Background:
In a large metropolitan acute hospital, occupational therapists (OT) and physiotherapists (PT) reported stroke patients were not receiving the recommended amount of upper limb (UL) therapy due to competing clinical demands. Evidence endorses group therapy should be used to increase therapy time and improve opportunities for socialisation to increase engagement in rehabilitation.
Aims:
To determine the feasibility of running an UL group in an acute neurosciences ward. Secondary aims were to increase 1) amount of UL therapy; 2) use of standardised UL outcome measures; 3) opportunities for patient socialisation; and 4) clinician confidence in UL goal setting and management.
Methods:
Information from a literature review and benchmarking of major Victorian public hospitals was used to design and implement an UL group on an acute neurosciences ward. Feasibility was evaluated during the three-month period of the group’s implementation. Patients meeting inclusion criteria, minutes of UL therapy per week, and outcome measures completed were collected. Clinicians were surveyed to understand their perceived confidence in UL management, (using Likert scales, with 10/10 indicating maximal confidence), and perceived barriers and enablers to conducting the group. Consumer feedback was collected.
Results:
Following group implementation, average minutes of active UL therapy per person per week increased from 22 to 57 minutes. Patients who had completed an UL outcome measure increased from 11% to 45%. The clinicians involved reported increased confidence assessing the UL (6.7/10–8.3/10) and writing measurable goals (5.9 – 8.1/10). Patients reported an average enjoyment rating of 9/10 with key reasons including: “focusing on my arm”, “being out of my room” and “seeing others like me”. No adverse events occurred.
Conclusion:
Overall, the group was feasible to implement. Despite challenges identified in the acute setting, there was positive feedback from both clinicians and consumers. The group has continued, because ‘arms matter’.