Faculty Collaboration Database

Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil 2009 Oct;90(10):1692-8

Date

10/06/2009

Pubmed ID

19801058

Pubmed Central ID

PMC3008558

DOI

10.1016/j.apmr.2009.04.005

Scopus ID

2-s2.0-70350498770 (requires institutional sign-in at Scopus site)   498 Citations

Abstract

UNLABELLED: Lang CE, MacDonald JR, Reisman DS, Boyd L, Jacobson Kimberley T, Schindler-Ivens SM, Hornby TG, Ross SA, Scheets PL. Observation of amounts of movement practice provided during stroke rehabilitation.

OBJECTIVE: To investigate how much movement practice occurred during stroke rehabilitation, and what factors might influence doses of practice provided.

DESIGN: Observational survey of stroke therapy sessions.

SETTING: Seven inpatient and outpatient rehabilitation sites.

PARTICIPANTS: We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: We recorded numbers of repetitions in specific movement categories and data on potential modifying factors (patient age, side affected, time since stroke, FIM item scores, years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were used to determine whether potential factors were related to the amount of practice in the 2 important categories of upper extremity functional movements and gait steps.

RESULTS: Practice of task-specific, functional upper extremity movements occurred in 51% of the sessions that addressed upper limb rehabilitation, and the average number of repetitions/session was 32 (95% confidence interval [CI]=20-44). Practice of gait occurred in 84% of sessions that addressed lower limb rehabilitation and the average number of gait steps/session was 357 (95% CI=296-418). None of the potential factors listed accounted for significant variance in the amount of practice in either of these 2 categories.

CONCLUSIONS: The amount of practice provided during poststroke rehabilitation is small compared with animal models. It is possible that current doses of task-specific practice during rehabilitation are not adequate to drive the neural reorganization needed to promote function poststroke optimally.

Author List

Lang CE, Macdonald JR, Reisman DS, Boyd L, Jacobson Kimberley T, Schindler-Ivens SM, Hornby TG, Ross SA, Scheets PL

Author

Sheila Schindler-Ivens PhD Assistant Professor in the Physical Therapy department at Marquette University

MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Aged, 80 and over
Female
Humans
Lower Extremity
Male
Middle Aged
Movement
Occupational Therapy
Physical Therapy Modalities
Recovery of Function
Stroke
Stroke Rehabilitation
Time Factors
Upper Extremity