Gaps in the physical therapy approach to functioning and disability after stroke: a scoping review
DOI:
https://doi.org/10.1590/Keywords:
Stroke, Physical Therapy Modalities, International Classification of Functioning, Disability and Health, Health ServicesAbstract
Investigating the use of the biopsychosocial
model in healthcare can point to shortcomings in
the approach to health domains that make care less
comprehensive. There are gaps of information on how
this model is employed by physical therapists in the care
of stroke survivors. These data could contribute to health
decision-making and targeting of resources across various
intervention settings. This scoping review analyzed clinical
trials conducted by physical therapists that had functioning/
disability in post-stroke adults as an outcome, with the aim of
investigating the biopsychosocial model approach. Articles
in which the intervention was applied by other professionals
and/or published only in languages not mastered by the
authors were excluded. Screening by two blinded reviewers
returned 25 articles across eight databases (Medline, PEDro,
Embase, Scopus, LILACS, CINAHL, Web of Science, and
the Cochrane CENTRAL database). The content of the functioning/disability assessment measures was linked to the
domains of the International Classification of Functioning, Disability,
and Health (ICF). With the ICF categories, a more detailed content
analysis was conducted, enabling a precise comparison across
intervention settings. We found that the functioning/disability
approach mostly focuses on covering the activity elements of the
biopsychosocial model, mainly mobility and self-care, regardless
of the intervention setting. The results of this study may be useful
for guiding the practice of physical therapists, providing data for
health managers to officially adopt the model as a decision-making
guide and clarifying to patients some of the objectives of physical
therapy after stroke.
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