A contemporary, post-pandemic description of UK occupational therapy and physiotherapy practice to rehabilitate the upper limb after stroke: The SUPPLES 2 online survey

Abstract

Objectives To provide a contemporary, post-pandemic description of UK occupational therapy and physiotherapy practice to rehabilitate the upper limb after stroke.

Setting A national online survey, first undertaken in 2018 (pre-pandemic), was re-administered to describe post-pandemic practice.

Participants The survey was distributed to UK-based occupational therapists and physiotherapists working with people after stroke, via professional and social networks.

Primary measures Shaped by the Template for Intervention Description and Replication (TIDieR) Checklist, the survey collected, and subsequently analysed the content, frequency and duration of upper limb rehabilitation after stroke.

Results A total of 122 occupational therapists (n=42) and physiotherapists (n=80) currently working clinically, across in-patient, out-patient and community settings, in the UK completed the survey. Respondents reported treating the upper limb a median three times a week (interquartile range 2-4; range 0-6) for a median of 25 minutes (interquartile range: 20-35; range 3-60; n=119). Repetitive, functionally-based activities were the most commonly reported interventions for mild (n=93; 81%) and moderate (n=72; 64%) impairment. Stretching (n=73; 66%) and positioning (n=49; 45%) were most frequently reported for severe impairment. In each of the three impairment categories, a larger number of interventions were reported than in the 2018 survey.

Conclusions Whilst the pandemic promoted the use of virtual interventions, most therapists had returned to face-to-face interventions. The findings highlight that current reported provision of upper limb therapy continues to be markedly less than the dose shown to be effective. The study provides important data which can be used to judge the success of attempts to align practice with new guidelines and inform 'usual therapy' for the upper limb after stroke in comparative studies.