Article Text

Download PDFPDF

Current therapy for the upper limb after stroke: a cross-sectional survey of UK therapists
  1. Rachel Stockley1,
  2. Rosemary Peel2,
  3. Kathryn Jarvis2,
  4. Louise Connell2
  1. 1 School of Nursing, University of Central Lancashire, Preston, UK
  2. 2 School of Health Sciences, University of Central Lancashire, Preston, UK
  1. Correspondence to Dr Rachel Stockley; rstockley1{at}uclan.ac.uk

Abstract

Objectives To survey the reported content, frequency and duration of upper limb treatment provided by occupational and physiotherapists for people after stroke in the UK.

Design A cross-sectional online survey was used. Description and analysis of the data were based on items from the Template for Intervention Description and Replication (Who, Where, What and How much).

Setting The online survey was distributed via professional and social networks to UK-based therapists.

Participants Respondents were occupational or physiotherapists currently working clinically in the UK with people after stroke. Over the 6 week data collection period, 156 respondents opened the survey, and 154 completed it. Respondents comprised 85 physiotherapists and 69 occupational therapists.

Results Respondents reported treating the upper limb a median of three times a week (range: 1 to 7) for a mean of 29 min (SD: 18). Most (n=110) stated this was supplemented by rehabilitation assistants, family and/or carers providing additional therapy a median of three times a week (range 1 to 7). Functional training was the most commonly reported treatment for people with mild and moderate upper limb deficits (>40%). There was much less consistency in treatments reported for people with severe upper limb deficits with less than 20% (n=28) reporting the same treatments.

Conclusions This study provides a contemporaneous description of reported therapy in the UK for people with upper limb deficits after stroke and a detailed template to inform standard therapy interventions in future research. Several evidence-based therapies were reported to be used by respondents (eg, constraint induced movement therapy), but others were not (eg, mental imagery). The findings also highlight that the current reported provision of upper limb therapy is markedly less than what is likely to be effective. This underlines an urgent need to configure and fund services to empower therapists to deliver greater amounts of evidence-based treatment for people with upper limb deficits after stroke.

  • Upper limb
  • stroke
  • therapy
  • survey
  • rehabilitation

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

View Full Text

Statistics from Altmetric.com

Footnotes

  • Presented at Part of these results were presented at the UK Stroke Forum in 2018.

  • Contributors RS developed the idea and undertook analysis of the results and drafted the paper. RP conducted analysis of the data and drafted the paper. LC developed the idea, oversaw analysis and drafted the paper. KJ developed the idea, oversaw analysis and drafted the paper.

  • Funding This work was supported by the Lancashire Institute for Global Health (LIFE) Grant number LSSM2.

  • Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The survey gained ethical approval from the Science Technology, Medicine and Health Ethics panel at the University of Central Lancashire (reference number: 869).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available here DOI: 10.17030/uclan.data.00000199

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.