Open Collections

Kasapi, Alexandra

University of British Columbia

Purpose: To co-create an exposure-based approach to post-stroke rehabilitation with treating physiotherapists. Additionally, we aimed to explore patient perspectives surrounding the implementation of the novel approach. Methods: Four physiotherapists (PTs) (practicing clinicians) working with stroke patients in a rehabilitation setting (two PTs working in in-patient units, one physiotherapist working in the intensive day rehabilitation program, and one PT working in the out-patient program), alongside clinical researchers in physiotherapy and psychology, were members of the co-creation team. All physiotherapists completed exposure-based cognitive behavioural techniques (EB-CBT) training and provided feedback regarding training components and implementation of the new approach through a series of co-creator meetings, as well as one on one discussions with the lead (clinical physiotherapist/researcher). The two out-patient PTs recruited a total of 6 patients undergoing stroke rehabilitation to participate in the study, and the two in-patient PTs remained as co-creators in this project. At discharge (from rehabilitation) and one-month post discharge, patients participated in semi-structured interviews and responded to Likert statements. Inductive content and thematic analyses were carried out on physiotherapist and patient semi-structured interviews, respectively, to assess perspectives on the integration and implementation of an exposure-based approach to the rehabilitation of walking function post-stroke. Intervention components consisted of education; goal setting; Exposure Hierarchies; homework; and graded exposure informed by the Rate of Perceived Stability (RPS) Scale. Results: We successfully co-created EB-CBT components to the physiotherapy rehabilitation of walking post-stroke in an out-patient setting. In addition, we explored patient perspectives surrounding the integrated approach and found that patients reported positive perspectives surrounding the integrated approach and reported that their PTs were able to help motivate and further challenge/progress patients and one-month after being discharged from their physiotherapy rehabilitation, walking and balance function was improving and patients were able to return to meaningful activities and transition to day-to-day life. Conclusion: Patients perceived the integrated EB-CBT approach to be beneficial to enhancing rehabilitation outcomes and facilitating self-progression. Future research is necessary in order to further modify/refine intervention parameters and to assess potential feasibility, as well as efficacy.

Text

2023-10-19

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/86221

Experimental Medicine

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/