Delphi Consensus Study and Clinical Practice Guideline Development for Functional Electrical Stimulation to support upright mobility in people with an upper motor neuron lesion

Abstract

Purpose A Clinical Practice Guideline (CPG) is required to provide guidance on optimal service delivery for Functional Electrical Stimulation (FES) to support upright mobility in people living with mobility difficulties due to an upper motor neuron lesion, such as stroke or multiple sclerosis. A modified Delphi consensus study was used to provide expert consensus on best practice.

Methods A Steering Group supported recruitment of an Expert Panel which included a range of stakeholders who participated in up to three survey rounds. In each round panellists were asked to rate their agreement of draft statements about best practice using a 6-point Likert scale and add free text to explain their answer. Statements that achieved over 75% agree/strongly agree on the Likert scale were included in the CPG. Those that did not were revised based on free text comments and proposed in the next survey round.

Results The first round included 82 statements with seven sub-statements. 65 people (84% response rate) completed survey round 1 leading to 62 statements and four sub-statements being accepted. Fifty-six people responded to survey round 2, and consensus was achieved for all remaining statements.

Conclusion The accepted statements are included within the CPG and provide recommendations about who can benefit from FES and how they can be optimally supported through FES service provision. As such the CPG will support advocacy for, and optimal design of, FES services.