Introduction: Clinical practice guidelines strongly recommend that that group circuit class (GCC) therapy should be used to increase scheduled therapy time for stroke survivors. There was no stroke GCC at Eastern Health in an inpatient subacute rehabilitation ward. We aimed to implement a stroke GCC to increase scheduled therapy time to provide therapy consistent with clinical practice guidelines.
Methods: A survey was completed with nursing, medical, OT and physiotherapy regarding confidence, facilitators and barriers for implementing a GCC for stroke. Based on survey results we established a protocol, educated and trained staff and organised patient timetables to accommodate other therapy sessions. The GCC was twice a week with staff to patient ratio of 1:3 with 6 stations, 8-10 min each. Each class lasted up to 90 minutes with 60 minutes of active therapy time. No additional resources were provided to introduce the GCC.
Results: A total of 55 participants with stroke (57% male) were admitted from 5 December 2023 to 4 April 2024. Thirty-seven (68%) attended the group at least once during their admission. Average change in FIM score during admission for those who attended was 32 points, which exceeds the minimally clinically important difference of the FIM in the stroke population of 22. There were nil adverse effects. The main reasons for non-attendance were COVID-19 infection, preference for one-to-one therapy, full group and patients discharged from physiotherapy service due to lack of goals.
Conclusion: We safely increased adherence to the stroke guidelines for stroke survivors to participate in a GCC from 0% to 68% in inpatient rehabilitation without any additional therapy resources.
Relevance to clinical practice or patient experience: Implementing a stroke GCC in an inpatient setting is achievable and did not require an increase in funding. Communication with the multi-disciplinary team can assist implementation.