The accuracy of predicting functional recovery in patients following a stroke, by physiotherapists and patients.
OBJECTIVE
The potential for post-stroke recovery and the range of predictive variables has been studied extensively. Knowledge of these variables alongside other factors, such as performance in therapy and professional experience, enable ongoing predictions to be made by members of the rehabilitation team. Patients' own predictions for their recovery has yet to receive much attention in this area of research. The aim of this study was to compare the predictive accuracy of the physiotherapist and the stroke patient with regard to functional change during a period 6-12 weeks post-stroke.


METHODS
The stroke sample (N = 29) came from two National Health Service Trusts as did the physiotherapists (N = 4). No comparisons were made between the hospitals and data was coded for anonymity. Estimations were made by both physiotherapists and patients regarding items on each of the three sections of The Rivermead Motor Assessment (RMA). Intra-class correlation coefficients (ICCs) were used to describe agreement of each set of predictions with the achieved RMA scores. The results reported here represent the main emphasis of the research; however, other areas were also screened (for example, change in cognition, language and quality of life) by use of basic standardized measures. Recovery was also compared to other known predictive variables, such as age, severity of stroke and urinary incontinence.


RESULTS
At follow-up assessment it was found that both physiotherapists' and patients' predictions demonstrated high and significant agreement with the achieved RMA scores at 12 weeks (ICCs ranging from 0.727 to 0.968). Physiotherapists' predictions demonstrated marginally higher levels of agreement than patients' predictions.


CONCLUSIONS
The degree of accuracy demonstrated by both physiotherapists and patients was considerable. The patient group was perhaps the more notable as no subject had had prior knowledge of a stroke. The implications in respect of lay persons' involvement in decision making and in the rehabilitative process, alongside the health professionals, are perhaps worthy of closer consideration.
Jones
F
F
Department of Occupational Therapy and Physiotherapy, University of Brighton, UK.
D000368:Aged; D002561:Cerebrovascular Disorders / Q000534:rehabilitation*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007600:Judgment; D008297:Male; D017063:Outcome Assessment, Health Care; D010361:Patients; D026741:Physical Therapy Modalities; D016896:Treatment Outcome