Observation of Physiotherapy Treatment Sessions - Exploring What Happens in Physiotherapy for Patients After Stroke.

Associated reactions are unintended and involuntary arm movements, normally seen as bending of the wrist and elbow, that may occur after stroke when a person is doing something effortful such as walking.

This is the first phase of a study that will investigate the effects that different approaches to physiotherapy have on the expression of associated reactions. During this phase, current practice among neuro-physiotherapists will be explored in relation to: the learning strategies used in stroke rehabilitation, the common interventions used in gait re-education, and the strategies adopted for the assessment and management of associated reactions.

The objectives are:

• To provide an insight into the learning strategies used by physiotherapists during the re-education of walking, including the verbal dialogue that takes place and any preferences (overt or subconscious) adopted for one type of learning strategy.
• To develop and refine a description of what is meant by the term "gait re-education"
• To provide an insight into how therapists currently manage associated reactions

This phase of the study will explore these objectives using direct non-participation observation of a number of physiotherapy treatment sessions. This will provide an insight into the nature of the therapy that takes place for retraining walking(e.g. the types of exercises commonly used) and the nature of the learning strategies frequently adopted, including the amount and content of explicit verbal instruction and feedback that is provided to patients.