Physiotherapy approach in stroke rehabilitation: Development and testing of a survey of current practice

BACKGROUND AND PURPOSE: Physiotherapy is a key discipline in stroke rehabilitation. Physiotherapists sometimes select interventions following personal preference rather than a scientific rational. Data on physiotherapy approaches used in stroke rehabilitation may help policy makers and educators to plan education strategies and implement efficient clinical practices, thus improving rehabilitation effectiveness. We aimed to develop and test a questionnaire designed to survey physiotherapy interventions utilized in stroke rehabilitation. METHODS: We used a multistep questionnaire development method (literature review and synthesis; questionnaire drafting; expert validation; cognitive interviewing). Afterwards the survey proceeded to reliability testing; the outcomes of interest were completion time, estimated comprehensiveness of the lists of interventions, and intraclass correlation coefficient (ICC). RESULTS AND DISCUSSION: Retrieved survey tools, their items, and a taxonomy were useful for the questionnaire development. We interviewed four experts; changes were made to the survey following their suggestions. Thirteen physiotherapists participated in cognitive interviewing and further changes were made. Thirty-five raters participated in the test-retest study. Most participants considered the list of physiotherapy interventions and assistive device exhaustive. Median compilation time and time interval between the two compilations were 7 minutes and 21 days. The observed ICC was 0.844 (95% confidence interval, 0.829/0.857). Our method provided a valid and reliable questionnaire, however further methodological considerations of sampling methods and contact delivery modes are needed. CONCLUSIONS: If adequately implemented, the questionnaire can provide information about interventions utilized in stroke rehabilitation practice by physiotherapists. Data eventually acquired could be useful for planning educational strategies and implementing effective clinical practices.