A survey of physical activity (PA) across the stroke pathway of care: physiotherapists’ routine practice and knowledge

Abstract

Background Stroke research mainly focuses on ambulant participants attending supervised exercise interventions, delivered by physiotherapists, that are not informed by behaviour change theory or measured accurately. It is not clear whether the findings are reflected in clinical practice across the stroke pathway. Objective This survey investigated physiotherapists’ practice, knowledge, training and understanding of PA interventions across the stroke pathway of care. Design An online self -administered 26-item survey was completed by physiotherapists working in the stroke population across the United Kingdom (UK) and Republic of Ireland (ROI). Results 77 valid responses were analysed. Tailored individual exercise (28% n = 21) was the most common PA intervention description and Treadmill training, the least common. Walking ability (68%) and Berg balance scale (62%) were the most common outcome measures reported to measure PA. Lack of time (n = 50) and services to signpost to (n = 48) were the most reported barriers to providing PA interventions. Conclusions We showed that physiotherapists have good awareness of, but mixed knowledge on, the PA guidelines, and valid measures of daily PA. In terms of implementation, there continues to be a focus on tailored exercise, particularly in non-ambulant people with stroke. Common barriers to the implementation of PA interventions across the stroke pathway were lack of time, limited community services to signpost to, and low patient responsiveness. Future studies should explore knowledge gaps in more detail, and address the barriers to implementation of PA in people with stroke.