Facilitating Community-Based Exercise for People With Stroke: Cross-Sectional e-Survey of Physical Therapist Practice and Perceived Needs

Carrie Lau; Danielle Chitussi; Sarah Elliot; Jennifer Giannone; Mary-Katherine McMahon; Kathryn M. Sibley; Alda Tee; Julie Matthews; Nancy M. Salbach

doi:10.2522/ptj.20150117

Abstract

Background Educating people with stroke about community-based exercise programs (CBEPs) is a recommended practice that physical therapists are well positioned to implement.

Objective The aim of this study was to evaluate the provision of education about CBEPs to people with stroke, barriers to providing education, and preferences for resources to facilitate education among physical therapists in neurological practice.

Design A cross-sectional e-survey of physical therapists treating adults with stroke in Ontario, Canada, was conducted.

Methods A link to the questionnaire was emailed to physical therapists in a provincial stroke network, a provincial physical therapy association, and on hospital and previous research lists.

Results Responses from 186 physical therapists were analyzed. The percentage of respondents who reported providing CBEP education was 84.4%. Only 36.6% reported typically providing education to ≥7 out of 10 patients with stroke. Physical (90.5%) and preventative (84.6%) health benefits of exercise were most frequently discussed. Therapists reported most commonly delivering education at discharge (73.7%). Most frequently cited barriers to educating patients were a perceived lack of suitable programs (53.2%) and a lack of awareness of local CBEPs (23.8%). Lists of CBEPs (94.1%) or brochures (94.1%) were considered to be facilitators. The percentage of physical therapists providing CBEP education varied across acute, rehabilitation, and public outpatient settings.

Limitations The percentage of physical therapists providing education may have been overestimated if respondents who deliver CBEP education were more likely to participate and if participants answered in a socially desirable way.

Conclusions Even though a high proportion of physical therapists provide CBEP education, education is not consistently delivered to the majority of patients poststroke. Although a CBEP list or brochure would facilitate education regarding existing CBEPs, efforts to implement CBEPs are needed to help overcome the lack of suitable programs.

Footnotes

Ms Lau, Ms Chitussi, Ms Elliott, Ms Giannone, Ms McMahon, Dr Sibley, and Dr Salbach provided concept/idea/research design, writing, and data analysis. Ms Lau, Ms Chitussi, Ms Elliott, Ms Giannone, Ms McMahon, and Dr Salbach provided data collection. Ms Lau, Ms Chitussi, Ms McMahon, and Dr Salbach provided project management. Dr Salbach provided fund procurement and facilities/equipment. Ms Tee, Ms Matthews, and Dr Salbach provided institutional liaisons. Ms Chitussi, Ms McMahon, Ms Tee, Ms Matthews, and Dr Salbach provided consultation (including review of manuscript before submission).
The University of Toronto Research Ethics Board approved the study protocol.
For Ms Lau, Ms Chitussi, Ms Elliot, Ms Giannone, and Ms McMahon, this research was completed in partial fulfillment of the requirements for a MScPT degree at the University of Toronto with funding from an Ontario Physiotherapy Association (OPA) Central Toronto District Student Research Grant. The authors acknowledge the OPA and the Ontario Stroke Network for assistance with recruitment. Dr Salbach holds a Canadian Institutes of Health Research New Investigator Award and an Ontario Ministry of Research and Innovation Early Researcher Award.