Physiotherapists’ and occupational therapists’ perceptions of the assessment of stroke patients for musculoskeletal rehabilitation in the UK national health service


Background and Purpose: This exploratory study focused on the assessment of stroke patients for musculoskeletal rehabilitation in the United Kingdom National Health Service. It was the first phase of research on developing telerehabilitation for the assessment of patients who have had a stroke. The assessment of stroke patients for musculoskeletal rehabilitation is currently performed at the therapist’s discretion using different outcome measures. When looking at the Department of Health’s “National Clinical Guidelines for Stroke”, it is stated that there are a variety of outcome measures, yet no particular one is recommended. It is specified that each rehabilitation sector should select its own methodologies. Aim: The aim of this exploratory study was to understand physiotherapists’ and occupational therapists’ perspectives of the strengths and weaknesses of current rehabilitative assessment of stroke patients in the UK National Health Service. Methods: This study had 2 parts, non-participant observation with 2 therapists and 3 patients, and 10 semi-structured interviews with 5 physiotherapists and 5 occupational therapists to identify current practice, problem areas, and what types of improvements could be made. Interviews were transcribed and analyzed using thematic coding. Results: Seven emergent themes were identified portraying how outcome measures are currently not being used in a standardized way within National Health Service hospitals. This means that the feedback provided to patients, therapists and healthcare commissioners is limited. Therapists are currently performing more informal assessments each time a patient begins therapy and concerns are shown with these methods of assessment, including subjectivity, standardization issues and time. Interviewed therapists were clear that they believed that change is required within this field. Conclusions: This study raises concerns about the methodologies used for the assessment of stroke patients for rehabilitative purposes in the United Kingdom National Health Service.

Share and Cite:

Golby, C. , Hundt, G. and Raja, V. (2013) Physiotherapists’ and occupational therapists’ perceptions of the assessment of stroke patients for musculoskeletal rehabilitation in the UK national health service. Health, 5, 1478-1485. doi: 10.4236/health.2013.59201.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Mackay, J. and Mensah, G. (2004) The atlas of heart disease and stroke. World Health Organization, Geneva.
[2] O’Donnell, M.J., et al. (2010) Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): A case-control study. The Lancet, 376 112-123. doi:10.1016/S0140-6736(10)60834-3
[3] National Institute for Health and Clinical Excellence (2008) Stroke: National clinical guideline for diagnosis and initial management of of acute stroke and transient ischaemic attack (TIA). NICE, London.
[4] Intercollegiate Stroke Working Party (2012) National clinical guidelines for stroke. Royal College of Physicians, London.
[5] Young, J. and Forster, A. (2007) Review of stroke rehabilitation. British Medical Journal, 334, 86. doi:10.1136/bmj.39059.456794.68
[6] Tyson, S. and Turner, G. (1999) The process of stroke rehabilitation: What happens and why. Clinical Rehabilitation, 13, 322. doi:10.1191/026921599674794965
[7] Smith, J., Forster, A. and Young, J. (2008) Service needs and delivery following stroke: Evidence based review. University of Leeds and Commission for Rural Communities. formated
[8] Kwan, J. (2007) Care pathways for acute stroke care and stroke rehabilitation: From theory to evidence. Journal of Clinical Neuroscience, 14, 189-200. doi:10.1016/j.jocn.2006.01.026
[9] Buck, D., et al. (2000) Evaluation of measures used to assess quality of life after stroke. Stroke, 31, 2004-2010. doi:10.1161/01.STR.31.8.2004
[10] de Haan, R., et al. (1993) Measuring quality of life in stroke. Stroke, 24, 320-327. doi:10.1161/01.STR.24.2.320
[11] Jette, D.U., et al. (2009) Use of standardized outcome measures in physical therapist practice: Perceptions and applications. Physical Therapy, 89, 125-135. doi:10.2522/ptj.20080234
[12] Skinner, A. and Turner-Stokes, L. (2006) The use of standardized outcome measures in rehabilitation centres in the UK. Clinical Rehabilitation, 20, 609-615. doi:10.1191/0269215506cr981oa
[13] Bryman, A. (2004) Social research methods. 2nd Edition, Oxford University Press, New York, 592.
[14] Appleby, J., et al. (2010) Improving NHS productivity— More with the same, not more of the same. The Kings Fund, London.
[15] Saka, Ö., McGuire, A. and Wolfe, C. (2009) Cost of stroke in the United Kingdom. Age and Ageing, 38, 27-32. doi:10.1093/ageing/afn281

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.