Observation of amounts of movement practice provided during stroke rehabilitation
By Catherine E. Lang, J. MacDonald, Darcy S. Reisman, Lara A. Boyd, Teresa Jacobson Kimberley, S. Schindler-Ivens, T. Hornby, S. Ross, Patricia L. Scheets. Archives of Physical Medicine and Rehabilitation, 2009
677 citations recorded by the source corpus.
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 7 inpatient and outpatient rehabilitation sites. Participants We observed a convenience sample of 312 physical and occupational therapy sessions for people with stroke. Intervention NA 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, Functional Independence Measure item scores, and years of therapist experience). Descriptive statistics were used to characterize amounts of practice. Correlation and regression analyses were used to determine if potential factors were related to the amount of practice in the two 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% 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 above accounted for significant variance in the amount of practice in either of these two categories. Conclusions The amount of practice provided during post-stroke rehabilitation is small compared to animal models. It is possible that current doses of task-specific practice during rehabilitation are not adequate to drive the neural reorganization needed to optimally promote function post stroke.
Subfields: Cognitive Neuroscience, Neurology, Rehabilitation
View Paper: https://www.semanticscholar.org/paper/63658167b1fc618ff70be21bdfb264324d696f3e
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Citations in the corpus
- Virtual Reality Therapy for Adults Post-Stroke: A Systematic Review and Meta-Analysis Exploring Virtual Environments and Commercial Games in Therapy (2014, background): “This requisite high repetition is problematic, however, because observational data show that clients generally perform a very limited number of movement repetitions in traditional therapy sessions [5].”