Physiotherapy practice in stroke rehabilitation: a survey

Objective: This survey aimed to provide an expert consensus view of the theoretical beliefs underlying physiotherapy practice in stroke rehabilitation the United Kingdom. Method: Questionnaires (with sections related to: therapist background, physiotherapy management, theoretical beliefs and gait re-education strategies used) were posted to all senior level physiotherapists working in stroke care (n=1022). Results: The majority of respondents had more than 10 years experience overall, and at least 5 years experience in stroke care. The Bobath concept was the preferred approach (n=67%) followed by an `eclectic' approach (n=31%). This survey identified four theoretical themes underlying current practice in neurological physiotherapy: the promotion of normal movement, the control of tone, the promotion of function, and the recovery of movement with optimization of compensation. Conclusions: A consensus was obtained on 16 theoretical beliefs; however the evidence base underlying these beliefs remains sparse. Many of these beliefs require further debate within the physiotherapy profession such as the amount of time spent on preparation for function, the automatic translation of movement into function, carry over outside therapy, and the way in which tasks should be practised.