Dose and content of training provided to stroke survivors with severe upper limb disability undertaking inpatient rehabilitation: An observational study

Hayward, Kathryn S., Barker, Ruth N., Wiseman, Amy H. and Brauer, Sandra G. (2013) Dose and content of training provided to stroke survivors with severe upper limb disability undertaking inpatient rehabilitation: An observational study. Brain Impairment, 14 3: 392-405. doi:10.1017/BrImp.2013.31


Author Hayward, Kathryn S.
Barker, Ruth N.
Wiseman, Amy H.
Brauer, Sandra G.
Title Dose and content of training provided to stroke survivors with severe upper limb disability undertaking inpatient rehabilitation: An observational study
Journal name Brain Impairment   Check publisher's open access policy
ISSN 1443-9646
1839-5252
Publication date 2013-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.1017/BrImp.2013.31
Open Access Status Not yet assessed
Volume 14
Issue 3
Start page 392
End page 405
Total pages 14
Place of publication Cambridge, United Kingdom
Publisher Cambridge University Press
Language eng
Subject 2728 Clinical Neurology
2802 Behavioral Neuroscience
2805 Cognitive Neuroscience
2808 Neurology
3206 Neuropsychology and Physiological Psychology
3616 Speech and Hearing
Abstract Background: To retrain upper limb function after stroke, a high dose of activity-related therapy is recommended. However, observational studies indicate that the dose undertaken is minimal. While it is speculated that those with severe disability will perform less therapy, this remains to be explored. Objective: Quantify the dose and content of upper limb therapy performed by stroke survivors with severe upper limb disability during routine inpatient rehabilitation. Methods: Therapy provided by physiotherapists and occupational therapists to 32 stroke survivors receiving inpatient rehabilitation over 20 weekdays was recorded. Dose of individual and group therapy was analysed by discipline and severity of upper and lower limb disability. Dose and content of individual therapy was also analysed by functional domain. Results: On average, 46 minutes of individual and 11 minutes of group upper limb therapy were provided per participant, per day. Occupational therapists provided a higher dose of both individual and group therapy compared to physiotherapists (p < 0.0005). Findings suggest that greater residual upper and lower limb movement can lead to provision of a higher dose of activity-related therapy. Within individual therapy, a higher dose (29 versus 17 minutes, p < 0.002) and greater number (1218 versus 549) of impairment- than activity-related interventions were administered. Conclusions: The dose of activity-related upper limb therapy provided to stroke survivors with severe disability was limited. There is a need to identify interventions and models of service delivery that can increase the intensity and appropriateness of therapy that stroke survivors with severe disability undertake during inpatient rehabilitation.
Keyword Dose
Occupational therapy
Physiotherapy
Stroke
Upper limb
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID PB 09B 4847
ID511241
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
 
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