@article{ref1,
title="How are balance and mobility problems after stroke treated in England? An observational study of the content, dose and context of physiotherapy",
journal="Clinical rehabilitation",
year="2018",
author="Tyson, Sarah F. and Woodward-Nutt, Kate and Plant, Sarah",
volume="32",
number="8",
pages="1145-1152",
abstract="OBJECTIVE: To describe the dose, intensity and context of physiotherapy for balance and mobility problems after stroke. <br><br>DESIGN: Process mapping to describe the context and non-participant observation of therapy sessions to describe the dose and content of therapy. SETTING: Four inpatient stroke units in North-West England. PARTICIPANTS: Therapy staff and previously mobile stroke survivors who were treating, or receiving treatment for balance and mobility problems in the participating units. <br><br>RESULTS: Two units were stand-alone rehabilitation units; two offered a service at the weekends. One had no access to community-based rehabilitation. All had dedicated treatment facilities but often did not use them because of lack of space and difficulty transporting patients. Twenty-two patients participated and 100 treatment sessions were observed. Practicing walking, sit-to-stand and transfers were the most frequent objectives and interventions usually with the therapist(s) physically facilitating the patient's movements. The dose of practise was low; mean repetitions of sit-to-stand per session was 5 (SD 6.4); mean time spent upright per session was 11.24 (SD = 7) minutes, and mean number of steps per session was 202 (SD 118). The mean number of staff per patient was 2.1 (SD = 0.6, mode = 2), usually involving two qualified therapists. Falls prevention or management, wheelchair skills and bed mobility were not practised. <br><br>CONCLUSION: Stroke physiotherapy for balance and mobility problems features low-dose, low-intensity therapist-led practice, mainly of walking and sit-to-stand. Staff:patient ratios were high. Therapists need to organize treatment sessions to maximize the intensity of functional task practice.<p /> <p>Language: en</p>",
language="en",
issn="0269-2155",
doi="10.1177/0269215518777789",
url="http://dx.doi.org/10.1177/0269215518777789"
}