Background: Clinical practice guidelines recommend that survivors of stroke engage in independent practice, in addition to structured therapy, for best recovery after stroke. Unfortunately, majority of patients (74%) on rehabilitation wads are sedentary.
Project Aim: To understand current practice among physiotherapists for the provision of 'independent practice' resources to patients undergoing inpatient rehabilitation after stroke in Victoria.
Methods: Senior physiotherapists working in inpatient rehabilitation were invited to complete an online survey. Questions aimed to identify whether independent practice resources are routinely provided and potential barriers leading to non-provision. Questions about the type of resources provided, whether prescription is reviewed and if compliance is measured were also asked.
Results: Responses were received from 11 health services in Victoria. All health services (100%) reported prescribing independent practice resources via either paper-based customised templates (91%) and/or hand written (55%) material but the majority (73%) were only available in English. Impaired cognition was cited as the most significant barrier to non-provision (91%) and/or patient dependence (73%), patient non-compliance (45%) and lack of clinician time (36%). Eight health services (73%) reported regularly updating programs but only three (27%) had a system to track compliance. Lack of clinician time impacts the ability of staff to update and review independent practice programs.
Conclusion: Majority of health services provide paper-based independent practice resources but don’t have embedded systems to monitor compliance. Clinicians need effective systems to track compliance and require protected time to review and update these programs to achieve best outcomes for patients undergoing rehabilitation after stroke.