Purpose: The purpose of this study was to understand the perceived benefits and clinical utility of cardiopulmonary exercise testing (CPET) from the perspectives of physiotherapists and patients and to explore the factors that influence adopting CPET in a stroke rehabilitation setting. Method: A qualitative descriptive study was conducted. Physiotherapists ( n = 6) participated in a focus group to discuss the use of CPET in practice. Patients ( n = 8) who had completed CPET during stroke rehabilitation participated in a semi-structured interview to explore their experiences. Thematic analysis was performed. Results: CPET increased the physiotherapists’ confidence in prescribing exercise, especially for medically complex patients. Ongoing medical management early post-stroke was a barrier to referral. Physiotherapists expressed decreased confidence in interpreting test results. Consultation with local experts facilitated the use of CPET. Patients described how CPET increased their confidence to participate in exercise. They desired more information before and after CPET to better understand the purpose and results and their relation to their rehabilitation goals. Conclusions: Both physiotherapists and patients described the benefit of having CPET available to support them as they participated in exercise in a stroke rehabilitation setting. Physiotherapists would benefit from having educational tools to support their interpretation and application of test results, and patients would benefit from improved communication and education to support their understanding of the relevance of CPET to their rehabilitation goals. Future research should explore these findings in other stroke rehabilitation settings.

In the acute care setting faecal incontinence is often associated with diarrhoea, both of which are challenging nursing problems. In this environment, it is essential that health-care professionals are able to provide good quality care, therefore, the assessment and management of faecal incontinence are fundamental elements of practice. This article examines the importance of identifying faecal incontinence within health-care settings, highlights the under-reporting of this condition and demonstrates that through careful assessment, appropriate treatment options can be used to provide optimum patient care. The article also describes the implementation of local guidelines for a bowel management system that were developed to promote best practice in patients being nursed in a high dependency health-care area.

Faecal incontinence is a distressing and embarrassing problem that can have a profound affect upon quality of life. The true incidence is unclear, as figures from studies vary depending on the definition used and the population studied. Data from a comprehensive study by Nelson et al (1995) found that 2.2% of the population has faecal incontinence and 10% of those have severe symptoms. The incidence increases with age (Perry, 2002) This article sets out to highlight the importance of assessment along with exploring appropriate conservative and surgical management options for faecal incontinence. If conservative management fails, sacral nerve stimulation (SNS) is one treatment option which is a minimally invasive technique allowing modulation of nerves and muscles in the pelvic floor. The procedure is carried out in two stages: the diagnostic stage involves a peripheral nerve evaluation (test) and a therapeutic stage involves permanent implantation of the stimulating device. Results from a recent study focusing on the medium term follow up for SNS will be presented.