Coralie English1, Julie Bernhardt2, Susan Hillier2. 1. From the International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia (C.E., S.H.); and Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (C.E., J.B.). Coralie.english@unisa.edu.au. 2. From the International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia (C.E., S.H.); and Stroke Division, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (C.E., J.B.).
Abstract
BACKGROUND AND PURPOSE: The optimum model of physiotherapy service delivery for maximizing active task practice during rehabilitation after stroke is unknown. The purpose of the study was to examine the relative effectiveness of 2 alternative models of physiotherapy service delivery against a usual care control with regard to increasing patient activity. METHODS: Substudy within a large 3-armed randomized controlled trial, which compared 3 different models of physiotherapy service delivery, was provided for 4 weeks during subacute, inpatient rehabilitation (n=283). The duration of all physiotherapy sessions was recorded. In addition, 32 participants were observed at 10-minute intervals for 1 weekday and 1 weekend day between 8:00 am and 4:30 pm. At each observation, we recorded physical activity, location, and people present. RESULTS: Participants receiving 7-day-week and circuit class therapy received an additional 3 hours and 22 hours of physiotherapy time, respectively, when compared with usual care. Participants were standing or walking for a median of 8.2% of observations. On weekdays, circuit class therapy participants spent more time in therapy-related activity (10.2% of observations) when compared with usual care participants (6.1% of observations). On weekends, 7-day therapy participants spent more time in therapy-related activity (4.2% of observations) when compared with both usual care and circuit class therapy participants (0% of observations for both groups). Activity levels outside of therapy sessions did not differ between groups. CONCLUSIONS: A greater dosage of physiotherapy time did not translate into meaningful increases in physical activity across the day. CLINICAL TRIAL REGISTRATION URL: http://www.anzctr.org.au/. Unique identifier: ACTRN12610000096055.
RCT Entities:
BACKGROUND AND PURPOSE: The optimum model of physiotherapy service delivery for maximizing active task practice during rehabilitation after stroke is unknown. The purpose of the study was to examine the relative effectiveness of 2 alternative models of physiotherapy service delivery against a usual care control with regard to increasing patient activity. METHODS: Substudy within a large 3-armed randomized controlled trial, which compared 3 different models of physiotherapy service delivery, was provided for 4 weeks during subacute, inpatient rehabilitation (n=283). The duration of all physiotherapy sessions was recorded. In addition, 32 participants were observed at 10-minute intervals for 1 weekday and 1 weekend day between 8:00 am and 4:30 pm. At each observation, we recorded physical activity, location, and people present. RESULTS:Participants receiving 7-day-week and circuit class therapy received an additional 3 hours and 22 hours of physiotherapy time, respectively, when compared with usual care. Participants were standing or walking for a median of 8.2% of observations. On weekdays, circuit class therapy participants spent more time in therapy-related activity (10.2% of observations) when compared with usual care participants (6.1% of observations). On weekends, 7-day therapy participants spent more time in therapy-related activity (4.2% of observations) when compared with both usual care and circuit class therapy participants (0% of observations for both groups). Activity levels outside of therapy sessions did not differ between groups. CONCLUSIONS: A greater dosage of physiotherapy time did not translate into meaningful increases in physical activity across the day. CLINICAL TRIAL REGISTRATION URL: http://www.anzctr.org.au/. Unique identifier: ACTRN12610000096055.
Authors: David H Saunders; Mark Sanderson; Sara Hayes; Maeve Kilrane; Carolyn A Greig; Miriam Brazzelli; Gillian E Mead Journal: Cochrane Database Syst Rev Date: 2016-03-24
Authors: Matthew W McDonald; Kathryn S Hayward; Ingrid C M Rosbergen; Matthew S Jeffers; Dale Corbett Journal: Front Behav Neurosci Date: 2018-07-11 Impact factor: 3.558