Journal of Multidisciplinary Healthcare (Oct 2023)
The Content of Physiotherapy and Factors Impacting on Reablement – A National Study
Abstract
Ulrika Olsson Möller,1,2 Magnus Zingmark,2– 5 Joakim Ekstrand,1 Maria Haak1 1Department of Nursing and Health Sciences, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden; 2Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden; 3Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden; 4Health and Social Care Administration, Municipality of Östersund, Östersund, Sweden; 5Department of Community Medicine and Rehabilitation, Faculty of Medicine, Umeå University, Umeå, SwedenCorrespondence: Ulrika Olsson Möller, Department of Nursing and Health Sciences, Elmetorpsvägen 15, Kristianstad, 291 39, Sweden, Email [email protected]: Reablement is a multidisciplinary intervention aimed at promoting function and independence for people with functional decline. Detailed descriptions of various professions’ actions are needed for organization and evaluation of reablement services. This study describes physiotherapy practice in a reablement context in Swedish municipalities, focusing on the content and magnitude of interventions.Methods: Physiotherapists (n=108) from 34 municipalities answered a web-based survey covering the target group, content and duration of their actions, and number of contacts initiated over a 3-week period. Data were analyzed with descriptive statistics and multiple logistic regression.Results: Overall, 1005 cases were reported, with a mean age of 78.9 years (SD: 11.7); about 91% (n=912) were aged ≥ 65 and 61% (n=612) were women. About 70% were allocated to home care; 16% (n=160) of these had minor functional limitations (eg, needing safety alarms/help with domestic tasks), and 55% (n=550) had major functional limitations (eg, needing help with personal activities of daily living). The most reported actions were providing technical aids (60.8%, n=576), instructions/counseling (41.5%, n=393), walking/climbing stairs (27.6%, n=262), strength training (27.2%, n=258), and fall prevention (25.5%, n=242). Almost half of the cases included one action (n=494) and about 89% (n=890) targeted primary needs (body functions, walking indoors, self-care, or domestic life), mainly in clients with major functional limitations (odds ratio=2.96; 95% confidence interval: 1.95– 4.49). About 50% (n=517) of the cases involved 1– 2 contacts; about 55% (n=549) were completed within 3 weeks. Exercise was associated with ≥ 6 visits over ≥ 7 weeks. Supervision of home care staff was performed in 19.1% (n=181) of cases.Conclusion: Reablement physiotherapy mostly comprises a few actions over a relatively short period. Whether this is a conscious strategy based on the purpose of home-based physiotherapy or clients’ needs and wishes, or conversely an expression of limited resources, remains to be investigated.Keywords: healthy aging, home care, physical activity, physiotherapy, reablement, technical aids
