title: Research-based evidence in stroke rehabilitation: an investigation of its implementation by physiotherapists and occupational therapists.
abstract: Stroke rehabilitation is a multidimensional process that is designed to facilitate restoration of and/or adaptation to loss of functioning. The use of research-based evidence in informed decision-making is insufficient. Occupational therapy and physiotherapy constitute important contributions to rehabilitation. The study aim was to investigate characteristics of the implementation of research-based evidence in stroke rehabilitation by occupational therapists and physiotherapists, using the International Classification of Functioning, Disability and Health as a conceptual framework.
  
  
  
  A prospective cohort study, including all service levels within stroke rehabilitation. Consecutive patients with stroke admitted to a university hospital between May and December 2012 were enrolled by 13 therapists. Documentation of daily practice was collected from medical records. Analysis compared the therapists' documentation with the national clinical guidelines for physiotherapy and occupational therapy in the rehabilitation of adults with brain injury.
  
  
  
  The study included 131 patients. The therapists' praxis was seen to be in agreement with the majority of the national clinical guidelines. However, joint goal-setting and evaluation using standardized measures were seldom documented.
  
  
  
  Although the therapists recognize evidence-based practice as a framework for achieving quality in rehabilitation, findings suggest that they do not employ research-based evidence to the fullest extent. Implications for Rehabilitation In order to individualize the rehabilitation offered, more attention and focus on involving and giving words to patients' expectations, perceptions, experiences, and perspectives is needed. With the intention of enabling meaningful participation the health professionals need to pay more attention to the importance of environmental factors. Both guidelines and clinical practice should consider all components of the International Classification of Functioning, Disability and Health when formulating, and implementing, recommendations in rehabilitation praxis in order to aim for rehabilitation that is based both on evidence and a holistic approach.
authors.affiliation: a Health Sciences Research Center, University College Lillebaelt , Odense , Denmark ;|b Institute of Clinical Research, University of Southern Denmark , Odense , Denmark ;
authors.forename: Hanne Kaae
authors.initials: HK
authors.lastname: Kristensen
authors.affiliation: b Institute of Clinical Research, University of Southern Denmark , Odense , Denmark ;|c Department of Neurobiology, Care Sciences and Society , Karolinska Institutet Stockholm , Sweden ;
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ytterberg
authors.affiliation: d The Department of Rehabilitation , Odense University Hospital , Odense , Denmark ;
authors.forename: Dorrie Lee
authors.initials: DL
authors.lastname: Jones
authors.affiliation: e SEARCH - Research Group for Synthesis of Evidence and Research, Research Unit for Musculoskeletal Function and Physiotherapy (FoF) , Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark ;|f Centre for Evidence Based Practice, Bergen University College , Bergen , Norway.
authors.forename: Hans
authors.initials: H
authors.lastname: Lund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003718:Denmark; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072087:Occupational Therapists; D009788:Occupational Therapy / Q000592:standards*; D059825:Physical Therapists; D026741:Physical Therapy Modalities / Q000592:standards*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000379:methods*; D057170:Translational Research, Biomedical
keywords: Evidence-based practice; ICF; knowledge translation; occupational therapists; physiotherapists; stroke