TITLE:
Physiotherapists’ and occupational therapists’ perceptions of the assessment of stroke patients for musculoskeletal rehabilitation in the UK national health service
AUTHORS:
Christopher Golby, Gillian Lewando Hundt, Vinesh Raja
KEYWORDS:
Stroke Rehabilitation; Musculoskeletal Assessment; Physiotherapy; Occupational Therapy
JOURNAL NAME:
Health,
Vol.5 No.9,
September
13,
2013
ABSTRACT:
Background and Purpose: This exploratory study focused on the assessment of stroke patients
for musculoskeletal rehabilitation in the United Kingdom National Health Service.
It was the first phase of research on developing telerehabilitation for the assessment of patients who have had a
stroke. The assessment of stroke patients for musculoskeletal rehabilitation is
currently performed at the therapist’s discretion using different outcome
measures. When looking at the Department of Health’s “National Clinical Guidelines for Stroke”, it is stated that there are a variety of outcome measures,
yet no particular one is recommended. It is specified that each rehabilitation
sector should select its own methodologies. Aim: The aim of this
exploratory study was to understand physiotherapists’ and occupational therapists’ perspectives of the strengths
and weaknesses of current rehabilitative assessment of stroke patients
in the UK National Health Service. Methods: This study had 2 parts, non-participant
observation with 2 therapists and 3 patients, and 10 semi-structured interviews
with 5 physiotherapists and 5 occupational therapists to identify current
practice, problem areas, and what types of improvements could be made. Interviews
were transcribed and analyzed using thematic coding. Results: Seven emergent
themes were identified portraying how outcome measures are currently not
being used in a standardized way within National Health Servicehospitals. This means
that the feedback provided to patients, therapists and healthcare commissioners
is limited. Therapists are currently performing more informal assessments each
time a patient begins therapy and concerns
are shown with these methods of assessment, including subjectivity, standardization issues and time. Interviewed therapists were
clear that they believed that change is required within this field. Conclusions: This study raises
concerns about the methodologies used for the assessment of stroke patients for
rehabilitative purposes in the United Kingdom National Health Service.