To what extent are family members and friends involved in physiotherapy and the delivery of exercises to people with stroke?

PURPOSE: To examine the views of people with stroke, their 'family members/friends' and physiotherapists on the role of the family in physiotherapy and the delivery of exercises following stroke.
METHODS: A self-report questionnaire was administered to 100 'family members/friends' and 75 people with stroke. Two focus groups were conducted with 10 expert physiotherapists working in the area of stroke rehabilitation.
RESULTS: Family members of people with stroke are willing to participate in the delivery of unsupervised exercises in the hospital and the home setting (n = 91). Furthermore, this is also acceptable to people with stroke (n = 65) as an adjunct to routine physiotherapy. Physiotherapists highlighted a number of factors that influenced participation in physiotherapy such as; level of interest and motivation of the family (n = 5), availability (n = 3) and importance of education (n = 2). 'Family members/friends' identified reasons that would also limit participation such as work commitments (n = 24), lack of confidence (n = 20) and unsuitable treatment times (n = 13). The expert practitioners outlined a number of areas that family involvement can have an impact, such as treatment carry-over, assisting the family unit to cope on discharge and improving handling skills.
CONCLUSIONS: Our study identifies an under-utilised role for 'family members/friends' in the rehabilitation of people with stroke. Family mediated exercises can maximise the carry-over outside formal physiotherapy giving patients the opportunity for informal practice. This study highlights the need to examine the value of a structured programme of exercises that can be delivered to people with stroke by their 'family members/friends'.