Unpacking the black box of therapy -- a pilot study to describe occupational therapy and physiotherapy interventions for people with stroke.
OBJECTIVE
To describe the components used in the practice of occupational therapy and physiotherapy for people with stroke and to examine variability between services.


METHODS
A time-sampling strategy in which therapists recorded their face-to-face interventions with stroke patients during 12 weeks over a total of 17 months.


METHODS
Six occupational therapists and seven physiotherapists from four services (three day hospitals and one domiciliary stroke rehabilitation service) recorded interventions with 89 stroke patients recruited to a larger randomized controlled trial.


METHODS
Frequencies of use of interventions, together with other details about delivery of therapy, were recorded using a data collection booklet and coding system designed by the participating therapists.


RESULTS
The median treatment time for a session was 45 minutes. The most frequently recorded components of physiotherapy intervention were 'walking', 'standing balance' and 'upper limb movement pattern', and of occupational therapy 'physical function', 'social and leisure activities' and 'other'. There was variability between the services in terms of median treatment time, use of intervention codes, frequency of treatment sessions, amount of time spent working with assistance and amount of group work.


CONCLUSIONS
The findings support the view that occupational therapy and physiotherapy with people with stroke are not homogeneous activities, and vary between therapists and services. Recommendations include further development of the tool, and use of other methodologies to explore the process and nature of stroke rehabilitation.
Ballinger
C
C
School of Occupational Therapy and Physiotherapy, University of Southampton, UK. cbl@soton.ac.uk
Ashburn
A
A
Low
J
J
Roderick
P
P
D000368:Aged; D002561:Cerebrovascular Disorders / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009788:Occupational Therapy / Q000379:methods / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000379:methods / Q000706:statistics & numerical data; D010865:Pilot Projects; D013997:Time Factors