Beliefs of rehabilitation professionals towards guided self-rehabilitation contracts for post stroke hemiparesis

Top Stroke Rehabil. 2017 Dec;24(8):608-613. doi: 10.1080/10749357.2017.1373501. Epub 2017 Sep 28.

Abstract

Purpose To investigate the beliefs of physiotherapy students (ST), professionals (PT) and physicians (MD) about engaging patients with post-stroke hemiparesis into Guided Self-Rehabilitation Contracts (GSC), to increase their exercise intensity and responsibility level. Method A survey examining beliefs about post-stroke rehabilitation was completed by first (n = 95), second (n = 105), and third (n = 48) year STs; PTs (n = 129) and MDs (n = 65) in France. Results The belief about whether a patient may exercise alone varied between the professional groups with more STs and MDs finding it acceptable: 62% of PTs vs. 74% of STs (p = 0.005) and 79% of MDs (p = 0.02). For 93% of therapists (STs and PTs together), the caregiver may take part in physical therapy sessions. The appropriate weekly duration of exercises in chronic hemiparesis should be over 5 h for 19% of PTs, 37% of STs, and 51% of MDs (MDs vs. PTs, p < 0.005). After stroke, functional progress through rehabilitation is possible all lifelong for 11% of STs, 19% of PTs (p < 0.05, STs vs. PTs), and 29% of MDs (MD vs. PT, NS). Conclusions The strategy of asking patients to perform exercises alone, in the practice or at home, is still not accepted by a large proportion of physical therapy professionals as compared with students or with physicians. Most therapists still see a <5-h weekly duration of exercise as sufficient after stroke. Few therapists are ready to utilize the persistence of behavior-induced brain plasticity regardless of age or delay after the lesion.

Keywords: Professionals models; physical therapy; physicians; professional; self-rehabilitation; stroke; students.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Female
  • France
  • Humans
  • Male
  • Middle Aged
  • Paresis / rehabilitation*
  • Patient Participation*
  • Physical Therapists
  • Physical Therapy Modalities
  • Physicians
  • Self Care
  • Stroke / complications*
  • Stroke Rehabilitation*
  • Students, Medical
  • Surveys and Questionnaires
  • Young Adult