Physiotherapy practice patterns in gait rehabilitation for adults with acquired brain injury

ABSTRACT

Objective: Gait dysfunction is common following acquired brain injury (ABI). Clinical practice guidelines can improve patient outcomes; however, information regarding ABI-specific management of gait dysfunction is limited. This study aimed to describe practice patterns of Canadian physiotherapists regarding gait rehabilitation in adults post-ABI.

Methods: An electronic questionnaire was developed and distributed across Canada to describe physiotherapy assessment methods, outcome measures, and treatment interventions used to manage gait dysfunction in adults with mild-moderate and severe ABI.

Results: Of 103 respondents who accessed the questionnaire, 59 met inclusion criteria and participated in the study. Methods most frequently used “often or very often” at initial and discharge assessments included visual observation (≥88.2% for adults with mild-moderate and severe ABI) and the Berg Balance Scale (≥76.3% for adults with mild-moderate ABI). Higher level gait training exercises were used more often for adults with mild-moderate than severe ABI. Physiotherapists commonly reported further research was required to develop and validate gait-specific outcome measures (42.4%) and treatment techniques (76.3%).

Conclusions: Physiotherapists’ use of gait-specific treatment interventions, but not assessment methods, differs depending on ABI severity. Future work should investigate factors influencing these practice patterns. In addition, clinician-identified research priorities include ABI gait-specific outcome measures and technology-based interventions.

KEYWORDS:

• Acquired brain injury
• gait
• physical therapy
• rehabilitation
• practice patterns

Acknowledgments

This research was completed in partial fulfillment of the requirements for the MScPT degree at the University of Toronto, Toronto, Ontario. The authors would like to thank the pilot testers for their input on the questionnaire and the Canadian Bobath Instructors Association, Neuroscience Division and Canadian Physiotherapy Association for their assistance in distributing the questionnaire. Kara Patterson is supported by a research clinician personnel award from the Heart and Stroke Foundation.

Disclosure statement

The authors report no declarations of interest.