SIG Clinical Pathways meeting of the WFNR SIGs

SIG Clinical Pathways meeting of the WFNR SIGs 05. 03. 15 in Abu Dhabi

SIG activities • Mission and goals • SIG Activities – Web site www. clinical-pathways. org – Newsletter service (e. g. about the FLAME trial, FIT trial, Cochrane review on the effects of electromechanical gait trainer in stroke rehab) – WCNR 2014 Workshop „Assessment after stroke“ (Jozef, Ayse, Mayowa) – WCNR 2014 „News from clinical trials“ session (Tony, Thomas, Gert, Mayowa) rather activity of the WFNR EC (educational committee) – Summer school Neurorehabilitation 2014 • Forthcoming actions – Suggestions for the WCNR 2016 in Philadelphia (pre-congress workshop and sessions) – Summer school Neurorehabilitation 2016 – Book project „Update Neurorehabilitation“ • Strategic activities and propositions – Summer school Neurorehabilitation as format for other regions (EC) – Evidence-based best practice recommendations for neurorehabilitation (SIG CP)

Mission and goals of the SIG Clinical Pathways • The SIG Clinical Pathways is not focussing on a specific topic in neurorehabilitation, but acts as a group with cross-sectional interest in neurorehabilitation therapy. • A major intention of the SIG Clinical Pathways is to alert to clinical evidence that is relevant for clinical decision making in neurorehabilitation. This activity might facilitate the individual rehabilitation professional’s ability to receive up to date information and close gaps between clinical research and clinical practice. (newsletters, web site, educational formats) • In addition, the SIG Clinical Pathways will engage in the development of best practice recommendations in neurorehabilitation (guidelines). These pathways/guidelines would formulate evidence-based therapeutic approaches in more general terms that could further be adapted to the specific circumstances of a given rehabilitation service by its users.

Dissemination options include, but are not limited to: (a) Publishing newsletter about “pivotal trials” or reviews (alerting to clinical evidence that is directly relevant for clinical decision making) (web site, WFNR newsletter, journal “Neurologie und Rehabilitation”). (b) Preparing and presenting focused courses, for example, at the World Congress (WCNR), contingent upon approval of the program committee. (c) Comprehensive courses on best practice in neurorehabilitation (summer school) and publishing a comprehensive “update neurorehabilitation” (comprehensive stand alone educational initiative -> EC) (d) Provision of international NR guidelines / evidence-based clinical practice recommendations

web site of the SIG Clinical Pathways www. clinical-pathways. org

"Assessment and outcome measurement in rehabilitation after stroke“ Common pre-congress workshop by the SIG Clinical Pathways and the SIG on Measurement, Assessment, and Classification held on 08. 04. 2014 at the WCNR 2014 Topics: 1. Impairment scales and composite stroke scales (Józef Opara) Stroke scales such as NIHSS; impairment scales such as Motricity Index, Fugl. Meyer test, Ashworth / REPAS 2. Assessment of Activities and Participation (Ayse Kucukdeveci) Barthel, FIM; Frenchay Activity Index; Rivermead Motor assessment, Box and block test, Nine hole peg test, Berg Balance scale, Timed up and go, 6 minutes walking test; London Handicap scale, WHODAS II 3. Assessment of Qo. L (Mayowa Owolabi) SF-12, Euro. Qo. L, Stroke Impact Scale, HRQOL In Stroke Patients (HRQOLISP)

"News from clinical trials for stroke rehabilitation services – a WFNR SIG Clinical Pathways symposium" SIG Clinical Pathways Symposium held on 11. 04. 2014 at the WCNR 2014 Chairs Tony Ward, Thomas Platz Lectures 1. Recent pivotal trials in stroke rehabilitation (Thomas Platz) 2. Neurorehabilitation after stroke: A systematic review of the evidence (Gert Kwakkel) 3. Applicability of the evidence in developing countries (Mayowa Owolabi).

Summer school Neurorehabilitation SSNR – 02. -05. 07. 2014 in the & sponsored by: Alfried Krupp von Bohlen Halbach Foundation 1. Multi-professional 2. Programme harmonised with EFNR Neuro. Rehab curriculum 3. Topics: ICF, assessment, goal setting, therapeutic nursing, motor rehabilitation, NR of speech, swallowing, visual perception, cognition, emotion, for specific disorders => in parallel book “Update Neurorehabilitation 2014” (Hippokampus-Verlag) 4. Language: German –> Austria, Germany, Switzerland Format as model for SSNRs around the globe. To be organised by local organisers with local referees; if needed (subsidiary) international referees (“flying faculty”) (activity of the EC). next SSNR in Greifswald in July 2016

Development and international Consensus on Best Practice Recommendations (WFNR guidelines) • These recommendations will formulate evidence-based therapeutic approaches in more general terms that could further be adapted to the specific circumstances of a given rehabilitation service by its users. • Evidence based best practice recommendations – for topics such as arm motor rehabilitation after stroke, gait rehabilitation after stroke, spasticity management after stroke and – disorders of consciousness (suggested by Caterina Pistarini) – any other topic – use evidence-based recommendations (e. g. DGNR guidelines) – international coordinating and consensus platform (SIG clinical Pathways) – open access publication (NNR ? )

Methodology for evidence-based best practice guidelines • • • Guideline project description Systematic search (guidelines, meta-analyses, trials [RCT]) Critical appraisal of the literature (critical appraisal forms, evidence tables, synopsis for specific topics) Recommendations (draft version) (GRADE) Consensus conference on recommendations Dissemination

WCNR 2016 in Philadelphia - suggestion for a pre-congress workshop "Evidence-based clinical practice in neurorehabilitation: what, when, why? ” Common proposal by the SIG Clinical Pathways and the SIG on Mild and Severe Brain Injury for a pre-congress workshop Chairs: Caterina Pistarini (SIG BIIG), Thomas Platz (SIG CP) Part A "Management of disorders of consciousness" (Caterina Pistarini). "Arm rehabilitation" (Thomas Platz), Part B "Rehabilitation of stance and gait" (Klaus-Martin Stephan, supported by Dominic Perennou) "Management of spasticity" (Jörg Wissel, supported by Tony Ward)

WCNR 2016 in Philadelphia – suggestion for a symposium "Organisation of care in Neurorehabilitation” Common proposal by the SIG Clinical Pathways and the SIG Early Rehabilitation Chairs: Heinrich Binder (SIG ER), Thomas Platz (SIG CP) (a) Evidence-based clinical “what, when, and why” recommendations for motor rehabilitation after stroke – a brief introduction (Thomas Platz) (b) Early rehabilitation – scope and reality of inpatient rehabilitation in developed countries with evidence from the German multicentre study (Marcus Pohl) (c) Early home supported discharge – evidence and reality of applied services around the globe (Jozef Opara) (d) Demands and reality of NR in developing countries (Mayowa Owolabi)

Suggestion for the WCNR 2016 in Philadelphia WFNR Educational Committee symposium Chairs Thomas Platz and Jane Burridge 1. Summer school neurorehabilitation - educational format and experience (Martin Lotze) 2. Flying faculty - past and future (Volker Hömberg) 3. Recommendations for motor rehabilitation after stroke: what, when, why? (Thomas Platz) 4. Round table discussion (Heinrich Binder, Jane Burridge, Volker Hömberg, Tatia Lee, Dominic Perennou, Caterina Pistarini, Thomas Platz)

… many thanks to S. A. Wasti and the organizers for the most generous hospitality SIG Clinical Pathways