Stroke survivors’ perspectives on two novel models of inpatient rehabilitation: seven-day a week individual therapy or five-day a week circuit class therapy

Abstract

Purpose: To explore stroke survivors’ perspectives of two novel models of inpatient physiotherapy, which provide an increased amount of therapy: five days a week circuit class therapy and seven days a week individual therapy. Method: This is a qualitative descriptive study using semi-structured interviews and thematic analysis. The participants were 10 purposively sampled stroke survivors in the post-acute phase of recovery, who had experienced seven days a week individual therapy or five days a week circuit group therapy during inpatient rehabilitation. Results: Three main themes emerged from the data: Too much, too little or just right; My experience – alone and together; and Meeting my needs. Findings revealed considerable variety in participants’ beliefs, priorities and preferences regarding how intensely they could work; their experience of success and challenge individually and collectively; and their need to have their own unique individual needs met. Lack of choice seemed to be a linking concept between the themes. Conclusion: In order to provide patient-centred services, novel methods of increased therapy must take into consideration the individual needs and preferences of the people accessing them. One model may not meet all these needs, hence a “menu” of options for therapy sessions (different timing, frequency, duration, content, rest and supervision) may be required to accommodate the diversity of patient needs, preferences and capacities.

Implications for Rehabilitation

• People with stroke have diverse needs and preferences regarding the modes of delivering more therapy during rehabilitation.

• These diverse needs may not be met by one rigid service model.

• Therapists and service providers could engage their clients in a dialogue about the need for more therapy and how it can be delivered.

• This dialogue could include options of the various ways to increase their therapy.

• Therapists need to provide clear reasons and education around therapy components, including rest time and practice schedules.

Keywords:

• Circuit therapy
• consumer perspective
• evidence-based practice
• implementation
• physiotherapy
• stroke

Acknowledgements

The time and thought provided by the participants of the study are gratefully acknowledged.

Declarations of interest

The authors report no conflicts of interest. This work was part of a trial funded by the National Health and Medical Research Council of Australia, grant number 631904 and registered with the Australian and New Zealand Trial Registry (ACTRN12610000096055).