https://orcid.org/0000-0002-6879-9563
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Abstract
Purpose
Reablement is a multidisciplinary intervention aimed at promoting function and independence for people with functional decline. Detailed descriptions of various professions’ actions are needed for organization and evaluation of reablement services. This study describes physiotherapy practice in a reablement context in Swedish municipalities, focusing on the content and magnitude of interventions.
Methods
Physiotherapists (n=108) from 34 municipalities answered a web-based survey covering the target group, content and duration of their actions, and number of contacts initiated over a 3-week period. Data were analyzed with descriptive statistics and multiple logistic regression.
Results
Overall, 1005 cases were reported, with a mean age of 78.9 years (SD: 11.7); about 91% (n=912) were aged ≥65 and 61% (n=612) were women. About 70% were allocated to home care; 16% (n=160) of these had minor functional limitations (eg, needing safety alarms/help with domestic tasks), and 55% (n=550) had major functional limitations (eg, needing help with personal activities of daily living). The most reported actions were providing technical aids (60.8%, n=576), instructions/counseling (41.5%, n=393), walking/climbing stairs (27.6%, n=262), strength training (27.2%, n=258), and fall prevention (25.5%, n=242). Almost half of the cases included one action (n=494) and about 89% (n=890) targeted primary needs (body functions, walking indoors, self-care, or domestic life), mainly in clients with major functional limitations (odds ratio=2.96; 95% confidence interval: 1.95–4.49). About 50% (n=517) of the cases involved 1–2 contacts; about 55% (n=549) were completed within 3 weeks. Exercise was associated with ≥6 visits over ≥7 weeks. Supervision of home care staff was performed in 19.1% (n=181) of cases.
Conclusion
Reablement physiotherapy mostly comprises a few actions over a relatively short period. Whether this is a conscious strategy based on the purpose of home-based physiotherapy or clients’ needs and wishes, or conversely an expression of limited resources, remains to be investigated.
Abbreviations
CI, confidence interval; HCP, health care professional; LASRA, local authority senior rehabilitation advisor; OR, odds ratio; OT, occupational therapist; PT, physiotherapist; SD, standard deviation.
Data Sharing Statement
Data are available upon request from [email protected].
Ethics Approval and Informed Consent
The participants were LASRAs, OTs and PTs. At the beginning of the study, the LASRAs received information about the study, including the assurance that participation was voluntary, and were asked whether the municipality they represented would be willing to participate. Once they gave a positive response and their informed consent, the research team emailed information about the study to the OTs and PTs in the municipality. Each municipality decided the extent to which it would participate; that is, how many of its OTs and PTs would take part in the study. The study was approved by the Ethical Board at Umeå University (ref: 2015/268-31Ö).
Acknowledgments
The authors thank all the participants in this study for their valuable time. We would also like to thank Kake Pugh/Karin Fischer-Buder at Proper English AB for the language editing of our manuscript.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.