Do Rehabilitation Practitioners Leverage Social Support to Promote Post-stroke Physical Activity? A Survey Study

Research Objectives: To characterize rehabilitation practitioners’ practice implementing social support as a strategy to promote physical activity after stroke.

Design: Cross-sectional survey

Setting: Online survey of practitioners who practice in clinical and community-based settings where stroke patients receive care in the United States

Participants: Rehabilitation practitioners (occupational therapists, occupational therapy assistants, physical therapists, and physical therapy assistants) who hold a license to practice in the United States and who provided treatment for at least one stroke patient in the past 3 months.

Interventions: Not applicable

Main Outcome Measures: Survey respondents indicated their familiarity and frequency of recommending social support as a means of achieving physical activity recommendations using a 1 (Not familiar/I do not recommend this to any patient) to 5 (Extremely familiar/I recommend this to every patient) point Likert-type scale. Respondents also rated the degree to which 10 factors were a barrier or facilitator using a 7-point bipolar scale.

Results: Rehabilitation practitioners (N=707; occupational therapy n=301, 42.4%; physical therapy n=406, 57.2%) who practice in outpatient clinics (n=218, 30.7%), skilled nursing facilities/transitional care units (n=159, 22.4%), acute care (n=145, 20.4%), and inpatient rehabilitation (n=96, 13.5%) settings across all regions of the United States (West, n=50, 7.0%; Midwest, n=310, 43.7%; South n=157, 22.1%; multiple states, n=154, 21.7%) completed the survey. Among these, 76.2% (n=227) of occupational therapy practitioners and 72.8% (n=294) of physical therapy practitioners reported being quite or extremely familiar with the importance of social support to promote physical activity. Occupational therapy (n=197, 66.1%) and physical therapy (n=262, 65.7%) practitioners reported recommending social support for physical activity to almost every or every stroke patient on their caseload. Respondents noted that their scope of practice and role in the rehabilitation team were facilitators of their ability to use social support. In addition, the presence and willingness of other people in the patients’ lives and knowledge of social support assessments, interventions, and community resources were also identified as facilitators. Access to social support assessments was more frequently considered a barrier. Access to social support interventions was considered either a barrier or support by equivalent proportions of practitioners.

Conclusions: Improving practitioners’ access to social support assessments and social support interventions may enable skilled implementation of social support as a strategy to promote post-stroke physical activity. Future analyses focused on practice-setting and field-specific barriers and facilitators will support the design of effective implementation strategies.

Author(s) Disclosures: This study was funded through the University of Minnesota Foundation.