Critical features of physical therapists specializing in stroke rehabilitation
Neurology Specialized
Other
Student
Geriatrics or Neurology
Fig. 3. Boxplot of script concordance test (SCT) score per group, showing the median
score (the central horizontal line), the middle 50% of score (the box), and the minimum
and maximum scores (bottom and top horizontal lines). Neurology Specialized: PTs
specializing in neurology according to criteria of the Dutch Stroke Guideline; Other,
other specializations or non-specialized (e.g. musculoskeletal or cardiovascular
specialization); Student, students of PT: Geriatrics or Neurology focus; PTs focusing on
geriatrics or neurology who do not meet all criteria for the neurology specialized group.
423
ting of guideline knowledge, the frequency
of reading scientific literature, the number
of unique stroke patients treated in the last
12 months, acquaintance with international
clinical guidelines, completion of the Dutch
Neurorehabilitation course, and participa-
tion in professional development activities
(p < 0.1) (Table III). Since no multicollinea-
rity was detected between the determinants,
all determinants were included in the mul-
tivariate analysis
The multivariate analysis, using both
forward and backward linear regression,
showed that greater guideline knowledge,
successful completion of the Dutch Neu-
rorehabilitation course, and participation
in professional development activities were
statistically significantly associated with a
higher SCT score (Table III). In this model,
22.5% (R 2 ) of the variability of the SCT was
accounted for by these 3 factors.
DISCUSSION
To our knowledge, this is the first study
in which a SCT was developed for PTs working in
stroke rehabilitation to discriminate between levels
of specialization in terms of implementing consistent
clinical reasoning. The SCT showed good construct
validity, as it was able to distinguish PTs specializing
in stroke rehabilitation on the basis of their SCT scores.
The SCT score reflects the degree to which their use of
the Stroke CPG matched that of experts. Furthermore,
our data show that greater perceived knowledge of the
stroke guidelines, successful completion of the Dutch
Neurorehabilitation course, and systematic participa-
graduated PTs with a different specialization, as well as
with the physical therapy students and the group focu-
sing on neurology or geriatrics. The mean differences
between the students and the other specialized PTs did
not achieve statistical significance (p = 0.3). This is il-
lustrated in a boxplot of SCT score per group (Fig. 3)
Identification of critical features of physical
therapists specializing in stroke rehabilitation
The bivariate analysis showed associations between the
SCT score and six PT characteristics: Self-reported ra-
Table III. Bivariate and multivariate linear regression analysis
Bivariate analysis Multivariate analysis (n=210)
Standardized Unstandardized Standardized Unstandardized
Beta
Self-reported rating of guideline knowledge*
Frequency of reading scientific literature on
stroke care per year*
Years of employment within a specialization
Number of unique stroke patients treated per
year*
Acquainted with international guideline (s) in
stroke rehabilitation*
Working in a team (n = 133)
University education (n = 9)
Dutch Neurorehabilitation course successfully
completed* (n = 44)
Participating in additional professional
development activities* (n = 78)
Constant
SE p-value 95% CI Beta 0.41 1.69 0.26 0.000 1.17–2.21 0.26 1.07 0.30
0.21
0.08 0.23
0.07 0.08
0.06 0.002
0.247 0.08–0.38
–0.05–0.19 0.20 0.02 0.01 0.003 0.01–0.04 4.1
0.20
–0.02
0.10
B
10.61 3.59 0.003
–0.001 0.003 0.760
3.78 2.74 0.170
B
SE
p-value 95% CI
< 0.001 0.48–1.65
1.39 0.003 1.37–6.87
2.4 1.17
54.62 1.60 0.046
< 0.001
3.54–17.68
–0.01–0.01
–1.63–9.18
0.38 7.42 1.27 0.000 4.92–9.93 0.21
0.34 5.62 1.09 0.000 3.48–7.76 0.14
0.05–4.68
51.47–57.77
*Significant determinants of the score on the script concordance test for physical therapists in stroke care (p < 0.1).
n: number of participants; B: unstandardized beta coefficient; SE: standard error of the estimate; 95% CI: 95% confidence interval.
J Rehabil Med 51, 2019