Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study

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...

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Main Authors: McCluskey, Annie, Ada, Louise, Kelly, Patrick J., Middleton, Sandy, Goodall, Stephen, Grimshaw, Jeremy M., Logan, Pip, Longworth, Mark, Karageorge, Aspasia
Format: Article
Published: BioMed Central 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/40006/
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author McCluskey, Annie
Ada, Louise
Kelly, Patrick J.
Middleton, Sandy
Goodall, Stephen
Grimshaw, Jeremy M.
Logan, Pip
Longworth, Mark
Karageorge, Aspasia
author_facet McCluskey, Annie
Ada, Louise
Kelly, Patrick J.
Middleton, Sandy
Goodall, Stephen
Grimshaw, Jeremy M.
Logan, Pip
Longworth, Mark
Karageorge, Aspasia
author_sort McCluskey, Annie
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-400062020-05-04T17:12:15Z https://eprints.nottingham.ac.uk/40006/ 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 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. BioMed Central 2015-07-29 Article PeerReviewed McCluskey, Annie, Ada, Louise, Kelly, Patrick J., Middleton, Sandy, Goodall, Stephen, Grimshaw, Jeremy M., Logan, Pip, Longworth, Mark and Karageorge, Aspasia (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 . 296/1-296/9. ISSN 1472-6963 Physical therapy Occupational therapy Physiotherapy Knowledge translation Walking http://dx.doi.org/10.1186/s12913-015-0952-7 doi:10.1186/s12913-015-0952-7 doi:10.1186/s12913-015-0952-7
spellingShingle Physical therapy
Occupational therapy
Physiotherapy
Knowledge translation
Walking
McCluskey, Annie
Ada, Louise
Kelly, Patrick J.
Middleton, Sandy
Goodall, Stephen
Grimshaw, Jeremy M.
Logan, Pip
Longworth, Mark
Karageorge, Aspasia
Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study
title Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study
title_full Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study
title_fullStr Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study
title_full_unstemmed Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study
title_short Compliance with Australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study
title_sort compliance with australian stroke guideline recommendations for outdoor mobility and transport training by post-inpatient rehabilitation services: an observational cohort study
topic Physical therapy
Occupational therapy
Physiotherapy
Knowledge translation
Walking
url https://eprints.nottingham.ac.uk/40006/
https://eprints.nottingham.ac.uk/40006/
https://eprints.nottingham.ac.uk/40006/