Basic instructional course

3.08 Applying the clinical practice guidelines for use of AFO or FES post stroke: Shared decision-making in action

Location: Tlaquepaque, Second floor

Description

Abstract

The application of Ankle Foot Orthosis (AFO) or Functional Electrical Stimulation (FES) to address the activity limitations and participation restrictions of individuals with gait dysfunction is common practice post stroke. The Clinical Practice Guideline (CPG) for the Use of AFO and FES Post-Stroke provides evidence to guide the shared decision-making process. This educational session will focus on knowledge translation by demonstrating the application of a clinical decision-making framework focused on implementing the CPG. Videos and a case-based approach will be used to exemplify the shared clinical decision-making process applying Action Statement 2: AFO or FES to Improve Gait Speed in Chronic Stroke. Using a hypothesis driven exam, the case will present a patient specific participation and activity limitation related to gait speed. The examination process will include gait analysis highlighting common gait deviations post stroke and use of the appropriate outcome measures. The potential device effects to consider in the chronic phase of stroke will be discussed. A comparison of FES and various AFO types and their potential impact on gait speed will be illustrated to recommend the most appropriate device type. Clinical decision-making considerations will be highlighted to emphasize the need for a patient centered approach to best meet the needs of the individual. Evidence from the CPG will be highlighted in the case and integrated throughout the presentation to further guide decision making.

Statement of the objective / learning objectives

Perform a hypothesis driven exam to identify gait deviations in an individual with chronic strokeApply The CPG for the Use of AFO or FES Poststroke into the shared decision making for a patient case

Chair

Lisa Brown
Boston University, USA

Presenter

Therese Johnston
Arcadia University, Glenside, USA

Event Location

Tlaquepaque, Second floor