1000 reps a day - the use of strategies to increase intensity of practice in rehabilitation

Background: To optimise outcomes after stroke large amounts of practice
are required. In fact hundreds of repetitions per day may be essential.
However, stroke survivors in rehabilitation spend the majority of their
day inactive and only a small part of their day engaged in active practice.
Therapists can increase the opportunities available to stroke survivors to
practice in several ways including; encouraging stroke survivors to spend
large parts of the day in the therapy area while the therapists assist
several stroke survivors at any one time, running classes and groups
and involving families in therapy.
Aims: To quantify therapists’ current use of strategies that have the potential
to increase opportunities for stroke survivors in rehabilitation to do
intensive practice.
Methods: A survey of physiotherapists and occupational therapists working
in rehabilitation units in Australia was undertaken. The survey contained
questions about the delivery of services in their workplace.
Results: The survey was responded to by 214 therapists working in
rehabilitation. The majority of therapists (58%) work with one stroke
survivor at a time, with those stroke survivors spending less than one
hour a day in the therapy area. The majority of therapists (67%) do not
routinely involve families in practice. A small proportion of therapists
(11%) run classes and groups daily. The majority of therapists (77%)
report that stroke survivors are completing less than 100 repetitions
of practice per day.
Conclusion: Therapists are not routinely using strategies to increase the
opportunities provided to stroke survivors to practice intensively in
rehabilitation.