Physiotherapy after stroke: To what extent is task-oriented practice a part of conventional treatment after hospital discharge?

Abstract

Research has shown that motor training after stroke should be task-oriented. It is still unknown whether the task-oriented approach is implemented into clinical practice. The purpose of the present study was to survey to which extent task-specific training was a part of conventional physiotherapy practice given to stroke patients after discharge from hospital. This cross-sectional survey was a sub-study of a randomized controlled trial. Physiotherapists treating patients included in the trial were asked to register their choice of treatment according to 11 predefined activity categories during the second week after discharge from hospital. Nineteen physiotherapists treating 46 patients suffering from mild-to-moderate stroke were included. The activities chosen in most patients were sit-to-stand (60.9%), balance in standing position (65.2%), walking on even ground (78.3%), and stair climbing (56.5%). Only two patients (4.3%) practiced transfers or balance related to activities of daily living (ADL), such as washing, dressing, and toileting. This study shows that conventional physiotherapy practice for a selected group of Norwegian stroke patients was mainly based on a task-oriented approach, although with very little emphasis on training in relation to ADL. Future research is needed to ensure that evidence-based treatment is given to all stroke patients.