How much, how often, when and where? A description of NHS routine occupational and physical therapy from the DARS trail

Publication authors

Prescott M, Ford G, Bhakta B, Cozens A, Hartley S, Holloway I, Meads D, Ruddock S, Santorelli G, Sackley C, Walker M, Farrin A


Introduction: DARS (Dopamine Augmented Rehabilitation in Stroke) was a multi-centre, double-blind, RCT of co-carelopda in combination with routine therapy in 593 patients admitted to acute stroke services after new or recurrent stroke.

Methods: Details of routine occupational or physical therapy were recorded for up to 6 weeks, with no more than 2 sessions per day for 30 days, as delivered by NHS staff within 57 UK stroke services (acute inpatient stroke rehabilitation facility plus community rehabilitation service of either early supported discharge or community stroke teams). Within trial therapy was defined as active physical and occupational therapy, directed at motor skills such as walking, transfers, dressing, but not psychological input sessions, speech and language therapy, swallowing, splinting.

Results: 14,551 therapy sessions were delivered within the trial; 7319 in hospital, 7232 in the community. All but 1 of the patients discharged within 6 weeks, commenced community therapy within 5 days. Overall, the mean number of sessions per patient was 24 (SD 13.5). The mean length of session was 43 (SD 15.6) minutes: most lasted between 30 and 50 minutes but 6% were over 60 minutes. On average, 41 (SD 15.1) minutes were spent on motor activities, 17 (SD 15.0) minutes on non-motor activity.

Discussion: This vast data set from a UK-wide stroke rehabilitation trial provides a unique insight into routine NHS rehabilitation focusing directed at motor skills. Within the trial, routine therapy met the RCP guideline 45 minute target. Further discussion of the relationship between therapy and severity will be presented.