title: Content of conventional therapy for the severely affected arm during subacute rehabilitation after stroke: An analysis of physiotherapy and occupational therapy practice.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  46 patients after stroke with poor arm motor control recruited from inpatient neurological units from three rehabilitation centers in the Netherlands.
  
  
  METHODS
  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.
authors.affiliation: Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, The Netherlands.|Institute for Applied Health Research, School for Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Lex D
authors.initials: LD
authors.lastname: de Jong
authors.affiliation: Institute for Applied Health Research, School for Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Frederike
authors.initials: F
authors.lastname: van Wijck
authors.affiliation: Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Roy E
authors.initials: RE
authors.lastname: Stewart
authors.affiliation: Department of Rehabilitation, Donders Center for Neuroscience, Radboud University Medical Center Nijmegen, The Netherlands.
authors.forename: Alexander C H
authors.initials: ACH
authors.lastname: Geurts
authors.affiliation: Department of Rehabilitation Medicine, and Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009788:Occupational Therapy / Q000379:methods*; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D000071939:Stroke Rehabilitation / Q000379:methods*
keywords: Disability and Health; International Classification of Functioning; physical therapy modalities; stroke; upper extremity