Physiotherapists’ use of aerobic exercise during stroke rehabilitation: a qualitative study using chart-stimulated recall

Abstract

PurposeWe aimed to explore the factors that affect physiotherapists’ use of AE during stroke rehabilitation for people with stroke.Material and methodsWe conducted a qualitative descriptive study using thematic analysis informed by a pragmatic worldview. Physiotherapists attended one on one semi-structured interviews to answer some general questions about aerobic exercise and then discussed the charts of their 4 most recently discharged patients. Both deductive and inductive coding were used for analysis.ResultsTen physiotherapists participated. Healthcare policies and limited resources were mostly discussed in general questions while specific profiles of patients with stroke, their goals and preferences were mostly discussed in patient specific questions. Three themes were identified:1) physiotherapists’ perspectives and practices around aerobic exercise; 2) profiles of people with stroke, as well as their goals and their exercise modality preferences; and 3) influence of health system priorities, rehabilitation intensity policy, and resources.ConclusionsPhysiotherapists’ behaviours regarding use of aerobic exercise for people with stroke are not a binary behaviour of prescribing or not prescribing aerobic exercise. Their behaviours are better understood on a continuum; between two ends of not prescribing aerobic exercise, and prescribing aerobic exercise with defined intensity, duration, and frequency.