Article

OBJECTIVE: To understand the use of therapy extenders in stroke rehabilitation.
DESIGN: Descriptive analysis of a prospective observational cohort study.
RESULTS: Two hundred ninety-eight patients with moderate stroke and 284 with
severe stroke from 5 inpatient rehabilitation facilities with complete physical
and occupational therapy data are included in the study. Overall, occupational
therapists and assistants contributed approximately 70% and 21% of all
occupational therapy hours, respectively. For physical therapy, these percentages
in moderate group (60% vs. 31%) differ from those in severe group (65% vs. 23%).
Some variations in the use of therapy extenders are noted in both disciplines
across sites. Physical and occupational therapists spend more time in delivering
advanced activities that include ongoing integrated evaluation and treatment
planning or modification. Their assistants spend more time in delivering
lower-level activities, such as bed mobility, transfers, dressing, or
nonfunctional activities. Also, therapists are more likely to assign
responsibility to assistants to treat moderate motor impairment among patients
with stroke. CONCLUSIONS: Characterizing therapy practice in stroke
rehabilitation is not straightforward. It is multifactorial and takes into
account the (1) type of therapy, (2) therapy activity, (3) therapy provider
including extender personnel, (4) specific training in stroke, and (5) years of
experience. Future research to examine the association between use of therapy
extenders and outcomes is recommended.

Langue : ANGLAIS