Rehabilitation to support leisure participation following stroke: a national survey of clinical practice in Australia

PURPOSE: To describe how allied health clinicians assess and treat leisure participation after stroke and identify factors influencing their practice. MATERIALS AND METHODS: Allied health clinicians working in health and disability settings completed an online survey. Assessment and intervention approaches were collected with survey questions aligned to the TIDieR checklist. Perceived barriers to providing leisure rehabilitation were captured using the 26-item Determinants of Implementation Behaviour Questionnaire. RESULTS: Among the 131 clinicians who completed the survey, the largest proportion of respondents were occupational therapists (35%), physiotherapists (35%), and speech pathologists (18%). Most referred to clinical guidelines to inform their leisure rehabilitation practice. Of the 105 assessments reportedly used, only seven included a leisure-specific item or scale. Common intervention approaches included targeting underlying impairments (upper limb [44%] and mobility [44%]) and modifying activities (54%). Barriers to providing leisure rehabilitation included limited funding, training and resources. CONCLUSION: Allied health clinicians rely on guidelines that do not meaningfully inform leisure rehabilitation, leaving practice dependent on individual reasoning and inconsistent access to resources. Further research to understand clinicians' clinical reasoning and training needs can inform the design of effective leisure-focused interventions and help address a clear gap in stroke rehabilitation.