Implementering av høyintensiv gangtrening for slagpasienter

More than 17 years could pass before the evidence that is published today is used in the care of rehabilitation patients. Knowledge translation (KT) is a process to expedite the use of evidence in clinical practice, and includes the generation of new knowledge as well as the clinical implementation of established evidence.  Research suggests that use of processes, such as the Knowledge-to-Action Framework, may improve the success of KT efforts. 

To facilitate KT of an evidence-based gait training approach for individuals with stroke, the South Eastern Regional Center for Knowledge Translation in Rehabilitation (Regional kompetansetjeneste for rehabilitering, RKR), developed a tailored training program for clinicians and researchers at Oslo University Hospital (OUS) and Oslo Municipality Rehabilitation Unit (Rehabiliteringsavdelingen, Oslo kommune). The overarching objectives for this training program are to use KT approaches to successfully translate research on high intensity gait training into the treatment of patients with subacute stroke at these two inpatient rehabilitation facilities in Norway. 

The hybrid online and in-person training program has been tailored to meet the needs of Oslo University Hospital and the Oslo Municipality Rehabilitation Unit. Using the Knowledge-to-Action Framework, the group systematically assessed current practice, including resulting patient outcomes, clinician perceptions of the high intensity program, and barriers to implementation of the program that exist at all levels of the hospital system. Specific KT interventions have been selected to overcome the barriers, including a series of courses and workshops to improve knowledge and skill related to the high intensity gait training program.  

Education and training methods include a four hour online course that describes the theoretical underpinnings of the high intensity gait training program, and in-person training that recently occurred in the United States over five days in November. Jenni Moore PT, DHSc, NCS, an advisor for RKR, and 7 Norwegian clinicians and researchers, have visited other hospitals that have implemented the high intensity gait training program, including the Shirley Ryan Ability Lab (Chicago, IL), Mary Free Bed Rehabilitation Hospital (Grand Rapids, MI), and the Rehabilitation Hospital of Indiana (Indianapolis, IN).  During each of the site visits, participants learned about how the facilities overcame barriers to implement the program, observed patients undergoing training, and discussed application of the program with patients. 

Over the next year, Oslo University Hospital (OUS) and Oslo Municipality Rehabilitation Unit (Rehabiliteringsavdelingen, Oslo kommune, avdeling Aker), will implement and assess the effectiveness of the high intensity gait training program with continued guidance from RKR.

Bent Høie visits the Gait training project at Aker 

I forbindelse med tildelingsmidler fra Innovasjon Norge til samhandlingsprosjekter innen helse, besøkte Statsråd Bent Høie Aker Helsearena tidligere i høst, for å lære mer om disse samarbeidsprosjekter mellom Sunnaas sykehus, Oslo universitetssykehus og Oslo kommune. I den forbindelse presenterte spesialfysioterapeut og forsker ved OUS, Elisabeth Bø og Ingvild Rosseland, fra Oslo kommune, Forsterket rehabilitering Aker, gangstreningsprosjektet for statsråden. 

Dette er et viktig eksempel på at det går an å dele viktig kunnskapsbasert praksis på tvers av sykehus, kommuner og institusjoner.