@misc{SchefflerSchimboeckSchoeleretal., author = {Scheffler, Bettina and Schimb{\"o}ck, Florian and Sch{\"o}ler, Almut and R{\"o}sner, Katrin and Spallek, Jacob and Kopkow, Christian}, title = {Tailored GuideLine Implementation in STrokE Rehabilitation (GLISTER) in Germany. Protocol of a Mixed Methods Study Using the Behavior Change Wheel and the Theoretical Domains Framework}, series = {Frontiers in Neurology}, volume = {13}, journal = {Frontiers in Neurology}, issn = {1664-2295}, doi = {10.3389/fneur.2022.828521}, pages = {1 -- 10}, abstract = {Objective: Evidence-based guidelines are important for informing clinical decision-making and improving patient outcomes. There is inconsistent usage of guidelines among physical therapists involved in stroke rehabilitation, suggesting the existence of a gap between theory and practice. Addressing the German guideline "evidence-based rehabilitation of mobility after stroke (ReMoS)," the aims of this project are (1) to describe the current physical therapy practice within the context of stroke rehabilitation in Germany, (2) to evaluate barriers and facilitators of guideline usage, (3) to develop, and (4) to pilot test a theory-based, tailored implementation intervention for the benefit of guideline recommendations. Materials and Methods: This study uses a stepwise mixed methods approach for implementing a local guideline. A self-reported online questionnaire will be used to survey the current physical therapy practice in stroke rehabilitation. The same survey and systematic-mixed methods review will be used to evaluate the barriers and facilitators of guideline usage quantitatively. Semi-structured interviews will add a qualitative perspective on factors that influence ReMoS guideline implementation. The Behavior Change Wheel and Theoretical Domains Framework will be used to support the development of a tailored implementation intervention which will be pilot tested in a controlled study. Patient and physical therapy-related outcomes, as well as the appropriateness, such as acceptance and feasibility of the tailored implementation intervention, will be analyzed. Conclusion: This will be the first endeavor to implement a guideline in German stroke rehabilitation with a focus on changing care provider behavior based on the knowledge of current practice and determining factors using a tailored and theory-based intervention.}, language = {en} } @misc{SchefflerSchimboeckSchoeleretal., author = {Scheffler, Bettina and Schimb{\"o}ck, Florian and Sch{\"o}ler, Almut and R{\"o}sner, Katrin and Spallek, Jacob and Kopkow, Christian}, title = {Current physical therapy practice and implementation factors regarding the evidence-based 'Rehabilitation of Mobility after Stroke (ReMoS)' guideline in Germany: a cross-sectional online survey}, series = {BMC neurology}, volume = {22}, journal = {BMC neurology}, issn = {1471-2377}, doi = {10.1186/s12883-022-02780-5}, pages = {1 -- 13}, abstract = {Background Evaluation of the current physical therapy practice for German stroke rehabilitation with respect to the 'Rehabilitation of Mobility after Stroke (ReMoS)' guideline recommendations and the associated implementation factors. Methods A descriptive cross-sectional study employing an online survey was performed among German physical therapists in 2019. The survey consisted of three sections with open and closed questions: 1) self-reported use of ReMoS recommendations, 2) barriers of guideline use and 3) socio-demographic characteristics. The benchmark level for guideline adherent physical therapy was set at > 80\%. Results Data from 170 questionnaires were eligible for analysis. Participants' mean age was 41.6 years, 69.4\% were female, while 60.1\% had no academic degree. The ReMoS guideline was unknown to 52.9\% of the responders. Out of all the 46 ReMoS guideline recommendations, only 'intensive walking training without a treadmill' was reported to be performed in a guideline adherent manner. Respondents usually denied any personal limitations, such as limited knowledge, or that the ReMoS guideline did not fit their routine practice. Conclusions Among German physical therapists, the ReMoS guideline is not well-known and many interventions are not performed as recommended, illustrating the discrepancies between the ReMoS guideline recommendations and current physical therapy practice. Interventions aimed at overcoming this gap should consider both knowledge of existing barriers and facilitators of guideline usage.}, language = {en} } @misc{KalischDanniesKopkowetal., author = {Kalisch, Luisa and Dannies, Sarah Jasmin and Kopkow, Christian and Scheffler, Bettina}, title = {Evaluation und Einflussfaktoren leitlinienadh{\"a}renter Physiotherapie in der Akut-Versorgung von Individuen mit COVID-19: eine deskriptive Querschnittstudie}, series = {7. Forschungssymposium Physiotherapie der Deutschen Gesellschaft f{\"u}r Physiotherapiewissenschaft e.V.}, volume = {20}, journal = {7. Forschungssymposium Physiotherapie der Deutschen Gesellschaft f{\"u}r Physiotherapiewissenschaft e.V.}, number = {S 01}, publisher = {Thieme}, doi = {10.1055/s-0043-1777917}, language = {de} } @misc{BremerIdenKopkowetal., author = {Bremer, Alexander and Iden, Laurin and Kopkow, Christian and Scheffler, Bettina}, title = {Evidenzbasierte Leitlinienempfehlungen f{\"u}r die Physiotherapie bei Individuen mit dem Idiopathischen Parkinson Syndrom - eine systematische {\"U}bersichtsarbeit}, series = {7. Forschungssymposium Physiotherapie der Deutschen Gesellschaft f{\"u}r Physiotherapiewissenschaft e.V.}, volume = {20}, journal = {7. Forschungssymposium Physiotherapie der Deutschen Gesellschaft f{\"u}r Physiotherapiewissenschaft e.V.}, number = {S 01}, publisher = {Thieme}, doi = {10.1055/s-0043-1777933}, language = {de} } @misc{LuxemburgovaDankhoffKopkowetal., author = {Luxemburgov{\´a}, Kateřina and Dankhoff, Samy and Kopkow, Christian and Scheffler, Bettina}, title = {Evidenzbasierte Leitlinienempfehlungen f{\"u}r die Physiotherapie bei Schlaganfall - eine systematische {\"U}bersichtsarbeit}, series = {7. Forschungssymposium Physiotherapie der Deutschen Gesellschaft f{\"u}r Physiotherapiewissenschaft e.V.}, volume = {20}, journal = {7. Forschungssymposium Physiotherapie der Deutschen Gesellschaft f{\"u}r Physiotherapiewissenschaft e.V.}, number = {S 01}, publisher = {Thieme}, doi = {10.1055/s-0043-1777951}, language = {de} } @misc{SchefflerSchimboeckSchoeleretal., author = {Scheffler, Bettina and Schimb{\"o}ck, Florian and Sch{\"o}ler, Almut and R{\"o}sner, Katrin and Spallek, Jacob and Kopkow, Christian}, title = {Implementierung der „Rehabilitation der Mobilit{\"a}t nach Schlaganfall (ReMoS)" - Leitlinie: Eine Querschnittbefragung von Physiotherapeut*innen in Deutschland}, series = {5. Forschungssymposium Physiotherapie, FSPT2022 Abstractband}, journal = {5. Forschungssymposium Physiotherapie, FSPT2022 Abstractband}, doi = {https://doi.org/10.26127/BTUOpen-5923}, pages = {39 -- 40}, language = {de} } @misc{BahnsSchefflerKopkow, author = {Bahns, Carolin and Scheffler, Bettina and Kopkow, Christian}, title = {Guideline-Adherent Physiotherapy for Patients With Hip and Knee Osteoarthritis in Germany: Protocol for an Implementation Research Project Using the Theoretical Domains Framework and the Behavior Change Wheel}, series = {JMIR Research Protocols}, volume = {12}, journal = {JMIR Research Protocols}, issn = {1929-0748}, doi = {10.2196/47834}, abstract = {Background: Hip and knee osteoarthritis is common and leads to pain, stiffness, and disability. Clinical practice guidelines provide recommendations based on the best available evidence to assist health care professionals and patients in clinical decision-making. However, several studies have reported a gap between guideline recommendations and clinical practice in physiotherapy. Improved implementation strategies and the removal of existing barriers may facilitate the transfer of evidence into clinical practice and contribute to optimized quality of care. Objective: This paper presents the protocol for a study that aims to describe the current physiotherapy practice in patients with hip and knee osteoarthritis and to investigate physiotherapists' adherence to clinical practice guidelines, to identify and specify barriers to and facilitators of guideline use and implementation, and to develop and pilot test a theory-based tailored implementation intervention aiming to increase guideline use in osteoarthritis care. Methods: The research project is divided into 4 parts. During the first part, we will conduct a nationwide web-based survey among German physiotherapists to evaluate the current management of hip and knee osteoarthritis and to evaluate whether treatment aligns with guideline recommendations. Subsequently, semistructured interviews will be conducted to specify barriers to and facilitators of guideline use and implementation among physiotherapists (part 2). On the basis of these findings, in part 3, we will develop a theory-driven implementation intervention based on the Theoretical Domains Framework and the Behavior Change Wheel, which will be evaluated in a controlled pilot study in terms of effectiveness, feasibility, and acceptability (part 4). Results: Data collection of the web-based survey among German physiotherapists (part 1) was completed in December 2021. The semistructured interviews (part 2) were conducted between January and September 2023. Recruitment of physiotherapy practices to participate in the development of the implementation intervention is expected to start in January 2024. Conclusions: This research project aims to develop a theory-driven implementation intervention to facilitate the transfer of evidence from hip and knee osteoarthritis guidelines in physiotherapy practice. We hypothesize that successful implementation will lead to increased guideline adherence in physiotherapists, which in turn will improve the quality of care. The results from our project will provide valuable knowledge concerning the development process and effectiveness of tailored implementation interventions.}, language = {en} } @article{RoesnerSchefflerKaehleretal., author = {Roesner, Katrin and Scheffler, Bettina and Kaehler, Martina and Schmidt-Maciejewski, Bianca and Boettger, Tabea and Saal, Susanne}, title = {Effects of physical therapy modalities for motor function, functional recovery, and post-stroke complications in patients with severe stroke: a systematic review update}, series = {Systematic Reviews}, volume = {13}, journal = {Systematic Reviews}, number = {1}, publisher = {Springer Science and Business Media LLC}, issn = {2046-4053}, doi = {10.1186/s13643-024-02676-0}, pages = {25}, abstract = {Background Physical therapy interventions play a crucial role in the daily care of patients recovering from severe stroke. However, the efficacy of these interventions and associated modalities, including duration, intensity, and frequency, have not been fully elucidated. In 2020, a systematic review reported the beneficial effects of physical therapy for patients with severe stroke but did not assess therapeutic modalities. We aim to update the current evidence on the effects of physical therapy interventions and their modalities in relation to the recovery phase in people with severe stroke in a hospital or inpatient rehabilitation facility. Methods We searched CENTRAL, MEDLINE, Web of Science, and three other relevant databases between December 2018 and March 2021 and updated the search between April 2021 and March 2023. ClinicalTrials.gov and ICTRP for searching trial registries helped to identify ongoing RCTs since 2023. We included individual and cluster randomized controlled trials in the English and German languages that compared physical therapy interventions to similar or other interventions, usual care, or no intervention in a hospital or rehabilitation inpatient setting. We screened the studies from this recent review for eligibility criteria, especially according to the setting. Critical appraisal was performed according to the Cochrane risk-of-bias tool 2.0. The data were synthesized narratively. Results The update identified 15 new studies, cumulating in a total of 30 studies (n = 2545 participants) meeting the eligibility criteria. These studies reported 54 outcomes and 20 physical therapy interventions. Two studies included participants during the hyperacute phase, 4 during the acute phase,18 during the early subacute phase, and 3 in the late subacute phase. Three studies started in the chronic phase. Summarised evidence has revealed an uncertain effect of physical therapy on patient outcomes (with moderate to low-quality evidence). Most studies showed a high risk of bias and did not reach the optimal sample size. Little was stated about the standard care and their therapy modalities. Discussion There is conflicting evidence for the effectiveness of physical therapy interventions in patients with severe stroke. There is a need for additional high-quality studies that also systematically report therapeutic modalities from a multidimensional perspective in motor stroke recovery. Due to the high risk of bias and the generally small sample size of the included studies, the generalizability of the findings to large and heterogeneous volumes of outcome data is limited.Systematic review registrationPROSPERO CRD42021244285.}, language = {en} } @misc{BahnsSchefflerKopkow, author = {Bahns, Carolin and Scheffler, Bettina and Kopkow, Christian}, title = {Implementing Osteoarthritis Guidelines in Physiotherapy in Germany : study protocol of a mixed-method study using the theoretical domains framework and the behaviour change wheel}, series = {Osteoarthritis and Cartilage}, volume = {30}, journal = {Osteoarthritis and Cartilage}, number = {Supplement 1}, issn = {1063-4584}, doi = {10.1016/j.joca.2022.02.520}, pages = {S386}, language = {en} } @misc{RennerJeitzinerAlbertetal., author = {Renner, Caroline and Jeitziner, Marie-Madlen and Albert, Monika and Brinkmann, Sabine and Diserens, Karin and Dzialowski, Imanuel and Heidler, Maria-Dorothea and L{\"u}ck, Martina and Nusser-M{\"u}ller-Busch, Ricki and Sandor, Peter S. and Sch{\"a}fer, Andreas and Scheffler, Bettina and Wallesch, Claus and Zimmermann, Gudrun and Nydahl, Peter}, title = {Guideline on multimodal rehabilitation for patients with post-intensive care syndrome}, series = {Critical Care}, volume = {27}, journal = {Critical Care}, number = {1}, publisher = {Springer Science and Business Media LLC}, issn = {1364-8535}, doi = {10.1186/s13054-023-04569-5}, pages = {1 -- 14}, abstract = {Background Intensive Care Unit (ICU) survivors often experience several impairments in their physical, cognitive, and psychological health status, which are labeled as post-intensive care syndrome (PICS). The aim of this work is to develop a multidisciplinary and -professional guideline for the rehabilitative therapy of PICS. Methods A multidisciplinary/-professional task force of 15 healthcare professionals applied a structured, evidence-based approach to address 10 scientific questions. For each PICO-question (Population, Intervention, Comparison, and Outcome), best available evidence was identified. Recommendations were rated as "strong recommendation", "recommendation" or "therapy option", based on Grading of Recommendations, Assessment, Development and Evaluation principles. In addition, evidence gaps were identified. Results The evidence resulted in 12 recommendations, 4 therapy options, and one statement for the prevention or treatment of PICS. Recommendations: early mobilization, motor training, and nutrition/dysphagia management should be performed. Delirium prophylaxis focuses on behavioral interventions. ICU diaries can prevent/treat psychological health issues like anxiety and post-traumatic stress disorders. Early rehabilitation approaches as well as long-term access to specialized rehabilitation centers are recommended. Therapy options include additional physical rehabilitation interventions. Statement: A prerequisite for the treatment of PICS are the regular and repeated assessments of the physical, cognitive and psychological health in patients at risk for or having PICS. Conclusions PICS is a variable and complex syndrome that requires an individual multidisciplinary, and multiprofessional approach. Rehabilitation of PICS should include an assessment and therapy of motor-, cognitive-, and psychological health impairments.}, language = {en} }