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Standardizing Outcome Assessment in Parkinson Disease
Journal of Neurologic Physical Therapy ( IF 3.8 ) Pub Date : 2020-11-25 , DOI: 10.1097/npt.0000000000000343
Amy M. Yorke , Suzanne Trojanowski , Nora E. Fritz , Angee Ludwa , Matthew Schroeder

Supplemental Digital Content is Available in the Text. Background and Purpose: Rehabilitation therapists do not consistently utilize standardized outcome measures. The purpose of this study was to develop and implement a tailored knowledge translation (KT) intervention to facilitate application of standardized outcome measures used in patients with Parkinson disease (PD) receiving outpatient rehabilitation. Methods: Four clinics within a hospital-based outpatient system including physical therapists (n = 7) and occupational therapists (n = 2) collaborated with researcher clinicians. A mixed-methods study, using the knowledge to action (KTA) framework, was executed to standardize the assessment battery completed on patients with PD. The project was titled iKNOW-PD (integrating KNOWledge translation for Parkinson Disease). Results: Four measures were selected for iKNOW-PD (9-Hole Peg Test, miniBESTest, 10-m walk test, and 5 times sit-to-stand). A multimodal intervention that overcame specific identified barriers (equipment, time) was implemented to ensure successful uptake. Consistency of utilizing iKNOW-PD measures on initial evaluation and discharge, across therapists and clinics, was evaluated. Therapists significantly increased the use of iKNOW-PD measures from 1.9 to 3.1 on initial evaluation (P < 0.001). The 10-meter walk test demonstrated the greatest uptake (>50%) from pre-iKNOW-PD to post-iKNOW-PD. Discussion and Conclusions: Standardizing outcome assessment for persons with PD in an outpatient setting can be successfully implemented. Overcoming identified barriers and capitalizing on facilitators promoted the uptake of standardized outcomes. Following the 6-month intervention period, therapists endorsed an improvement in their application of standardized measures and labeled iKNOW-PD as a positive experience that allowed them to minimize variability in practice. Video Abstract available for more insights from the authors (see the Video, Supplemental Content 1, available at: http://links.lww.com/JNPT/A329).

中文翻译:

帕金森病预后评估的标准化

补充数字内容在文本中可用。背景和目的:康复治疗师并没有始终如一地使用标准化的结果测量方法。本研究的目的是开发和实施量身定制的知识翻译 (KT) 干预措施,以促进在接受门诊康复的帕金森病 (PD) 患者中使用的标准化结果措施的应用。方法:医院门诊系统内的四个诊所,包括物理治疗师(n = 7)和职业治疗师(n = 2),与研究临床医生合作。使用知识到行动 (KTA) 框架进行了一项混合方法研究,以标准化对 PD 患者完成的评估组合。该项目名为 iKNOW-PD(整合帕金森病知识翻译)。结果:iKNOW-PD 选择了四项措施(9 孔桩测试、miniBESTest、10 米步行测试和 5 次从坐到站)。实施了克服特定障碍(设备、时间)的多模式干预,以确保成功实施。评估了治疗师和诊所在初始评估和出院时使用 iKNOW-PD 措施的一致性。治疗师在初始评估中显着增加了 iKNOW-PD 测量的使用,从 1.9 到 3.1(P < 0.001)。10 米步行测试显示从 iKNOW-PD 前到 iKNOW-PD 后的最大吸收 (>50%)。讨论和结论:可以成功实施门诊 PD 患者的标准化结果评估。克服已确定的障碍并利用促进者促进了标准化成果的采用。在 6 个月的干预期之后,治疗师赞同改进标准化措施的应用,并将 iKNOW-PD 标记为一种积极的体验,使他们能够最大限度地减少实践中的可变性。视频摘要可提供作者的更多见解(参见视频,补充内容 1,可在:http://links.lww.com/JNPT/A329 获得)。
更新日期:2020-11-25
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