Abstract Background and aims UK national clinical guidelines recommend stroke rehabilitation at an intensity of 3 hours per day at least 5 out of 7 days for those with motor deficits. However, in an acute stroke unit (ASU), not all patients tolerate or benefit from receiving physiotherapy at a uniform intensity. Our aim was to understand whether the current staffing establishment can provide physiotherapy at a frequency that is clinically appropriate to patients’ presentation. Methods This study took place in an ASU in a central London hospital. Treating physiotherapists specified session frequency (days/week) for patients using clinical reasoning following assessment and their response to treatment. Physiotherapy was scheduled to be delivered through a timetabled structure at this frequency. The scheduled and actual frequency of sessions were recorded over 6 months. Staffing requirements necessary to meet the rehabilitation intensity specified in UK guidelines were also calculated. Results Physiotherapy scheduled frequency ranged between 1 and 7 days/week, with 60% of patients scheduled for 5-7 days per week. Patients’ actual physiotherapy frequency was similar to their scheduled frequency across the range of intensities, and all values were within one day. The current level of physiotherapy staffing is insufficient to provide motor rehabilitation to all patients on the ASU at the recommended intensity and frequency. Conclusions Using a dose prescription model based upon patient need, allows more efficient and effective physiotherapy delivery across the acute stroke rehabilitation service. The model ensures the physiotherapy service is flexible to meet patients’ rehabilitation needs, especially those who require high dose physiotherapy. Conflict of interest Katrina Raschen: Nothing to disclose
Raschen et al. (2026) studied this question.