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Table 3 Unadjusted intervention effect on change in implementation of 18 treatments

From: Facilitated interprofessional implementation of a physical rehabilitation guideline for stroke in inpatient settings: process evaluation of a cluster randomized trial

Treatment

Time

Estimated % of times implemented (95% CI)

Effect

n

Facilitated (F) group

n

Passive (P) group

(ChangeF-ChangeP) % (95% CI)

1. Sit-to-stand*†‡§

Pre

647

20.4 (17.3, 23.5)

193

36.3 (29.5, 43.1)

 

Post

276

39.1 (33.4, 44.9)

265

33.6 (27.9, 39.3)

Change

 

18.7 (12.2, 25.3)

 

−2.7 (−11.5, 6.2)

21.4 (10.4, 32.4)

2. LE ROM and/or stretching (i.e. to prevent spasticity and contractures)‡

Pre

151

15.9 (10.1, 21.7)

118

8.5 (3.4, 13.5)

 

Post

143

10.5 (5.5, 15.5)

135

17.8 (11.3, 24.2)

Change

 

−5.4 (−13.1, 2.3)

 

9.3 (1.1, 17.5)

−14.7 (−26.0, −3.5) ||

3. Use of LE external support (i.e. brace)‡§

Pre

647

7.3 (5.3, 9.3)

193

15.0 (10.0, 20.1)

 

Post

276

8.7 (5.4, 12.0)

265

17.4 (12.8, 21.9)

Change

 

1.4 (−2.5, 5.3)

 

2.3 (−4.5, 9.1)

−0.9 (−8.7, 6.9)

4. Task-specific training (i.e. stairs)*†‡

Pre

151

31.8 (24.3, 39.2)

118

26.3 (18.3, 34.2)

 

Post

143

38.5 (30.5, 46.5)

135

37.8 (29.6, 46.0)

Change

 

6.7 (−4.3, 17.6)

 

11.5 (0.1, 22.9)

−4.8 (−20.6, 11.0)

5. Training for sitting balance*†

Pre

151

23.8 (17.0, 30.7)

118

17.0 (10.2, 23.7)

 

Post

143

17.5 (11.2, 23.7)

135

25.2 (17.9, 32.5)

Change

 

−6.4 (−15.6, 2.9)

 

8.2 (−1.8, 18.2)

−14.6 (−28.2, −1.0) ||

6. Training for standing balance†‡

Pre

151

51.7 (43.7, 59.6)

118

36.4 (27.7, 45.1)

 

Post

143

52.5 (44.2, 60.7)

135

60.0 (51.7, 68.3)

Change

 

0.8 (−10.7, 12.2)

 

23.6 (11.6, 35.6)

−22.8 (−39.4, −6.2)

7. FES for the LE†

Pre

151

0.7 (−0.6, 2.0)

118

0 (0, 0)

 

Post

143

0.7 (−0.7, 2.1)

135

0.7 (−0.7, 2.2)

Change

 

0 (−1.9, 1.9)

 

0.7 (−0.7, 2.2)

−0.7 (−3.1, 1.7)

8. Walking practice†‡§

Pre

647

15.9 (13.1, 18.7)

193

31.6 (25.0, 38.2)

 

Post

276

39.1 (33.4, 44.9)

265

32.8 (27.2, 38.5)

Change

 

23.2 (16.8, 29.6)

 

1.2 (−7.4, 9.9)

22.0 (11.2, 32.8)

9. Treadmill walking practice†

Pre

151

2.7 (0.1, 5.2)

118

6.8 (2.2, 11.3)

 

Post

143

1.4 (−0.5, 3.3)

135

5.2 (1.4, 8.9)

Change

 

−1.3 (−4.5, 2.0)

 

−1.6 (−7.5, 4.3)

0.3 (−6.4 7.1)

10. UE ROM and/or stretching (i.e. to prevent spasticity and contractures)*†‡§

Pre

647

12.7 (10.1, 15.2)

193

21.8 (15.9, 27.6)

 

Post

276

21.4 (16.5, 26.2)

265

25.3 (20.1, 30.5)

Change

 

8.7 (3.2, 14.2)

 

3.5 (−4.3, 11.4)

5.2 (−4.4, 14.7)

11. Interventions to prevent shoulder pain (i.e. sling)*‡§

Pre

647

25.0 (21.7, 28.4)

193

25.4 (19.2, 31.5)

 

Post

276

25.7 (20.6, 30.9)

265

21.1 (16.2, 26.1)

Change

 

0.7 (−5.5, 6.8)

 

−4.3 (−12.1, 3.6)

4.9 (−5.1, 14.9)

12. Task-specific training (i.e. self-care tasks)*†‡§

Pre

647

28.9 (25.4, 32.4)

193

37.3 (30.5, 44.1)

 

Post

276

40.9 (35.1, 46.8)

265

43.4 (37.4, 49.4)

Change

 

12.0 (5.3, 18.8)

 

6.1 (−3.0, 15.2)

6.0 (−5.4, 17.3)

13. Techniques to reduce hand edema*†§

Pre

151

7.3 (3.1, 11.4)

118

10.2 (4.7, 15.6)

 

Post

143

5.6 (1.8, 9.4)

135

8.9 (4.1, 13.7)

Change

 

−1.7 (−7.3, 3.9)

 

−1.3 (−8.6, 6.0)

0 (−9.6, 8.8)

14. Ice/heat or soft tissue massage for shoulder

Pre

151

1.3 (−0.5, 3.2)

118

8.5 (3.4, 13.5)

 

Post

143

2.8 (0.1, 5.5)

135

5.2 (1.4, 8.9)

Change

 

1.5 (−1.8, 4.7)

 

−3.3 (−9.6, 3.0)

4.8 (−2.3, 11.8)

15. FES for wrist/arm/shoulder*†

Pre

151

2.0 (−0.2, 4.2)

118

2.5 (−0.3, 5.4)

 

Post

143

1.4 (−0.5, 3.3)

135

1.5 (−0.6, 3.5)

Change

 

−0.6 (−3.5, 2.4)

 

−1.1 (−4.6, 2.4)

0.5 (−4.1, 5.1)

16. Educate patient or caregiver on how to handle arm or shoulder*†‡

Pre

647

8.8 (6.6, 11.0)

193

13.0 (8.2, 17.7)

 

Post

276

9.4 (6.0, 12.9)

265

10.2 (6.5, 13.8)

Change

 

0.6 (−3.5, 4.7)

 

−2.8 (−8.8, 3.2)

3.4 (−3.9, 10.6)

17. UE constraint-induced therapy

Pre

151

4.6 (1.3, 8.0)

118

10.2 (4.7, 15.6)

 

Post

143

0.7 (−0.7, 2.1)

135

4.4 (1.0, 7.9)

Change

 

−3.9 (−7.6, −0.3)

 

−5.7 (−12.2, 0.8)

1.8 (−5.6, 9.2)

18. Visual imagery to enhance arm recovery‡

Pre

151

2.7 (0.1, 5.2)

118

5.1 (1.1, 9.1)

 

Post

143

6.3 (2.3, 10.3)

135

5.2 (1.4, 8.9)

Change

 

3.6 (−1.1, 8.4)

 

0.1 (−5.4, 5.6)

3.5 (−3.7, 10.8)

  1. Abbreviations: n number of observations, CI confidence interval, LE lower extremity, ROM range of motion, FES functional electrical stimulation, UE upper extremity
  2. Italic text indicates statistically significant results
  3. *Demonstration and opportunity to practice during change management workshop
  4. †Clinical protocol provided in SCORE guideline
  5. ‡Clustering effect at provider level
  6. §Clustering effect at patient level
  7. ||No longer significant after adjusting for clustering at the provider and patient level