A content analysis of physiotherapy for postural control in people with stroke: an observational study.

Abstract

The lack of information about the content of therapy packages is a frequent criticism in stroke rehabilitation research. This study aimed to describe, in detail, the content of one aspect of physiotherapy; the rehabilitation of postural control. The design was a cross-sectional survey and the setting was in 11 NHS Trusts. The participants were 35 stroke physiotherapists working in acute and rehabilitation settings who recorded the treatment of 132 patients in 644 treatment sessions using the Stroke Physiotherapy Intervention Recording Tool. Analysis was carried out by descriptive statistics, one-way ANOVAS and chi-squares which were used to describe content of interventions and effects of the aim of treatment. Physiotherapists' clinical practice focused on therapist-led interventions, which aimed to normalize muscle tone and promote normal movement patterns. The most frequent interventions were 'preparation for treatment' (n = 1969, 43%), 'practising balance and walking activities' (n = 1583, 34%) and 'practising functional tasks' (n = 703, 15%). Interventions to encourage independence or activity outside the treatment session were rarely used. This pattern was seen regardless of the aim of treatment (the restoration of sitting balance, standing balance or stepping/walking).