Physiotherapists' knowledge, attitude and practice of motor learning in stroke rehabilitation.
Elmi Meyer, Helena W Nel, Dineo Mahlangu and 1 others
PMID 42428160WHAT IT FOUND
Of 40 South African physiotherapists surveyed, most had only moderate knowledge of motor learning and none scored well, though nearly all valued it.
Most gave feedback with an internal focus rather than the external focus the literature recommends.
Key findings
01By the study's own scoring, 36 of the 40 respondents (90%) had moderate knowledge of motor learning in stroke rehabilitation and four (10%) had poor knowledge. No respondent reached the 'good' category. The median score was 5 out of 10 questions, with an interquartile range of 4.0 to 5.5.
02Knowledge gaps sat in particular areas: modern motor control approaches, outcome measures for motor learning, the difference between learning and performance, and which type of exercise promotes motor learning. No respondent answered correctly the question about the best time frame after stroke to deliver physiotherapy.
03Reported practice was uneven. 37 of 40 (92.5%) gave feedback with an internal focus of attention and 26 (66.67%) set exercise difficulty well within what the patient could already do, while only a minority always or often set the treatment environment up to reflect the patient's own home or community.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Forty people answered out of an ideal 369, a 10.8% response rate. The authors call this a limitation and say it may mean the results do not represent South African physiotherapists. Most respondents (33 of 40, 82.5%) worked in private practice and only seven in the public sector, so public sector practice is barely represented. The authors suggest poor internet access at public facilities may be why. Half of the respondents (20, 50%) had treated only one to 10 stroke survivors in the past year, and for most, adult neurological rehabilitation was not their main area of interest. The authors state plainly that the results would likely have differed if only physiotherapists with a special interest in stroke had taken part. The survey went to one professional association's mailing list, was sent only once, and respondents could forward it to others, so it captured people willing to answer a survey who happened to see it. Practice was self-reported. Nothing was observed and no patient outcome was measured. The questionnaire was written by the researchers for this study and only checked by two experts and piloted on two physiotherapists. The seven respondents who regularly treated stroke survivors are too few to generalise from, as the authors themselves say. The study did not ask why respondents did or did not follow the recommendations, so any explanation for the practice gaps is speculation.
Declared interests
The authors state that they received no financial support for the research, authorship or publication of the article.
The easy way to misread this
Do not read this as a picture of what South African physiotherapists know and do. Forty physiotherapists answered out of an ideal sample of 369, most worked in private practice, and half did not treat stroke survivors regularly, so the authors say the findings may not represent the profession. Also note that 'moderate knowledge' here means answering only four to seven of 10 questions correctly, which is not a strong score.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →