Document Detail


Observation of amounts of movement practice provided during stroke rehabilitation.
MedLine Citation:
PMID:  19801058     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Catherine E Lang; Jillian R Macdonald; Darcy S Reisman; Lara Boyd; Teresa Jacobson Kimberley; Sheila M Schindler-Ivens; T George Hornby; Sandy A Ross; Patricia L Scheets
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  90     ISSN:  1532-821X     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-10-22     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1692-8     Citation Subset:  AIM; IM    
Affiliation:
Program in Physical Therapy, Program in Occupational Therapy, and Department of Neurology, Washington University, St. Louis, MO, USA. langc@wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Female
Humans
Lower Extremity / physiopathology*
Male
Middle Aged
Movement*
Occupational Therapy / methods*
Physical Therapy Modalities*
Recovery of Function
Stroke / physiopathology,  rehabilitation*
Time Factors
Upper Extremity / physiopathology*
Grant Support
ID/Acronym/Agency:
HD047669/HD/NICHD NIH HHS; K01 HD047669-03/HD/NICHD NIH HHS; K01 HD047669-04/HD/NICHD NIH HHS; K01 HD047669-05/HD/NICHD NIH HHS
Comments/Corrections
Comment In:
Arch Phys Med Rehabil. 2010 Apr;91(4):665-6   [PMID:  20382307 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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