References 15 publications

Standardized tools for assessing balance and mobility in stroke clinical practice guidelines worldwide: A scoping review

Standardized tools for assessing balance and mobility in stroke clinical practice guidelines worldwide: A scoping review

Use of standardised outcome measures among physiotherapists in French-speaking sub-Saharan Africa

Current clinical practice in managing somatosensory impairments and the use of technology in stroke rehabilitation

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