A Cross-Sectional Study to Verify the Behaviour Change Techniques Used by Physiotherapists in Promoting Upper Limb Activity Post-Stroke - Abstract
Background: Stroke frequently leads to upper limb disability, limiting daily activities. Despite recommendations for high-intensity functional task
training, many patients underutilize their affected limb, often compensating with the non-affected arm. Be- haviour Change Techniques (BCTs) may enhance
physiotherapist’s ability to promote affected limb use.
Objective: To identify and characterize BCTs used by physiotherapists to promote upper limb activity in stroke patients.
Methods: A cross-sectional study observed 30 physiotherapists during three 1-hour treatment sessions (90 sessions total) with stroke patients exhibiting
upper limb impairments. Sessions were audio/video recorded and analyzed using the Behaviour Change Technique Taxonomy v1 (BCTTv1), categorizing
techniques across eight motivational domains. Descriptive statistics summarized BCT frequency and characteristics.
Results: No physiotherapists used evidence-based BCTs aligned with functional task training. However, motivational techniques were common in conventional
physiotherapy, with “reducing negative emotion” (34.2%), “verbal persuasion about capability” (7.5%), and “demonstration of behaviour” (6.7%) being most
frequent. Sessions aver- aged 8–10 exercise repetitions, significantly below recommended levels.
Conclusion: Physiotherapists frequently employ motivational strategies but lack integration with evidence-based BCTs or functional task training. Targeted
training in BCT frameworks could improve upper limb rehabilitation outcomes.