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Physical Therapy Interventions for Patients With Stroke in Inpatient Rehabilitation Facilities

DU Jette, PT, DSc, is Professor and Department Chair, Physical Therapy Program, Simmons College, 300 The Fenway, Boston, MA 02115 (USA) (diane.jette{at}simmons.edu)
NK Latham, PT, PhD, is Assistant Research Professor, Sargent College, Boston University, Boston, Mass
RJ Smout, MS, is Senior Analyst, Institute for Clinical Outcomes Research, Salt Lake City, Utah
J Gassaway, MS, RN, is Director of Project/Product Development, Institute for Clinical Outcomes Research
MD Slavin, PT, PhD, is Director of Education and Dissemination, Center for Rehabilitation Effectiveness, Sargent College, Boston University
SD Horn, PhD, is Senior Scientist, Institute for Clinical Outcomes Research

Address all correspondence to Dr Jette

Background and Purpose. The purpose of this study was to describe physical therapy provided to patients with stroke in inpatient rehabilitation facilities. Subjects and Methods. Data were collected from 972 patients with stroke receiving physical therapy services at 6 rehabilitation facilities in the United States. Descriptive statistics were derived to describe physical therapy sessions, including proportion of therapy time spent in specific functional activities and proportion of those activities that included any of 59 interventions. Results. Mean length of stay was 18.7 days (SD=10.3), and patients received physical therapy, on average, 13.6 days (SD=7.8). Patients attended, on average, 1.5 (SD=0.3) physical therapy sessions per day, with each session lasting 38.1 minutes (SD=17.1). Gait and prefunctional activities were performed most frequently (31.3% and 19.7% of total treatment time, respectively). For gait activity, physical therapists used balance and postural awareness training in more than 50% of sessions and used strength training for more than 50% of sessions of prefunctional activities. Eighty-six percent of the patients received evaluation, and 84% of the patients and families received education. Discussion and Conclusion. Therapists selected an eclectic approach to intervention rather than specific intervention techniques. The approach to patients' care included interventions to remediate impairments and to compensate for functional limitations. Therapists also reported frequently using motor control and motor learning approaches to facilitate all activities. This approach to care is largely consistent with existing stroke care guidelines and advances in the scientific theories of motor control and motor learning.

Key Words: Physical therapy • Rehabilitation • Stroke

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