What do we need for a successful model of care to promote physical activity after stroke? Results from two web-based surveys of physiotherapists and exercise professionals in Singapore

Objectives

A collaborative model of care between physiotherapists (PTs) and exercise professionals (EPs) is needed to increase physical activity (PA) after stroke. We investigated the knowledge, attitudes and practices of PA promotion among PTs, the interest of EPs, and the barriers and facilitators to PA promotion faced by PTs and EPs in Singapore.

Design

We conducted two web-based surveys between August and November 2019, and January and July 2021.

Participants

Eligible participants were PTs who saw at least one stroke survivor in the last three months, and certified EPs who saw at least one client in the last six months. We reported categorical data using frequencies and percentages.

Results

Of 102 PTs and 44 EPs who initiated the surveys, 71 (70%) PTs and 35 (80%) EPs completed the surveys. Most knowledge questions were answered correctly. Almost all PTs perceived PA promotion as part of their role but only half (38/71;54%) practiced this often. Few (11/71;15%) used formal PA assessments. Most used goal setting (66/71;93%), advice/counselling (58/71;82%) and identification of barriers and solutions (51/71;72%). There was great interest from EPs to work with health professionals (30/35;86%) and stroke survivors (28/35;80%). While PTs faced barriers such as lack of time and resources, EPs faced barriers such as lack of referrals, knowledge and skills in stroke and exercise prescription.

Conclusion

Our study identified elements useful for informing a model of care between PTs and EPs in promoting post-stroke PA. Future research should focus on developing resources, pathways and training programs specific to stroke.

Contribution of the Paper

Our study is the first to report the insights of physiotherapists and exercise professionals on promoting PA after stroke in Singapore. We identified useful elements that can help inform a model of care between PTs and EPs in promoting post-stroke PA. These would include resources for brief PA counselling sessions and stroke-specific PA opportunities in the community (for PTs), and training workshops on stroke (for EPs).