Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice

Lex D de Jong; Frederike van Wijck; Roy E Stewart; Alexander C H Geurts; Pieter U Dijkstra

doi:10.1002/pri.1683

Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice

Lex D de Jong
, Frederike van Wijck
, Roy E Stewart
, Alexander C H Geurts
, Pieter U Dijkstra

EXtremities Pain Active lifestyle aNd Disability (EXPAND)

Research output: Contribution to journal › Article › Academic › peer-review

13 Citations (Scopus)

260 Downloads (Pure)

Abstract

BACKGROUND AND PURPOSE: Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions.

METHODS: Design: This is a retrospective analysis of randomized trial data.

PARTICIPANTS: 46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands.

PROCEDURE: PTs and OTs recorded duration and content of arm treatment interventions for 8 weeks using a bespoke treatment schedule with 15 International Classification of Human Functioning, Disability and Health categories.

RESULTS: PTs and OTs spent on average 4-7 min per treatment session (30 min) on arm treatment. OTs spent significantly more time providing arm treatment and treatment at the activities level than PTs. PTs spent 79% of their arm treatment time on body functions, OTs 41%. OTs spent significantly more time on "moving around using transportation," "self care," and "household tasks" categories.

CONCLUSIONS: Patients after stroke with a severely affected arm and an unfavorable prognosis for arm motor recovery receive little arm-oriented PT and OT. Therapists spent most arm treatment time on body functions. There was a considerable overlap in the content of PT and OT in 12 of the 15 categories. Results can be generalized only to patients with poor arm motor control and may not represent practice in other countries.

Original language	English
Article number	e1683
Number of pages	8
Journal	Physiotherapy research international : the journal for researchers and clinicians in physical therapy
Volume	23
Issue number	1
Early online date	16-Jan-2017
DOIs	https://doi.org/10.1002/pri.1683
Publication status	Published - Jan-2018

Keywords

FACILITIES
COMPONENTS
UPPER-LIMB
MOTOR RECOVERY
BLACK-BOX
UNIT CARE
INTERVENTIONS
OUTCOMES

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de Jong, L. D., van Wijck, F., Stewart, R. E., Geurts, A. C. H., & Dijkstra, P. U. (2018). Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice. Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 23(1), Article e1683. https://doi.org/10.1002/pri.1683

@article{a8812444132c41239fea2f5d75078971,

title = "Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice",

abstract = "BACKGROUND AND PURPOSE: Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions.METHODS: Design: This is a retrospective analysis of randomized trial data.PARTICIPANTS: 46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands.PROCEDURE: PTs and OTs recorded duration and content of arm treatment interventions for 8 weeks using a bespoke treatment schedule with 15 International Classification of Human Functioning, Disability and Health categories.RESULTS: PTs and OTs spent on average 4-7 min per treatment session (30 min) on arm treatment. OTs spent significantly more time providing arm treatment and treatment at the activities level than PTs. PTs spent 79\% of their arm treatment time on body functions, OTs 41\%. OTs spent significantly more time on {"}moving around using transportation,{"} {"}self care,{"} and {"}household tasks{"} categories.CONCLUSIONS: Patients after stroke with a severely affected arm and an unfavorable prognosis for arm motor recovery receive little arm-oriented PT and OT. Therapists spent most arm treatment time on body functions. There was a considerable overlap in the content of PT and OT in 12 of the 15 categories. Results can be generalized only to patients with poor arm motor control and may not represent practice in other countries.",

keywords = "FACILITIES, COMPONENTS, UPPER-LIMB, MOTOR RECOVERY, BLACK-BOX, UNIT CARE, INTERVENTIONS, OUTCOMES",

author = "\{de Jong\}, \{Lex D\} and \{van Wijck\}, Frederike and Stewart, \{Roy E\} and Geurts, \{Alexander C H\} and Dijkstra, \{Pieter U\}",

note = "Copyright {\textcopyright} 2017 John Wiley \& Sons, Ltd.",

year = "2018",

month = jan,

doi = "10.1002/pri.1683",

language = "English",

volume = "23",

journal = "Physiotherapy research international : the journal for researchers and clinicians in physical therapy",

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de Jong, LD, van Wijck, F, Stewart, RE, Geurts, ACH & Dijkstra, PU 2018, 'Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice', Physiotherapy research international : the journal for researchers and clinicians in physical therapy, vol. 23, no. 1, e1683. https://doi.org/10.1002/pri.1683

Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice. / de Jong, Lex D; van Wijck, Frederike; Stewart, Roy E et al.
In: Physiotherapy research international : the journal for researchers and clinicians in physical therapy, Vol. 23, No. 1, e1683, 01.2018.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke

T2 - An analysis of physiotherapy and occupational therapy practice

AU - de Jong, Lex D

AU - van Wijck, Frederike

AU - Stewart, Roy E

AU - Geurts, Alexander C H

AU - Dijkstra, Pieter U

PY - 2018/1

Y1 - 2018/1

N2 - BACKGROUND AND PURPOSE: Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions.METHODS: Design: This is a retrospective analysis of randomized trial data.PARTICIPANTS: 46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands.PROCEDURE: PTs and OTs recorded duration and content of arm treatment interventions for 8 weeks using a bespoke treatment schedule with 15 International Classification of Human Functioning, Disability and Health categories.RESULTS: PTs and OTs spent on average 4-7 min per treatment session (30 min) on arm treatment. OTs spent significantly more time providing arm treatment and treatment at the activities level than PTs. PTs spent 79% of their arm treatment time on body functions, OTs 41%. OTs spent significantly more time on "moving around using transportation," "self care," and "household tasks" categories.CONCLUSIONS: Patients after stroke with a severely affected arm and an unfavorable prognosis for arm motor recovery receive little arm-oriented PT and OT. Therapists spent most arm treatment time on body functions. There was a considerable overlap in the content of PT and OT in 12 of the 15 categories. Results can be generalized only to patients with poor arm motor control and may not represent practice in other countries.

AB - BACKGROUND AND PURPOSE: Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions.METHODS: Design: This is a retrospective analysis of randomized trial data.PARTICIPANTS: 46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands.PROCEDURE: PTs and OTs recorded duration and content of arm treatment interventions for 8 weeks using a bespoke treatment schedule with 15 International Classification of Human Functioning, Disability and Health categories.RESULTS: PTs and OTs spent on average 4-7 min per treatment session (30 min) on arm treatment. OTs spent significantly more time providing arm treatment and treatment at the activities level than PTs. PTs spent 79% of their arm treatment time on body functions, OTs 41%. OTs spent significantly more time on "moving around using transportation," "self care," and "household tasks" categories.CONCLUSIONS: Patients after stroke with a severely affected arm and an unfavorable prognosis for arm motor recovery receive little arm-oriented PT and OT. Therapists spent most arm treatment time on body functions. There was a considerable overlap in the content of PT and OT in 12 of the 15 categories. Results can be generalized only to patients with poor arm motor control and may not represent practice in other countries.

KW - FACILITIES

KW - COMPONENTS

KW - UPPER-LIMB

KW - MOTOR RECOVERY

KW - BLACK-BOX

KW - UNIT CARE

KW - INTERVENTIONS

KW - OUTCOMES

U2 - 10.1002/pri.1683

DO - 10.1002/pri.1683

M3 - Article

C2 - 28092139

SN - 1358-2267

VL - 23

JO - Physiotherapy research international : the journal for researchers and clinicians in physical therapy

JF - Physiotherapy research international : the journal for researchers and clinicians in physical therapy

IS - 1

M1 - e1683

ER -

de Jong LD, van Wijck F, Stewart RE, Geurts ACH, Dijkstra PU. Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice. Physiotherapy research international : the journal for researchers and clinicians in physical therapy. 2018 Jan;23(1):e1683. Epub 2017 Jan 16. doi: 10.1002/pri.1683

Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice

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