Understanding Behavior Change in Clinical Practice Guideline Implementation: A Qualitative Study.

Background And Purpose: Growing numbers of clinical practice guidelines (CPGs) are available to neurologic physical therapists to guide and inform evidence-based patient care. Adherence to CPG recommendations often necessitates behavior change for therapists and patients. The purpose of this qualitative study was to gain insight into the experiences, perspectives, and drivers of behavioral change for therapists working to improve adherence to a CPG.

2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for the Management of Headache.

Description: Headache medicine and therapeutics evidence have been rapidly expanding and evolving since the 2020 U.S. Department of Veterans Affairs (VA) and U.

A Partner-Engaged Approach to Developing an Implementation Research Logic Model for a Traumatic Brain Injury-Intensive Evaluation and Treatment Program.

Background: A partnered evaluation project with Veterans Health Administration Physical Medicine and Rehabilitation program office uses a partner-engaged approach to characterize and evaluate the national implementation of traumatic brain injury (TBI)Intensive Evaluation and Treatment Program (IETP).

Objective: This paper illustrates a partner-engaged approach to contextualizing the IETP within an implementation research logic model (IRLM) to inform program sustainment and spread.

Setting: The project was conducted at five IETP sites: Tampa, Richmond, San Antonio, Palo Alto, and Minneapolis.

A gaming app developed for vestibular rehabilitation improves the accuracy of performance and engagement with exercises.

Introduction: Vestibular hypofunction is associated with dizziness, imbalance, and blurred vision with head movement. Vestibular rehabilitation is the gold standard recommendation to decrease symptoms and improve postural stability. The Clinical Practice Guidelines for vestibular hypofunction suggest home exercises 3-5 times daily, but patient adherence is a problem, with compliance rates often below 50%.

Sensory functions and their relation to balance metrics: a secondary analysis of the LIMBIC-CENC multicenter cohort.

Introduction: Among patients with traumatic brain injury (TBI), balance problems often persist alongside hearing and vision impairments that lead to poorer outcomes of functional independence. As such, the ability to regain premorbid independent gait may be dictated by the level of sensory acuity or processing decrements that are shown following TBI assessment. This study explores the relationships between standardized sensory acuity and processing outcomes to postural balance and gait speed.

Exploring the relationship between sleep apnea and vestibular symptoms following traumatic brain injury.

Background: Traumatic brain injury (TBI) is a complex health problem in military veterans and service members (V/SM) that often involves comorbid vestibular impairment. Sleep apnea is another comorbidity that may exacerbate, and/or be exacerbated by, vestibular dysfunction.

Objective: To examine the relationship between sleep apnea and vestibular symptoms in V/SM diagnosed with TBI of any severity.

Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis.

Introduction: Among patients with traumatic brain injury (TBI), postural instability often persists chronically with negative consequences such as higher fall risk. One explanation may be reduced executive function (EF) required to effectively process, interpret and combine, sensory information. In other populations, a decline in higher cognitive functions are associated with a decline in walking and balance skills.

Use of the knowledge to action model improved physical therapist adherence to a common clinical practice guideline across multiple settings: a multisite case series.

Background: When a new guideline is published  there is a need to understand how its recommendations can best be implemented in real-world practice. Yet, guidelines are often published with little to no roadmap for organizations to follow to promote adherence to their recommendations. The purpose of this study was to evaluate the impact of using a common process model to implement a single clinical practice guideline across multiple physical therapy clinical settings.

Sensory Phenotypes for Balance Dysfunction After Mild Traumatic Brain Injury.

Background And Objectives: Recent team-based models of care use symptom subtypes to guide treatments of individuals with chronic effects of mild traumatic brain injury (mTBI). However, these subtypes, or phenotypes, may be too broad, particularly for balance (e.g.

Use of Stakeholder Feedback to Develop an App for Vestibular Rehabilitation-Input From Clinicians and Healthy Older Adults.

Close to half people over 60 years of age experience vestibular dysfunction. Although vestibular rehabilitation has been proven effective in reducing dizziness and falls in older adults, adherence to exercise programs is a major issue and reported to be below 50%. Therefore, this research aimed to develop an app with gaming elements to improve adherence to exercises that are part of vestibular rehabilitation, and to provide feedback to increase the accuracy during exercise performance.

The Primary Care Management of Headache: Synopsis of the 2020 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.

Introduction: In June of 2020, the U.S. DVA and DoD approved a new joint clinical practice guideline for assessing and managing patients with headache.

Is balance performance reduced after mild traumatic brain injury?: Interim analysis from chronic effects of neurotrauma consortium (CENC) multi-centre study.

Objectives: Determine if mild traumatic brain injury (mTBI) history is associated with balance disturbances.

Setting: Chronic Effects of Neurotrauma Consortium (CENC) centres.

Participants: The CENC multi-centre study enrols post-9/11 era Service Members and Veterans with combat exposure.

Ability of Functional Independence Measure to accurately predict functional outcome of stroke-specific population: systematic review.

Stroke is a leading cause of functional impairments. The ability to quantify the functional ability of poststroke patients engaged in a rehabilitation program may assist in prediction of their functional outcome. The Functional Independence Measure (FIM) is widely used and accepted as a functional-level assessment tool that evaluates the functional status of patients throughout the rehabilitation process.