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  • Title: Physical therapy during stroke rehabilitation for people with different walking abilities.
    Author: Latham NK, Jette DU, Slavin M, Richards LG, Procino A, Smout RJ, Horn SD.
    Journal: Arch Phys Med Rehabil; 2005 Dec; 86(12 Suppl 2):S41-S50. PubMed ID: 16373139.
    Abstract:
    UNLABELLED: Latham NK, Jette DU, Slavin M, Richards LG, Procino A, Smout RJ, Horn SD. Physical therapy during stroke rehabilitation for people with different walking abilities. OBJECTIVE: To describe how physical therapy (PT) activities during post-stroke inpatient rehabilitation vary by admission walking ability and over time. DESIGN: Observational cohort study. SETTING: Six inpatient rehabilitation hospitals in the United States. PARTICIPANTS: People receiving post-stroke PT (N=715) who were classified as walking at admission. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Percentage of time spent in 11 activities, percentage of patients who participated in each activity, and the FIM instrument scores. RESULTS: The majority of PT time was spent in gait activities. Even people with the most limited mobility spent 25% to 38% of PT time in gait activities during the first 6-hour treatment block. Treatment progression was evident, and a shift to more advanced activities occurred over time (eg, less bed mobility and more advanced gait). However, even in the final 6-hour block, a small proportion of time was spent on community mobility activities (1.2%-5.2%), and most people received no community mobility training. CONCLUSIONS: PT activities focused on specific functional tasks at the ability level of each individual patient and provided higher-level activities as patients improved their function. However, although there is increasing recognition that the environment influences task performance, little time was spent in community mobility activities before discharge.
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