Introduction
The Stroke Foundation’s Clinical Guidelines recommend maximising therapy time post stroke. Little is known about the adherence to this recommendation. The aim of this study was to determine the proportion of stroke survivors receiving physiotherapist-prescribed additional therapy (PPAT), in addition to usual care physiotherapy (UCPT), in the inpatient setting.
Methods
Design: retrospective cross-sectional review of clinical records.
Participants: patients with confirmed diagnosis of stroke admitted to the stroke unit of a tertiary hospital in Victoria and not palliated within 48 hours.
Data collection: patient demographic and clinical characteristics, UCPT and PPAT data, and length of stay (LOS).
Analysis: descriptive statistics.
Results
Of the 100 reviewed patient records 18 did not meet the inclusion criteria, and 82 were analysed. The mean (SD) age of patients was 70.6 (16.3) and 61% were male.Twenty-two patients (28%) were prescribed PPAT, of which most were provided an exercise program (59%) and/or referred to allied health assistant (50%). PPAT was commenced at 6.4 (5.8) days post-admission. The mean (SD) UCPT sessions received was 3.9 (3.7) and 13.8 (12.9) in UCPT only and UCPT plus PPAT patients respectively. The mean (SD) LOS was 5.8 (4.9) and 24.2 (23.0) days in UCPT only and UCPT plus PPAT patients respectively.
Conclusion
PPAT was prescribed to less than one third of individuals with stroke which highlights non-compliance with the Stroke Foundation’s Clinical Guidelines. Factors to determine non-compliance should be investigated. LOS may play a role.
Relevance to clinical practice or patient experience
Findings from this study suggest that physiotherapy departments consider investigating barriers and facilitators to PPAT in the inpatient setting. Increasing therapy time and enhancing opportunities for practice may empower stroke survivors to play an active role in their rehabilitation journey and recovery. This could lead to improved clinical outcomes, quality of life and reduced LOS.