http://www.sciencedirect.com/science/article/pii/S1836955313701462
Questions
How
accurately do physiotherapists estimate how long stroke survivors spend
in physiotherapy sessions and the amount of time stroke survivors are
engaged in physical activity during physiotherapy sessions? Does the
mode of therapy (individual sessions or group circuit classes) affect
the accuracy of therapists’ estimates?
Design
Observational study embedded within a randomised trial.
Participants
People who participated in the CIRCIT trial after having a stroke.
Intervention
47
therapy sessions scheduled and supervised by physiotherapists (n = 8)
and physiotherapy assistants (n = 4) for trial participants were
video-recorded.
Outcome measures
Therapists’ estimations of therapy time were compared to the video-recorded times.
Results
The
agreement between therapist-estimated and video-recorded data for total
therapy time and active time was excellent, with intraclass correlation
coefficients (ICC) of 0.90 (95% CI 0.83 to 0.95) and 0.83 (95% CI 0.73
to 0.93) respectively. Agreement between therapist-estimated and
video-recorded data for inactive time was good (ICC score 0.62, 95% CI
0.40 to 0.77). The mean (SD) difference between therapist-estimated and
video-recorded total therapy time, active time, and inactive time for
all sessions was 7.7 (10.5), 14.1 (10.3) and –6.9 (9.5) minutes
respectively. Bland-Altman analyses revealed a systematic bias of
overestimation of total therapy time and total active time, and
underestimation of inactive time by therapists. Compared to individual
therapy sessions, therapists estimated total circuit class therapy
duration more accurately, but estimated active time within circuit
classes less accurately.
Conclusion
Therapists
are inaccurate in their estimation of the amount of time stroke
survivors are active during therapy sessions. When accurate therapy data
are required, use of objective measures is recommended.
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