Sorinola I.1, Petty J.1, White C.1
1King's College London, Division of Health and Social Care Research, Academic Department of Physiotherapy, London, United Kingdom
Background: There is overwhelming evidence indicating that trunk performance is an important predictor of functional outcome after stroke. Despite this, there is limited focus on providing trunk training during early stroke rehabilitation to optimise recovery.There is a need to develop an approach to provide targeted trunk training during stroke rehabilitation.
Purpose: The overarching aims of this study were to develop: a trunk training schedule for early stroke rehabilitation; and a recording sheet to document the amount of trunk training currently delivered as part of early stroke rehabilitation.
Methods: Three linked studies were conducted including a systematic review, qualitative exploration and a Delphi questionnaire study. The systematic review was utilised to identify trunk training interventions after stroke. The qualitative study explored perceptions of Physiotherapists on trunk training after stroke and identify current approaches used in early stroke rehabilitation. The Delphi survey was used to gain a consensus of physiotherapists opinions on the developed schedule and checklist.
Results: Exercises targeting different trunk muscle groups, starting positions, progression elements and duration of exercises were identified in the systematic review. These were compiled into a treatment schedule of trunk strengthening exercises, functional exercises, progression parameters and a treatment recording form. Clinical reasoning plays a crucial role in stroke phyiotherapists´ decision on treatment goals, therapy content and exercise progression. No specific targetting of trunk training was reported. After two rounds of Delphi surveys, consensus was achieved for 22 out of 27 exercises, 11 out of 11 functional activities, 8 out of 8 exercise progression factors and 9 out of 12 functional activity progression factors.
Conclusion(s): The three stages of this development project resulted in an acceptable treatment schedule and recording checklist for trunk training and this is currently being tested in an ongoing feasibility study.
Implications: Developing an exercise traning schedule from available evidence and perceptions of users could enable acceptability and optimise engagement witht the developed schedule.
Funding acknowledgements: No funding was provided for this study.
Topic: Disability & rehabilitation
Ethics approval: The study was approved by the King´s College Research Ethics committee.
All authors, affiliations and abstracts have been published as submitted.
