Physiotherapy needs assessment of people with stroke following discharge from hospital, stratified by acute functional independence measure score

Abstract

Purpose: To determine the physiotherapy-related needs of people with stroke at discharge, 6 months after discharge, and 1 year after discharge from hospital, and to examine the results stratified by participants' acute Functional Independence Measure (FIM) scores.

Methods: A total of 241 adults with recent stroke were recruited into this longitudinal cohort study. As well as participating in a semi-structured interview that included questions about mobility needs and barriers, participants were asked to complete and return a closed-ended needs-assessment survey.

Results: During the interview, participants reported needs and barriers related to motor control, walking, stairs, fatigue, prevention of falls, and access to physiotherapy services. The survey identified many more needs, including transfers, wheelchair use, higher-level balance and mobility skills, and access to physiotherapy and suitable exercise facilities. Frequencies of needs and barriers tended to be lower among participants with higher acute FIM scores. There was no consistent trend for needs and barriers to decrease over time.

Conclusions: Over the first year after discharge from hospital, people with stroke report a large and varied number of persistent mobility-related needs. Physiotherapists have a role to play in advocating for adequate follow-up services and informing health policy with respect to the needs of their patients with stroke.

Keywords: mobility limitation; needs assessment; rehabilitation; stroke.

Figures

Figure 1

Frequency (%) and 95% CIs of reported needs from interview responses at discharge, 6 months after discharge, and 12 months after discharge of participants in acute FIM categories (a) ≤40, (b) 41–80, and (c) >80. FIM=Functional Independence Measure; PT=physiotherapy; d/c=discharge.

Figure 2

Frequency (%) and 95% CIs of reported barriers from interview responses at discharge, 6 months after discharge, and 12 months after discharge of participants in acute FIM categories (a) ≤40, (b) 41–80, and (c) >80. FIM=Functional Independence Measure; PT=physiotherapy; d/c=discharge.

Figure 3

Frequency (%) and 95% CIs of reported body structure/function–related needs from survey responses at discharge, 6 months after discharge, and 12 months after discharge for participants in acute FIM categories (a) 41–80 and (b) >80. FIM=Functional Independence Measure; PT=physiotherapy; d/c=discharge.

Figure 4

Frequency (%) and 95% CIs of reported activity participation–related needs from survey responses at discharge, 6 months after discharge, and 12 months after discharge for patients in acute FIM categories (a) 41–80 and (b) >80. FIM=Functional Independence Measure; PT=physiotherapy; d/c=discharge.

Figure 5

Frequency (%) and 95% CIs of reported service-related needs from survey responses at discharge, 6 months after discharge, and 12 months after discharge for participants in acute FIM categories (a) 41–80 and (b) >80. FIM=Functional Independence Measure; PT=physiotherapy; d/c=discharge.