Apples to Apples?  Experiences from Implementing High Intensity Gait Training in the US and Norway

Presented at the 2020 APTA Combined Sections Meeting (Denver, CO)

Jenni Moore, Chris Henderson, T. George Hornby, Elisabeth Bø, Lauren Lenca, Roberta Virva

Description:

Research on high-intensity gait training (HIGT) in stroke rehabilitation demonstrates a substantial impact on walking function including improved gait speed, walking distance, balance, aerobic capacity, and stepping activity.  HIGT was also strongly recommended in the clinical practice guideline for improving walking function in ambulatory chronic stroke, spinal cord injury, and brain injury.  While this evidence may advance our knowledge about interventions to improve walking recovery, a recent systematic review identified that research recommendations were not used about two-thirds of the time.  This lack of translation into routine clinical practice indicates that patients may not benefit from the advances in research without innovative efforts to ensure implementation.

This symposium will provide an overview of three projects that implemented HIGT into inpatient stroke rehabilitation in the United States and Norway.  Barriers and facilitators to using HIGT, as well as strategies to facilitate and monitor adherence to HIGT recommendations will be discussed.  Outcomes from each implementation project will be presented and strategies to facilitate sustainability will be described.  Similarities and differences between the clinical sites, as well as strategies that may facilitate translation of this evidence within other clinics will also be discussed.

Authors/Institutions

  • Jenni Moore PT, DHSc, NCS, Regional Center for Knowledge Translation in Rehabilitation, Sunnaas Hospital, Oslo, Norway; Institution for Knowledge Translation, Carmel, IN, USA

  • T. George Hornby PT, PhD, Indiana University, Indianapolis, IN

  • Chris Henderson PT, PhD, NCS Indiana University, Indianapolis, IN

  • Elisabeth Bø, PT, PhD Oslo University Hospital, Oslo, Norway

  • Roberta Virva PT, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI

  • Lauren Lenca PT, NCS Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI

Part 1: Development of a Knowledge Translation Plan for High-Intensity Gait

Training (~16.30 minutes)

Jenni Moore PT, DHS, NCS

Part 2: Overview of the Evidence that Supports High-Intensity Gait Training (~29 mins)

T. George Hornby PT, PhD

Part 3: Implementation of gait assessments and high intensity gait training into inpatient rehabilitation at Mary Free Bed Rehabilitation Hospital

Lauren Lenca PT, DPT and Roberta Virva PT, MS

Part 4: Research and clinical integration may facilitate implementation of high intensity gait training in inpatient stroke rehabilitation (~30 min)

Chris Henderson PT, PhD, NCS

Part 5: Implementation of high intensity gait training within two inpatient rehabilitation facilities in Norway (~24:00 min)

Elisabeth Bø PT, PhD

Part 6: Summary and Insights from Implementation in Different Contexts (~15 mins)

Jenni Moore PT, DHS, NCS