Exploring physiotherapy staff's perceptions of physiotherapy delivery in acute stroke rehabilitation.

Objective: To explore physiotherapists' perspectives on current and alternative models of physiotherapy delivery in acute stroke rehabilitation.

Design: Qualitative service evaluation.

Setting: An acute stroke rehabilitation unit within a London teaching hospital in the UK.

Participants: A purposive sample of 17 physiotherapy staff (qualified physiotherapists and physiotherapy support staff) working in the acute stroke rehabilitation unit at the time of, or in the previous 3 months of the study were recruited to participate.

Results: Three themes were identified: barriers to effective physiotherapy delivery, enablers of effective physiotherapy delivery, and alternative models of physiotherapy delivery. Themes were framed by the concept of providing effective and efficient physiotherapy guided by reflection. Main barriers included patients not being ready for and underutilisation of time within physiotherapy sessions. Use of timetabling and access to senior therapy support enabled more effective and efficient physiotherapy delivery. Alternative models to optimise physiotherapy delivery included different staff to patient ratios, group therapy, opportunistic physiotherapy delivery and self-management.

Conclusions: Several enablers of and barriers to providing effective and efficient physiotherapy post-stroke exist. Physiotherapists should consider implementing alternative models of physiotherapy delivery to increase the amount of physiotherapy provided to patients' post-stroke, thereby facilitating post-stroke functional recovery.