Implementing functional electrical stimulation clinical practice guidelines to support mobility: A stakeholder consultation.
Lisa Brown, Tamsyn Street, Adine Adonis and 4 others
PMID 36776737WHAT IT FOUND
Clinicians reported that functional electrical stimulation guidelines are often too vague to guide practice.
They cited inconsistent access, lack of confidence, and poor post-training support as key barriers. A tiered training model with ongoing peer support was identified as essential for successful implementation.
Key findings
01Participants found existing clinical practice guidelines insufficiently descriptive for real-world application, noting they lacked clear clinical decision-making processes.
02Major barriers to using functional electrical stimulation included clinician lack of confidence, unequal geographic access to devices, and inconsistent educational offerings.
03Successful implementation was linked to tiered training structures that combine education with mentored practice and ongoing peer support, rather than one-off courses.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was small (18 participants) and predominantly composed of physiotherapists, limiting the generalizability to other disciplines like occupational therapy or speech pathology. Participants were largely from Europe and North America, which may not reflect global barriers in low-resource settings. The study reports perceptions and themes, not objective measures of guideline effectiveness or patient outcomes.
Declared interests
The fee for the open access publication was covered by Boston University, where the primary author is employed. No other conflicts of interest were declared.
The easy way to misread this
Do not interpret these findings as evidence that current FES guidelines are ineffective or that FES does not work. The study reports clinician perceptions of barriers to implementation in a small, mostly physiotherapy-focused group, not clinical outcomes or guideline validity.