Priorities for closing the evidence-practice gaps in post-stroke aphasia rehabilitation: A scoping review

Publication date: Available online 18 September 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Kirstine Shrubsole, Linda Worrall, Emma Power, Denise A. O'Connor
ObjectiveTo identify implementation priorities for post-stroke aphasia management relevant to the Australian healthcare context.Data SourcesUsing systematized searches of databases (CINAHL, Medline), guideline and stroke websites, and other sources, evidence was identified and extracted for seven implementation criteria for 13 topic areas relevant to aphasia management. These seven priority-setting criteria were identified in the implementation literature; strength of the evidence; current evidence-practice gap; clinician preference; client preference; modifiability; measurability; and health impact.Study SelectionArticles were included if they were in English, related to a specific recommendation requiring implementation, and contained information pertaining to any of the seven prioritisation criteria.Data ExtractionThe scoping review methodology was chosen to address the broad nature of the topic.Evidence was extracted and placed in an evidence matrix. Following this, evidence was summarised, then aphasia rehabilitation topics prioritised using an approach developed by the research team.Data SynthesisEvidence from 100 documents was extracted and summarised. Four topic areas were identified as implementation priorities for aphasia: Timing, Amount and Intensity of Therapy; Goal Setting; Information, Education and Aphasia-Friendly Information; and Constraint-Induced Language Therapy.ConclusionsClosing the evidence-practice gaps in the four priority areas identified may deliver the greatest gains in outcomes for Australian stroke survivors with aphasia. Our approach to developing implementation priorities may be useful for identifying priorities for implementation in other healthcare areas.



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