Barriers and facilitators of using outcome measures in stroke rehabilitation in South Africa

Abstract

Background/AimsDespite outcome measures being found to be useful in stroke rehabilitation, surveys have indicated that therapists do not use them regularly. The aim of this study was to identify outcome measures commonly used in the rehabilitation of patients with stroke in South Africa and the barriers and facilitators to their use.MethodsA mixed-methods study was used. A cross-sectional study using a self-administered questionnaire to establish the outcome measures used by physiotherapists was undertaken first, and then qualitative interviews of physiotherapists were carried out to establish the barriers and facilitators to the use of outcome measures used in stroke rehabilitation.ResultsThe most commonly used impairment level outcome measure was the Modified Ashworth Scale (84%), while for activity limitation and participation restriction the Berg Balance Scale (96%) and the Stroke Impact Scale (32%) were used. The factors found to have an influence on the choice of outcome measure included time taken to complete the outcome measure, ability to integrate the outcome measure into daily practice, funds to buy the outcome measure, and the physiotherapist's knowledge of the outcome measure.ConclusionsThe most commonly used outcome measures are the Modified Ashworth Scale, the Berg Balance Scale and the Stroke Impact Scale. Physiotherapists mainly use outcome measures that are freely available, easy to understand, not time consuming, require less space to administer and are meaningful to patients.