Field-Testing an Occupational Therapy Clinical Intervention Manual to Guide Electrical Stimulation in Spinal Cord Injury

Research Objectives: Evaluate the utility of a manual to guide occupational therapists who administer Electrical stimulation (ES) in SCI.

Design: Field test to assess the manual’s impact on participants’ ES clinical knowledge and its value for supporting episodic OT treatments

Setting: Three geographically dispersed inpatient rehabilitation centers.

Participants: 18 occupational therapists were recruited from three geographical dispersed inpatient rehabilitation units. Inclusion criteria includes current OT or OTA license, (b) state-level eligibility to administer ES in an occupational therapy treatment session, and (c) active treatment of SCI within the previous 6 months.

Interventions: Participants received a face-to-face educational in-service, where existing evidence was shared that would guide OT clinical intervention in SCI, and the contents of the clinical intervention manual, with strategies to incorporate the manual into daily practice were also provided.

Main Outcome Measures: Outcome measures included: (1) pre-study survey, (2) field study survey, and (3) a post-study survey. The pre- and post-study survey consisted of 12 questions, identifying current use of ES, current knowledge and comfort using ES, as well as questions on the impact of the manual on their clinical practice patterns. Post-study survey participants completed the field survey after each treatment episode of ES application that explored their ES perceived impact on therapy, patient response, and overall therapist satisfaction of application.

Results: 18 OT clinicians submitted field surveys for 88 intervention episodes. 57% of participants indicated that their patients responded as anticipated by the manual. Participants consulted the manual for 34% of the episodes to promote consistency of ES application, aid in clinical decision making, to ensure consistency with evidence, to guide pad placement, and to solve parameter issues. Qualitative data gathered provided insight into participants’ utilization of manual use.

Conclusions: The OT ES clinical intervention manual successfully demonstrated as a method to convey evidence-informed, comprehensible, and clinically relevant information, guiding occupational therapists to greater clinical competence and improved treatment fidelity.

Author(s) Disclosures: No conflict of interests exists.