# PROFESSIONAL CONSENSUS ON UK NATIONAL STATEMENTS OF BEST PRACTICE FOR WAYS OF WORKING TO DELIVER ORTHOTIC INTERVENTIONS AFTER STROKE: AN EDELPHI STUDY

## TL;DR

Experts in the UK agreed on best practices for using orthotics in stroke rehabilitation through a Delphi study.

## Contribution

First UK-wide consensus on optimal ways of working for orthotic interventions after stroke.

## Key findings

- 62 out of 65 statements reached consensus in the first round.
- 64 statements achieved 75% consensus after two rounds.
- Professional agreement was reached on best practice statements for orthotic interventions in stroke care.

## Abstract

To reach consensus on statements of best practice for ways of working to deliver orthotic interventions after stroke among expert professionals in the UK involved in the delivery of orthotic intervention to patients after stroke.

A 2-round modified electronic Delphi exercise (eDelphi).

Thirty-two orthotic professionals with 2 years’ or more experience of delivering orthotic intervention within stroke rehabilitation, from varied geographical locations and experience levels participated in the eDelphi.

For the eDelphi exercise, 65 statements of best practice were assessed by participants. A 7-point Likert scale was used to determine agreement with statements. A consensus threshold of 75% was pre-determined in line with other studies.

After the first round, consensus was reached for 62 of the statements. All statements had 75% or above agreement. An 87.5% retention rate was maintained between rounds. After the second round 64 statements of best practice achieved 75% consensus.

Overall consensus 94.3% was achieved on the first UK-wide professionally agreed statements of best practice detailing the optimal ways of working when delivering orthotic interventions to enhance rehabilitation outcomes and reduce complications for stroke survivors.

Stroke survivors often have a need for supportive devices called orthotics to help them with standing, walking, and completing daily tasks. These orthotics are provided with the support of a specialist clinician called an orthotist. In the UK, these clinicians are not included in the main stroke rehabilitation team as standard and there are no guidelines for stroke clinical services to follow to help inform how and when orthotists should be involved with a stroke survivor’s care. Statements of best practice are a resource that clinical services, clinicians, and patients can use to guide their clinical care. The primary aim of this project was to develop UK-wide statements of best practice on the optimum ways of working to deliver orthotic intervention after stroke. This study is the culmination of several pieces of research, which ended in reaching a professional agreement with orthotists across the UK on what these statements of best practice should contain. This exercise is called a Delphi and is a tried and tested means of reaching agreement on a healthcare intervention.