Systematic Documentation of Physiotherapy Practice During Usual Care and High-Intensity Gait Training in Inpatient Stroke Rehabilitation.

Abstract

Background Usual care (UC) in stroke rehabilitation is often insufficiently documented, limiting evaluation of interventions such as high-intensity gait training (HIGT). Objective To describe physiotherapy delivery in UC and HIGT in inpatient stroke rehabilitation, focusing on session frequency, intensity, time, type and overall daily activity volume (FITT-V), and to evaluate the correspondence between heart rate-based and perceived exertion-based intensity monitoring. Methods This prospective quasi-experimental longitudinal study included 147 inpatients with stroke and impaired gait (median age 67 years, 67% male, median time since stroke 19 days). Median hospital stay was 33 days (IQR 25-42). Seventy-three received UC and 74 HIGT. Physiotherapy delivery and patient characteristics were collected prospectively. Exercise intensity was measured using heart rate zones (Polar H10) and Borg RPE. Daily steps and active time were recorded with the Polar Vantage V2. Results Across 1443 physiotherapy sessions lasting more than 10 min, weekly frequency was similar between groups (median 3.5 sessions), but HIGT sessions were longer (45 min vs. 38 min, p Conclusion FITT-V provides a structured approach to document physiotherapy delivery, revealing key differences in intensity, duration, and activity type that support targeted improvements in post-stroke rehabilitation. Challenges remain in accurately capturing perceived exertion, underscoring the need for complementary objective measures.