Prescribing upper limb exercises after stroke: A survey of current UK therapy practice.

Abstract

Objective: To investigate the current practice of physiotherapists and occupational therapists in prescribing upper limb exercises to people after stroke and to explore differences between professions and work settings. Design: A cross-sectional survey design. Participants: Occupational therapists and physiotherapists working in UK stroke rehabilitation. Results: The survey's response rate was 21.0% (n = 322); with 295 valid responses. Almost two thirds of therapists (64.7%, n = 191) agreed that they always prescribe upper limb exercises to a person with stroke if they can actively elevate their scapula and have grade 1 finger/wrist extension. Most therapists (98.6%, n = 278) prescribed exercises to be completed outside of therapy time, with exercises verbally communicated to family. Standardised upper limb specific outcome measures were used to evaluate the prescribed exercises by 21.9% (n = 62) of therapists. Differences were found between professions and across work settings. Conclusion: The majority of prescribed upper limb exercises were of low intensity (range of motion or stretching exercises) rather than repetitive practice or strengthening exercises. The use of standardised outcome measures was low. Progression of exercises and the provision of written instructions on discharge occur less frequently in inpatient settings than outpatient and community settings.