Variations in physiotherapy practices across reablement settings

ABSTRACT

Background: Reablement aims to improve the self-dependence of people with or at risk of functional decline. Physiotherapists (PTs) are responsible for assessments, developing interventions and supervising home trainers (HTs), who mostly conduct the reablement training. The content of reablement practice is not clearly described. This study explores how physiotherapy practice is performed in reablement settings and the content of the service provided to reablement users. Methods: Fieldwork was performed in seven Norwegian reablement teams. We conducted observations of seven triads, including PTs, HTs, and reablement users, followed by interviews with the PTs and HTs. We then conducted a systematic content analysis. Results: Three themes emerged from the analysis: 1) division of labor; 2) assessment; and 3) intervention. Different practices within these three characteristics of practice revealed two typologies of reablement teams. Teams with a fixed division of labor provided limited assessments and a nonspecific approach. Teams with a flexible division of labor were characterized by interdisciplinary collaboration, thorough assessments, and user-tailored interventions. Discussion: Values emphasizing responsivity enable a flexible and individually tailored reablement approach, in contrast to values emphasizing efficiency, which facilitate a nonspecific approach.

KEYWORDS:

• Division of labor
• home-based rehabilitation
• interprofessional
• multi-professional
• cooperation

Acknowledgments

We would like to thank all the participants, coworkers, and administrative employees on the included reablement teams. We acknowledge the Norwegian Fund for Post-Graduate Training in Physiotherapy for funding the study.

Declaration of Interest

The authors declare no conflicts of interest.

Notes

¹ An exercise program consisting of four exercises for leg strength and balance: sit-to-stand, knee lift, toe stand, and knee bend in a weight-bearing position (Helbostad, Sletvold, and Moe-Nilsen, 2004).

² A home-based balance and strength program documented to prevent falls (Kyrdalen, Moen, Røysland, and Helbostad, 2014).

Additional information

Funding

This work was supported by the Norwegian Fund for Post-Graduate Training in Physiotherapy [62716].