Current Clinical Practices of Saudi Physiotherapists in Stroke Rehabilitation

Abstract

Background and Purpose: Stroke is a major cause of disability and the third leading cause of death worldwide. Clinical practice guidelines for stroke rehabilitation identify stroke physiotherapists as an essential interdisciplinary team member to minimize residual impairments and disability, thereby improving the patient's ability to execute daily tasks. This article uses an existing American survey to compare Saudi physiotherapists' current practice and preferred interventions in stroke rehabilitation with their counterparts in other countries. Method: An electronic survey was sent between September and October 2020 to physiotherapists (n = 287) treating persons with stroke in Saudi Arabia. The questionnaire consisted of items related to stroke rehabilitation, including treatment approach, the goal of interventions, management of tone, facilitation of movement, function, and improved motor control. Chi-square tests (χ2) were used to test any associations between physiotherapists' responses with respect to their demographic characteristics. Quantitative data analysis was conducted using SPSS. Results: A total of 197 participants returned completed questionnaires (68.6%). Participants were asked which methods of stroke treatment they had practiced in their profession and which methods had been taught in school training. The Bobath/neurodevelopmental treatment (NDT) approach was the most commonly known approach in practice (77.66%), followed by the proprioceptive neuromuscular facilitation/Brunnstrom and motor relearning program (63.45%, 25.38%, respectively). The results showed a significant relationship between Saudi physiotherapists' current practice and the aim of treatment and function (P < .05). In general, respondents have agreed on preferred treatment approaches, with the majority referring to the Bobath/NDT method, although variation is observed between participants in some sections of the survey. The preferred treatment was based on the frequency of responses of the participants. Discussion and Conclusion: Variation has been observed between therapists regarding treatment applications in stroke rehabilitation. The current findings emphasize the need to investigate how and why practitioners use or do not use evidence in this area (such as national stroke guidelines). Future studies might need to engage Saudi stroke physiotherapists to find suitable ways to close the gap between the evidence for best practice and the use of evidence within day-to-day practices.

Assessing the Awareness and Practices of Physical Therapists in Managing Modifiable Risk Factors for Stroke in Saudi Arabia

“…Research has shown that when deciding which modalities or treatment programs to incorporate into their practice, physiotherapists rely on their initial training, the treatment techniques they learned during their initial training, their personal experience, prior trials with the effects of a treatment, continuing education concerned with practice that guides practice discussions and expert opinions, and the advice of colleagues (Alatawi, 2021). A recent survey of Saudi physiotherapists' preferred approaches to stroke rehabilitation revealed a need for increased education, experience, and understanding among the practitioners (Alanazi & Alrwaily, 2022).…”

Clinicians’ perceptions of manual handling policies in stroke rehabilitation: a qualitative focus group study

“…The handling of people with stroke is an essential part of PTs' practice (5,6). The results of systematic reviews show that many PTs with WRMDs suffered these injuries while lifting and transferring patients (7).…”

“…All participants in stroke rehabilitation considered patient handling crucial (5,6,8,9). Further investigation is needed to investigate the efficacy of the approach used for stroke rehabilitation.…”

The effect of game-based in comparison to conventional circuit exercise on functions, motivation level, self-efficacy and quality of life among stroke survivors

“…Therapeutic exercise with a focus on task specific training is the most utilized physiotherapy modality for stroke survivors. [8] It can be delivered either through individual or group session; with the group session normally conducted in a form of circuit class exercise. During circuit exercise session, a group of three or more participants is supervised by 2 to 3 physiotherapists in performing repetitive practice of a number of tasks which arranged in several workstations in sight of each other.…”

“…Therapeutic exercise with a focus on task specific training is the most utilized physiotherapy modality for stroke survivors [8] . It can be delivered either through individual or group session; with the group session normally conducted in a form of circuit class exercise.…”