Delphi consensus study and clinical practice guideline development for functional electrical stimulation to support upright mobility in people with an upper motor neuron lesion

Abstract

PurposeA Clinical Practice Guideline (CPG) is required to provide guidance on optimal service delivery for Functional Electrical Stimulation (FES) to support upright mobility in people living with mobility difficulties due to an upper motor neuron lesion, such as stroke or multiple sclerosis. A modified Delphi consensus study was used to provide expert consensus on best practice.MethodsA Steering Group supported the recruitment of an Expert Panel, which included a range of stakeholders who participated in up to three survey rounds. In each round, panelists were asked to rate their agreement with draft statements about best practice using a 6‐point Likert scale and add free text to explain their answer. Statements that achieved over 75% agree/strongly agree on the Likert scale were included in the CPG. Those that did not were revised based on free text comments and proposed in the next survey round.ResultsThe first round included 82 statements with seven substatements. Sixty‐five people (84% response rate) completed survey round 1 leading to 62 statements and four substatements being accepted. Fifty‐six people responded to survey round 2, and consensus was achieved for all remaining statements.ConclusionThe accepted statements are included within the CPG and provide recommendations about who can benefit from FES and how they can be optimally supported through FES service provision. As such the CPG will support advocacy for, and optimal design of, FES services.

Inclusive design in electrical stimulation technologies and neurorehabilitation for clinician and patient end users

“…3 Recently published comprehensive clinical practice guidelines (CPG) for FES walking, provide best practice recommendations and a framework for education, to guide development of courses and resources. 4,5 The development of CPG for other FES applications is now required. While CPG may mitigate some of the identified issues, there is also a need for evidence based academic resources such as course textbooks, to support the development of higher education level courses.…”