An observational study on usual physiotherapy care in a stroke rehabilitation unit

Abstract

Aim: To document the range of physiotherapy interventions undertaken by stroke patients with mobility deficits during ‘usual care’ in inpatient rehabilitation. Methods: Twenty consecutively admitted adults were approached to participate if they met the inclusion criteria: diagnosis of first stroke with leg weakness; functional ambulation category score ≥3; able to mobilise ≥14 metres on level ground; and able to provide consent. All individual physiotherapy sessions for each participant were observed for one day. The duration of each therapy session was recorded, as well as the duration and type of specific physiotherapy interventions. Findings: Twenty participants (12 males, 8 females; mean ± SD age: 69 ± 20 years) were observed. All participants attended at least one individual session of physiotherapy on the day this study was conducted. Physiotherapy sessions lasted 47.8 ± 7.6 minutes, with an average of 17.9 ± 6.9 minutes spent resting. The most frequently provided therapies were: gait training (10.8 ± 4.7 minutes per session); strength training (8.5 ± 7.0 minutes per session); and balance training (6.2 ± 3.6 minutes per session). Conclusions: In this sample of ambulant patients following stroke, inpatient physiotherapy rehabilitation focused on gait training, lower limb strengthening and balance training. Active therapy time was low and long rest periods with no prescribed activity were evident, which suggests therapy time is not optimally utilised in this population.