Accuracy of Physiotherapist Predictions for Independent Walking After Stroke.
Marie-Claire Smith, Benjamin J Scrivener, Luke Skinner and 1 others
PMID 39162247WHAT IT FOUND
Physiotherapists accurately predicted if stroke patients would walk independently by 26 weeks but were poor at predicting when.
The TWIST tool was more accurate than clinicians for early recovery timeframes. Experience and confidence did not improve prediction accuracy.
Key findings
01Physiotherapists were accurate in predicting whether a patient would achieve independent walking by 26 weeks, but poor at predicting the specific time it would take.
02The TWIST prediction tool was more accurate than physiotherapist predictions for patients achieving independent walking by 4, 6, and 9 weeks post-stroke.
03Neither years of stroke-specific experience nor self-rated confidence was associated with the accuracy of physiotherapist predictions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study cohort was the same one used to develop and internally validate the TWIST tool, which may inflate the tool's apparent accuracy. Follow-up did not extend beyond 26 weeks, so the tool cannot predict long-term walking status. Qualitative data on why clinicians trust or distrust prediction tools were not collected. Physiotherapists were not blinded to the patient's general clinical status, though they were unaware of the specific variables needed to calculate the TWIST score.
Declared interests
The authors declared no potential conflicts of interest. Funding was provided by non-U.S. government sources.
The easy way to misread this
Do not assume that senior physiotherapists are more accurate predictors of walking recovery timeframes than junior staff. The study found no relationship between years of experience and prediction accuracy, and self-rated confidence did not correlate with being correct.