Research-based evidence in stroke rehabilitation: an investigation of its implementation by physiotherapists and occupational therapists

Purpose: Stroke rehabilitation is a multidimensional process that is designed to facilitate restoration of and/or adaptation to loss of functioning. The use of research-based evidence in informed decision making is insufficient. Occupational therapy and physiotherapy constitute important contributions to rehabilitation. The study aim was to investigate characteristics of the implementation of research based evidence in stroke rehabilitation by occupational therapists and physiotherapists, using the International Classification of Functioning, Disability and Health as a conceptual framework. Method: A prospective cohort study, including all service levels within stroke rehabilitation. Consecutive patients with stroke admitted to a university hospital between May and December 2012 were enrolled by 13 therapists. Documentation of daily practice was collected from medical records. Analysis compared the therapists' documentation with the national clinical guidelines for physiotherapy and occupational therapy in the rehabilitation of adults with brain injury. Results: The study included 131 patients. The therapists' praxis was seen to be in agreement with the majority of the national clinical guidelines. However, joint goal-setting and evaluation using standardized measures were seldom documented. Conclusions: Although the therapists recognize evidence-based practice as a framework for achieving quality in rehabilitation, findings suggest that they do not employ research-based evidence to the fullest extent.