Clinical Reasoning of Physical Therapists regarding In-hospital Walking Independence of Patients with Hemiplegia.

Abstract

[Purpose] Physical therapists must often determine whether hemiparetic patients can walk independently. However, there are no criteria, so decisions are often left to individual physical therapists. The purpose of this study was to explore how physical therapists determine whether a patient with hemiplegia can walk independently in a ward. [Methods] The subjects were 15 physical therapists with experience of stroke patients’ rehabilitation. We interviewed them using semi-structured interviews related to the criteria of the states of walking in the ward of hemiparetic patients. The interviews were transcribed in full, and the texts were analyzed by coding and grouping. [Results] From the results of the interviews, PTs determined patients’ independence of walking in hospital by observation of behavior during walking or treatment. The majority of PTs focused on the patients’ state during walking, higher brain function, and their ability to balance. In addition, they often asked ward staff about patients’ daily life, and self-determination. [Conclusions] We identified the items examined by physical therapists when determining the in-hospital walking independence of stroke patients. Further investigation is required to examine which of these items are truly necessary.