Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study
McCluskey, Annie; Ada, Louise; Kelly, Patrick J.; Middleton, Sandy; Goodall, Stephen; Grimshaw, Jeremy M.; Logan, Pip; Longworth, Mark; Karageorge, Aspasia
Patrick J. Kelly
Jeremy M. Grimshaw
PIP LOGAN email@example.com
Professor of Rehabilitation Research
Background: Community participation is often restricted after stroke, due to reduced confidence and outdoor mobility. Australian clinical guidelines recommend that specific evidence-based interventions be delivered to target these restrictions, such as multiple escorted outdoor journeys. The aim of this study was to describe post-inpatient outdoor mobility and transport training delivered to stroke survivors in New South Wales, Australia and whether therapy differed according to type, sector or location of service provider.
Methods: Using an observational retrospective cohort study design, 24 rehabilitation service providers were audited.
Provider types included outpatient (n = 8), day therapy (n = 9), home-based rehabilitation (n = 5) and transitional aged care services (TAC, n = 2). Records of 15 stroke survivors who had received post-hospital rehabilitation were audited per service, for wait time, duration, amount of therapy and outdoor-related therapy.
Results: A total of 311 records were audited. Median wait time for post-hospital therapy was 13 days (IQR, 5–35).
Median duration of therapy was 68 days (IQR, 35–109), consisting of 11 sessions (IQR 4–19). Overall, a median of one session (IQR 0–3) was conducted outdoors per person. Outdoor-related therapy was similar across service providers,except that TAC delivered an average of 5.4 more outdoor-related sessions (95 % CI 4.4 to 6.4), and 3.5 more outings into public streets (95 % CI 2.8 to 4.3) per person, compared to outpatient services.
Conclusion: The majority of service providers in the sample delivered little evidence-based outdoor mobility and travel training per stroke participant, as recommended in national stroke guidelines.
|Journal Article Type||Article|
|Publication Date||Jul 29, 2015|
|Journal||BMC Health Services Research|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||McCluskey, A., Ada, L., Kelly, P. J., Middleton, S., Goodall, S., Grimshaw, J. M., …Karageorge, A. (2015). Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study. BMC Health Services Research, 15, https://doi.org/10.1186/s12913-015-0952-7|
|Keywords||Physical therapy, Occupational therapy, Physiotherapy, Knowledge translation, Walking|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0|
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0
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