How active are stroke patients in physiotherapy sessions and is this associated with stroke severity?

Figures & data

Table 1. Demographic baseline data.

	Very severe	Severe	Moderate	Mild	All
Observed patient sessions	49	20	29	9	107
Number of unique patients observed	31	15	23	9	78
Median (range) of repeat observations	3 (1–6)	1 (1)	1 (1–2)	0	1 (1–6)
Male^b	23 (46.9)	10 (50)	17 (58.6)	5 (55.6)	55 (51.4)
Female^b	26 (53.1)	10 (50)	12 (41.4)	4 (44.4)	52 (48.6)
Age^a	70.8	71.5	71.6	63.3	70.5
Days post-stroke^a	31.3	34.1	32.7	35.9	32.6
BI Score^a	1.7	7.4	11.3	15.9	6.5

^aMean values.

^bNumber (percentage).

Figure 1. Scatter plot showing BI versus active exercise in physiotherapy sessions as percentage of the session.

Table 2. Results from backwards stepwise regression at the first step and the final model.

Independent variable in regression	Step 1 Standardised Beta coefficient	Step 1 significance (p)	95% Confidence interval	Final model Standardised Beta coefficient	Final model significance (p)	95% Confidence interval
Barthel index	0.548	<0.001*	1.377 to 2.596	0.557	<0.001	1.422–2.614
Gender	0.059	0.510	−4.404 to 8.812	–	–	–
Age	−0.43	0.654	−0.299 to 0.189	–	–	–
Days post-stroke	−0.049	0.587	−0.139 to 0.079	–	–	–
Grade of treating PT	0.162	0.062*	−0.168 to 6.553	0.179	0.33	0.292–6.779

*p < 0.1 and included in final regression model. R² value of final regression model = 0.293.

Figure 2. Range bar showing mean active exercise percentage by stroke severity. Bars represent range of patient values with mean shown as horizontal lines with 95% confidence intervals. *Difference between group means significant at p = 0.001.

Table 3. Physiotherapy session times.

Stroke severity	Percentage of sessions planned for 45 min	Mean planned session length	Mean session length	Mean difference between planned and session length	Mean active exercise time	Mean active exercise percentage
Very severe	98	44.49	33.06	11.43*	12.95	38.22
Severe	95	44.25	31.94	12.31*	15.35	47.77
Moderate	90	43.45	31.51	11.94*	18.37	56.85
Mild	89	43.33	28.41	14.92*	17.38	61.88
All	94	44.07	32.04	12.03	15.24	47.04

*Difference is significant at 0.05 level when comparing planned session length and session length using paired t-test.

Table

Physiotherapy session – The time that the patient spends in their interaction with the physiotherapist(s) working on rehabilitation.

Beginning of a session – When the physiotherapist(s) begin their interaction with the patient either at their bedside or other area within the ward environment. This includes greeting the patient and any discussion. It does not include reading notes nor any MDT discussion.

End of a session –When the physiotherapist(s) leaves the patient either at their bedside or other area on the ward and the interaction between them ceases without anticipation of commencing again before the next session.

Active exercise – When the patient is engaging in task practice such as (but not limited to) walking, standing, activities in standing, sitting-to-standing, balancing in sitting, activities in sitting (such as using their paretic arm), activities in kneeling, and activities in lying. These may include activities which are assisted by the physiotherapist. If you are unsure whether a task should be classed as active exercise, record this as active exercise.

Inactivity – This includes all other time of the physiotherapy session where active exercise is not taking place including; when the patient is resting in sitting, resting in lying, or receiving passive movements from the physiotherapist(s). Periods of rest during active exercise for longer than 5 seconds should be recorded as inactivity.