Type of publication:

Service evaluation report

Author(s):

*Emily Farla

Citation:

Shrewsbury and Telford Hospital NHS Trust, January 2026

Abstract:

Purpose: The Shrewsbury and Telford NHS trust’s acute stroke rehabilitation therapy
team set up weekly circuit class therapy (CCT) groups in 2024, running alongside
individual therapy (IT) to improve stroke rehabilitation. Physiotherapists, occupational
therapists, speech and language therapists and therapy support workers delivered
both methods of rehabilitation. The service aimed to provide quality therapy to
improve motor and psychological outcomes in the acute stroke population, supported
by results reported in current literature. Anecdotal evidence was obtained from
attendees that suggested CCT to be a positive addition and so a formal review was
indicated. This service review aimed to answer; does attending additional inpatient
CCT groups up to three times per week in addition to standard therapy for inpatient
stroke patients at the Princess Royal Hospital (PRH), influence motor function,
psychological wellbeing scores and impact hospital length of stay (LOS)?
Methods: The service evaluation reviewed notes retrospectively between the months
of May and July 2025. All consenting adult patients diagnosed with a stroke in the
last 30 days and admitted on to the Stroke and Rehabilitation wards at PRH who
were receiving active treatment and referred to therapy were included. The review
aimed to collect 30-50 sets of data. Notes were screened to collect inpatient
demographics; including gender, age, height, weight, diagnosis, number of groups
attended, length of stay, and discharge destination and outcome measures; Modified
Rivermead Mobility Index, Distress Thermometer, and Stroke Recovery Perception
from baseline and discharge time points. Data was inputted into Excel and SPSS to
complete descriptive and inferential analysis. Patient identifiable data was removed
to ensure anonymity throughout analysis.
Results: 38/50 stroke inpatients admitted to the stroke rehabilitation ward were found
to have complete sets of data (n=38). Of the 38 inpatients nine received IT and 19
attended IT with additional CCT groups. Significant motor improvements were seen
in both the IT and additional CCT groups. Significant increases in psychological
outcomes and self-perceived improvement scores were seen in the additional CCT
group compared to the IT group. There appeared to be no relationship between CCT
attendance and LOS.
Conclusions: This service evaluation has shown additional CCT groups delivered
alongside IT on the stroke rehabilitation unit at the PRH is a significantly better
service in terms of patient perceived improvement and psychological outcomes with
an equivalent benefit to IT for motor outcomes. Though no impact of group
attendance on LOS was seen, it may be due to the external factors delaying
discharge. The findings from this service review support continuing provision of the
CCT service and has provided data for comparison with future service reviews.
Further research is needed to understand the relationship between CCT attendance
and becoming therapy fit for discharge and the impact of inpatient total treatment
time by adding CCT to IT for achievement of stroke therapy guidance.

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