Implementing core outcome sets in neurological physiotherapy: facilitators, barriers, sustainability

Background Neurological physiotherapy aims to improve the patient's mobility, independence and quality of life. Core outcome sets (COS) group essential assessments for the evaluation of the neurological patient according to the therapeutic goal. They are used in research and clinical practice.

Aim The aim of the project is to develop and implement neurological COS, standardizing both assessment and measurement time points, at a rehabilitation clinic.

Methods This project follows the EPIS Framework. In the exploration and preparation phases (Jan 2022 – July 2023), the context was evaluated via questionnaires and focus groups within the team. An expert-group of neurological physiotherapists designed a digital tool for the documentation and interpretation of the assessments. The implementation started on July 2023: a series of ad hoc trainings were realised for the dissemination and learning of the new tool. Before (T1 June 2023) and during implementation (T2 January 2024) and sustainability (T3 January 2025) phases following measurements were completed: number of therapists participating in training, percentage of patients in whom 1. the correct the tool 2. within the standard time frame is used.

Results Six COS were created depending on patient’s goal. Four additional COS were available for specific treatments (e.g. sports or respiratory physiotherapy). Lack of time and adequate training are thus far the main barriers for use, whilst the requirement to assess the patient every 2 weeks for a ward visit as well as a standardised procedure over time and between departments are reported as facilitators. The measurements concerning the implementation (T2) and sustainability (T3) phases are in analyses process.

Conclusion This project aims to create and implement an evidence-based use of objective patient assessment that is practicable in the context of an in-patient rehabilitation clinic. Its findings can lead to a more efficient utilisation of resources and facilitate patient-centred treatment.

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Artikel online veröffentlicht:
23. Oktober 2025