Department of Physiotherapy, St. Thomas' Hospital, London, UK.
Disabil Rehabil. 2022 Aug;44(16):4408-4414. doi: 10.1080/09638288.2021.1907459. Epub 2021 Apr 1.
Exercise improves functional outcome post-stroke, but how long patients with differing severity spend undertaking active exercise within physiotherapy sessions is unknown. We aimed to investigate if stroke severity is associated with time undertaking active exercise in physiotherapy sessions, and if any differences between planned and actual physiotherapy session length existed.
A prospective observational study of 107 stroke rehabilitation sessions in a UK acute stroke unit. Data recorded included patient demographics (age, gender, time post-stroke and Barthel Index score) and session attributes (planned and actual session length, time undertaking active exercise, grade of treating therapist).
There was a significant negative association between increasing stroke severity and percentage of time undertaking active exercise in physiotherapy sessions ( < 0.001). No other observed factors were associated with time undertaking active exercise. Mean session length across all levels of stroke severity was 32 min (SD 9.26) which was significantly less than planned ( < 0.05). There was no difference in mean session length or between planned and actual physiotherapy session length between patients of differing severity.
Patients with greater stroke severity participate in less active exercise in physiotherapy sessions than those with lesser stroke severity. Reasons for this disparity warrant further investigation.Implications for rehabilitationStroke patients with higher levels of severity engage in less active exercise during rehabilitation.A discrepancy exists between patients' planned physiotherapy session lengths and actual session lengths during stroke rehabilitation.Physiotherapists should be mindful in how to adapt their sessions (particularly with severe stroke patients) to maximise the amount of activity they undertake.Physiotherapists should be flexible in their delivery of rehabilitation to ensure that the length of patient sessions reflect patients' needs.
运动可改善卒中后功能预后，但不同严重程度的患者在物理治疗期间主动运动的时间尚不清楚。我们旨在研究卒中严重程度是否与物理治疗期间主动运动的时间有关，以及计划的和实际的物理治疗疗程之间是否存在差异。
这是一项在英国急性卒中单元进行的前瞻性观察研究，共纳入 107 例卒中康复疗程。记录的数据包括患者人口统计学特征（年龄、性别、卒中后时间和巴氏指数评分）和疗程特征（计划和实际疗程长度、主动运动时间、治疗师级别）。
卒中严重程度与物理治疗期间主动运动时间呈显著负相关（ < 0.001）。其他观察到的因素与主动运动时间无关。所有卒中严重程度水平的平均疗程长度为 32 分钟（SD 9.26），明显短于计划疗程长度（ < 0.05）。不同严重程度患者的平均疗程长度或计划和实际物理治疗疗程长度之间无差异。
卒中严重程度较高的患者在物理治疗期间主动运动的比例低于严重程度较低的患者。这种差异的原因需要进一步研究。
严重程度较高的卒中患者在康复期间进行的主动运动较少。在卒中康复期间，患者计划的物理治疗疗程长度与实际疗程长度之间存在差异。物理治疗师在如何调整疗程（尤其是严重卒中患者）以最大限度地增加患者活动量方面应保持谨慎。物理治疗师在提供康复服务时应具有灵活性，以确保患者疗程的长度反映患者的需求。
