Title : Do neurological physiotherapists consider executive dysfunctions post-stroke : A UK survey .
Rida Wahba
Introduction : People with stroke can experience deficits in executive functions ( EF ), such as working memory and attention . Such problems can affect stroke survivors ’ rehabilitation process , treatment outcomes and quality of life . Interventions , such as cardiorespiratory and resistance training , can improve EF in healthy older people but the effect on people with stroke is less clear . Cardiorespiratory and resistance training are commonly used in physiotherapy practice to address movement problems and tolerance for activity , but it is not known if physiotherapists are evaluating the impact of this training on EF . The aims of this study were to investigate physiotherapists ’, working in neurology : awareness of EF and its impact on rehabilitation ; how they identify and use assessment findings on EF with their patients ; and if they are evaluating the effect of cardiorespiratory and resistance training on EF .
Methods : Data was collected via an online cross-sectional survey that was circulated to neurological physiotherapist members ( n = 825 ) with the Association of Chartered Physiotherapists in Neurology ( ACPIN ) based on their expert knowledge in working with people who have had a stroke .
Results : Seventy-three participants answered the survey . EF deficits assessment varies between physiotherapists and depends on how they work with other team members . Preliminary analysis suggested that physiotherapists did not use standardised outcome measures to assess EF ; nonetheless , they use occupational therapists ’ assessment data to help design treatment plans . Other physiotherapists did not assess EF and only observed patients ’ responses to instructions to identify any EF deficits . Finally , cardiorespiratory and resistance training were found to be the main interventions with stroke patients , but EF outcomes not measured .
Conclusions : Attention and working memory have clinical impact on functional recovery in stroke survivors and are important for physiotherapists to consider . Moreover , EF deficits were less considered compared to physical impairments in intervention programmes as treatment outcomes . Physiotherapy helps stroke survivors to be physically independent which is important , but more importantly is helping them to be mentally independent . This can be done by examining the efficacy of cardiorespiratory and resistance training in improving executive dysfunctions after stroke and start assessing and considering executive functions in treatment plans .