Beliefs of rehabilitation professionals towards guided self-rehabilitation contracts for post stroke hemiparesis

Claire Marsal, Jean-Michel Gracies, Catherine Dean, Serge Mesure, Nicolas Bayle

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To investigate the beliefs of physiotherapy students (ST), professionals (PT) and physicians (MD) about engaging patients with post-stroke hemiparesis into Guided Self-Rehabilitation Contracts (GSC), to increase their exercise intensity and responsibility level. Method: A survey examining beliefs about post-stroke rehabilitation was completed by first (n = 95), second (n = 105), and third (n = 48) year STs; PTs (n = 129) and MDs (n = 65) in France. Results: The belief about whether a patient may exercise alone varied between the professional groups with more STs and MDs finding it acceptable: 62% of PTs vs. 74% of STs (p = 0.005) and 79% of MDs (p = 0.02). For 93% of therapists (STs and PTs together), the caregiver may take part in physical therapy sessions. The appropriate weekly duration of exercises in chronic hemiparesis should be over 5 h for 19% of PTs, 37% of STs, and 51% of MDs (MDs vs. PTs, p < 0.005). After stroke, functional progress through rehabilitation is possible all lifelong for 11% of STs, 19% of PTs (p < 0.05, STs vs. PTs), and 29% of MDs (MD vs. PT, NS). Conclusions: The strategy of asking patients to perform exercises alone, in the practice or at home, is still not accepted by a large proportion of physical therapy professionals as compared with students or with physicians. Most therapists still see a <5-h weekly duration of exercise as sufficient after stroke. Few therapists are ready to utilize the persistence of behavior-induced brain plasticity regardless of age or delay after the lesion.
LanguageEnglish
Pages608-613
Number of pages6
JournalTopics in Stroke Rehabilitation
Volume24
Issue number8
DOIs
Publication statusPublished - 28 Sep 2017

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Paresis
Contracts
Rehabilitation
Stroke
Exercise
Students
Physicians
Caregivers
France
Brain
Therapeutics

Keywords

  • professionals models
  • physical therapy
  • professionals
  • physicians
  • students
  • self-rehabilitation
  • stroke

Cite this

Marsal, Claire ; Gracies, Jean-Michel ; Dean, Catherine ; Mesure, Serge ; Bayle, Nicolas. / Beliefs of rehabilitation professionals towards guided self-rehabilitation contracts for post stroke hemiparesis. In: Topics in Stroke Rehabilitation. 2017 ; Vol. 24, No. 8. pp. 608-613.
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abstract = "Purpose: To investigate the beliefs of physiotherapy students (ST), professionals (PT) and physicians (MD) about engaging patients with post-stroke hemiparesis into Guided Self-Rehabilitation Contracts (GSC), to increase their exercise intensity and responsibility level. Method: A survey examining beliefs about post-stroke rehabilitation was completed by first (n = 95), second (n = 105), and third (n = 48) year STs; PTs (n = 129) and MDs (n = 65) in France. Results: The belief about whether a patient may exercise alone varied between the professional groups with more STs and MDs finding it acceptable: 62{\%} of PTs vs. 74{\%} of STs (p = 0.005) and 79{\%} of MDs (p = 0.02). For 93{\%} of therapists (STs and PTs together), the caregiver may take part in physical therapy sessions. The appropriate weekly duration of exercises in chronic hemiparesis should be over 5 h for 19{\%} of PTs, 37{\%} of STs, and 51{\%} of MDs (MDs vs. PTs, p < 0.005). After stroke, functional progress through rehabilitation is possible all lifelong for 11{\%} of STs, 19{\%} of PTs (p < 0.05, STs vs. PTs), and 29{\%} of MDs (MD vs. PT, NS). Conclusions: The strategy of asking patients to perform exercises alone, in the practice or at home, is still not accepted by a large proportion of physical therapy professionals as compared with students or with physicians. Most therapists still see a <5-h weekly duration of exercise as sufficient after stroke. Few therapists are ready to utilize the persistence of behavior-induced brain plasticity regardless of age or delay after the lesion.",
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Beliefs of rehabilitation professionals towards guided self-rehabilitation contracts for post stroke hemiparesis. / Marsal, Claire; Gracies, Jean-Michel; Dean, Catherine; Mesure, Serge; Bayle, Nicolas.

In: Topics in Stroke Rehabilitation, Vol. 24, No. 8, 28.09.2017, p. 608-613.

Research output: Contribution to journalArticleResearchpeer-review

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