Weekly Literature Roundup: Evidence That Moves Rehabilitation Forward

This week’s series explored critical evidence across the spectrum of physical therapy—ranging from professional identity to stroke rehabilitation technology. Each day, we examined one key article shaping the future of care. Here is the complete set of posts, recapped and expanded.

Monday: Designing for Autonomy in Residential Care

Van Loon et al. (2021) offer a systematic review exploring the facilitators and barriers to autonomy for older adults with physical impairments in residential care.

Key insights:

• Autonomy is enhanced through shared decision-making, flexible routines, and culturally sensitive care.

• Barriers include staff shortages, institutional rigidity, and poor environmental design.

• Recommendations call for reimagining both policies and spaces to support agency, dignity, and well-being.

This work challenges providers to consider not only how care is delivered, but also how the structures and attitudes behind care affect outcomes.

Citation: Van Loon, J., Luijkx, K., Janssen, M., de Rooij, I., & Janssen, B. (2021). Ageing & Society, 41(4), 1021-1050. https://doi.org/10.1017/S0144686X19001557

Tuesday: What Makes an Occupation a Profession?

This reflection drew on the famous definition by Justice Louis Brandeis: a profession is pursued primarily for others, measures success by contributions to society, and requires extensive intellectual training.

Discussion points included:

• The distinction between professions and trades is not the work itself, but the mindset and ethical commitment behind it.

• Professionals must resist pressures that reduce their roles to transactional exchanges or market commodities.

• Physical therapy must continually demonstrate its value as a profession through both clinical excellence and ethical conduct.

This post called on readers to embody and advocate for the professional values that sustain trust and credibility in healthcare.

Wednesday: Updated Guidelines for Vestibular Rehabilitation

Hall et al. (2022) present an updated clinical practice guideline on the treatment of unilateral and bilateral vestibular hypofunction.

Clinical recommendations:

• Vestibular physical therapy (VPT) is strongly recommended for improving symptoms, gaze stability, balance, and function.

• Saccadic or smooth-pursuit exercises should be avoided when used in isolation.

• Programs should be individualized and supervised, particularly for older adults.

• Duration varies by condition, with 4–6 weeks suggested for chronic unilateral cases and 6–9 weeks for bilateral cases.

This guideline supports a comprehensive, targeted, and evidence-based approach to VPT, emphasizing structured supervision and functional relevance.

Citation: Hall, C. D., et al. (2022). Journal of Neurologic Physical Therapy, 46(2), 118–177. https://doi.org/10.1097/NPT.0000000000000382

Thursday: Clinical Guidelines for Post-Stroke Use of AFO and FES

Johnston et al. (2021) provide a robust clinical practice guideline for the use of ankle-foot orthoses (AFO) and functional electrical stimulation (FES) in adults with post-stroke hemiplegia and decreased lower extremity motor control.

Key recommendations:

• Strong evidence supports the use of both AFO and FES to improve gait speed, mobility, and balance.

• Moderate evidence supports improvements in walking endurance, quality of life, and muscle activation.

• Neither AFO nor FES should be used solely for the purpose of reducing plantarflexor spasticity.

• AFOs may promote compensatory strategies, while FES may offer greater therapeutic potential.

• Device selection should be individualized and reassessed as patient needs evolve.

This guideline offers clinicians a practical framework for evidence-aligned decision-making across recovery phases.

Citation: Johnston, T. E., Keller, S., Denzer-Weiler, C., & Brown, L. (2021). Journal of Neurologic Physical Therapy, 45(2), 112–128. https://doi.org/10.1097/NPT.0000000000000347

Friday: Applying the CPG to Clinical Practice

Building on Thursday’s summary, today’s post translates the AFO/FES guideline into clinical considerations.

Reflections include:

• Gait interventions must align with patient goals—restorative or compensatory.

• Clinicians should anticipate the evolving needs of stroke survivors, adjusting devices and strategies over time.

• Success includes not just physical improvement but also perceived quality of life and satisfaction with care.

• Clear documentation and outcome tracking support better decision-making and patient engagement.

By anchoring practice in this guideline, clinicians can optimize outcomes across multiple ICF domains and ensure alignment between intervention and intent.

Final Thoughts

The week’s literature offers more than technical guidance—it provides a call to action. Whether addressing long-term care culture, professional identity, or device-based stroke rehabilitation, the common thread is this: the best care emerges when evidence, ethics, and empathy converge.

If you found this series valuable, share your reflections or let us know what topics you’d like covered next.