Goal-oriented instructions increase the intensity of practice in stroke rehabilitation compared with non-specific instructions : A within-participant, repeated measures experimental study

Journal article


Hillig, Tessa Rose, Ma, Haotian and Dorsch, Simone. (2019) Goal-oriented instructions increase the intensity of practice in stroke rehabilitation compared with non-specific instructions : A within-participant, repeated measures experimental study. Journal of Physiotherapy. 65(2), pp. 95-98. https://doi.org/10.1016/j.jphys.2019.02.007
AuthorsHillig, Tessa Rose, Ma, Haotian and Dorsch, Simone
Abstract

Questions
In stroke rehabilitation, do goal-oriented instructions increase the intensity of practice during therapy compared to a non-specific instruction? Is one type of goal-oriented instruction more effective at increasing the intensity of practice achieved by stroke survivors during therapy?

Design
A within-participant, repeated measures experimental study.

Participants
Twenty-four adults undertaking stroke rehabilitation at a metropolitan hospital as an inpatient or outpatient.

Intervention
Participants were observed performing exercises across 3 days. On each day, they performed an exercise with a non-specific instruction (‘do some [exercise]’) as a baseline measure and the same exercise with one of three goal-oriented instructions, delivered in a randomised order. The three goal-oriented instructions were: ‘do [exercise] 25 times’ (instruction A), ‘do [exercise] 25 times as fast as you can’ (instruction B), and ‘do [exercise] 25 times, as fast as you can, aiming for a personal best’ (instruction C). The last instruction included verbal encouragement during the exercise.

Outcome measures
The time taken to complete 25 repetitions under the baseline condition and each instruction was recorded and converted into repetitions per minute.

Results
All of the goal-oriented instructions resulted in a significant increase in the rate of repetitions of the exercise being performed compared to the baseline measure: percentage increase from baseline (95% CI) was 62% (31 to 93) with instruction A, 116% (67 to 165) with instruction B, and 128% (84 to 171) with instruction C. Instruction C had a significantly greater effect than instruction A: mean difference in percentage increase 65% (95% CI 13 to 118).

Conclusion
Goal-oriented instructions can result in significant increases in the rate of repetitions of exercise in stroke rehabilitation. The use of goal-oriented instructions is a simple, no-cost strategy that can be used to increase the intensity of practice in stroke rehabilitation.

Trial registration
ACTRN12619000146190.

Keywordsstroke; practice; communication; rehabilitation; physical therapy
Year2019
JournalJournal of Physiotherapy
Journal citation65 (2), pp. 95-98
PublisherAustralian Physiotherapy Association
ISSN1836-9553
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jphys.2019.02.007
Scopus EID2-s2.0-85063208443
Open accessPublished as ‘gold’ (paid) open access
Research or scholarlyResearch
Page range95-98
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online2019
Publication process dates
Deposited02 Jun 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8w231/goal-oriented-instructions-increase-the-intensity-of-practice-in-stroke-rehabilitation-compared-with-non-specific-instructions-a-within-participant-repeated-measures-experimental-study

Download files


Publisher's version
OA_Hillig_2019_Goal_oriented_instructions_increase_the_intensity.pdf
License: CC BY-NC-ND 4.0
File access level: Open

  • 1
    total views
  • 0
    total downloads
  • 0
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Digitally enabled aged care and neurological rehabilitation to enhance outcomes with Activity and MObility UsiNg Technology (AMOUNT) in Australia : A randomised controlled trial
Hassett, Leanne, van den Berg, Maayken, Lindley, Richard I., Crotty, Maria, McCluskey, Annie, van der Ploeg, Hidde P., Smith, Stuart T., Schurr, Karl, Howard, Kirsten, Hackett, Maree L., Killington, Maggie, Bongers, Bert, Togher, Leanne, Treacy, Daniel, Dorsch, Simone, Wong, Siobhan, Scrivener, Katharine, Chagpar, Sakina, Weber, Heather, ... Sherrington, Catherine. (2020) Digitally enabled aged care and neurological rehabilitation to enhance outcomes with Activity and MObility UsiNg Technology (AMOUNT) in Australia : A randomised controlled trial. PLoS Medicine. 17(2), pp. 1-24. https://doi.org/10.1371/journal.pmed.1003029
Functional electrical stimulation+iPad-based music therapy for upper limb recovery after stroke : Study protocol for a mixed methods randomised controlled trial
Silveira, Tanya Marie, Dorsch, Simone, Thompson, Grace and Tamplin, Jeanette. (2020) Functional electrical stimulation+iPad-based music therapy for upper limb recovery after stroke : Study protocol for a mixed methods randomised controlled trial. Nordic Journal of Music Therapy. pp. 1-24. https://doi.org/10.1080/08098131.2020.1795704
Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke : A systematic review
Scrivener, Katharine, Dorsch, Simone, McCluskey, Annie, Schurr, Karl, Graham, Petra L., Cao, Zheng, Shepherd, Roberta and Tyson, Sarah. (2020) Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke : A systematic review. Journal of Physiotherapy. 66(4), pp. 225-235. https://doi.org/10.1016/j.jphys.2020.09.008
Two weeks of intensive sit-to-stand training in addition to usual care improves sit-to-stand ability in people who are unable to stand up independently after stroke : A randomised trial
de Sousa, Davide G., Harvey, Lisa A., Dorsch, Simone, Varettas, Bronwyn, Jamieson, Serena, Murphy, Abby and Giaccari, Sarah. (2019) Two weeks of intensive sit-to-stand training in addition to usual care improves sit-to-stand ability in people who are unable to stand up independently after stroke : A randomised trial. Journal of Physiotherapy. 65(3), pp. 152-158. https://doi.org/10.1016/j.jphys.2019.05.007
In inpatient rehabilitation, large amounts of practice can occur safely without direct therapist supervision : An observational study
Dorsch, Simone, Weeks, Kevin, King, Laura and Polman, Etesa. (2019) In inpatient rehabilitation, large amounts of practice can occur safely without direct therapist supervision : An observational study. Journal of Physiotherapy. 65(1), pp. 23-27. https://doi.org/10.1016/j.jphys.2018.11.004
Progressive resistance training increases strength after stroke but this may not carry over to activity: a systematic review
Simone Dorsch, Louise Ada and Daniella Alloggia. (2018) Progressive resistance training increases strength after stroke but this may not carry over to activity: a systematic review. Journal of Physiotherapy. 64(2), pp. 84-90. https://doi.org/10.1016/j.jphys.2018.02.012
Interventions involving repetitive practice improve strength after stroke: A systematic review
Davide G. de Sousa, Lisa A Harvey, Simone Dorsch and Joanne V Glinsky. (2018) Interventions involving repetitive practice improve strength after stroke: A systematic review. Journal of Physiotherapy. 64(4), pp. 210-221. https://doi.org/10.1016/j.jphys.2018.08.004
Feasibility of a nurse-led weekend group exercise program for people after stroke
Scrivener, Katharine, Tourany, Raymond, McNamara-Holmes, Mary, Schurr, Karl, Dorsch, Simone and Dean, Catherine. (2017) Feasibility of a nurse-led weekend group exercise program for people after stroke. Stroke Research and Treatment. 2017, pp. 1 - 7. https://doi.org/10.1155/2017/4574385
Effect of affordable technology on physical activity levels and mobility outcomes in rehabilitation: A protocol for the Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial
Hassett, Leanne, van den Berg, Maayken, Lindley, Richard I., Crotty, Maria, McCluskey, Annie, van der Ploeg, Hidde P., Smith, Stuart T., Schurr, Karl, Killington, Maggie, Bongers, Bert, Howard, Kirsten, Heritier, Stephane, Togher, Leanne, Hackett, Maree, Treacy, Daniel, Dorsch, Simone Lise, Wong, Siobhan, Scrivener, Katharine, Chagpar, Sakina, ... Sherrington, Catherine. (2016) Effect of affordable technology on physical activity levels and mobility outcomes in rehabilitation: A protocol for the Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial. BMJ Open. 6(6), pp. 1 - 9. https://doi.org/10.1136/bmjopen-2016-012074
EMG-triggered electrical stimulation is a feasible intervention to apply to multiple arm muscles in people early after stroke, but does not improve strength and activity more than usual therapy: A randomized feasibility trial
Dorsch, Simone Lise, Ada, Louise and Canning, Colleen. (2014) EMG-triggered electrical stimulation is a feasible intervention to apply to multiple arm muscles in people early after stroke, but does not improve strength and activity more than usual therapy: A randomized feasibility trial. Clinical Rehabilitation. 28(5), pp. 482 - 490. https://doi.org/10.1177/0269215513510011
The strength of the ankle dorsiflexors has a significant contribution to walking speed in people who can walk independently after stroke : an observational study
Dorsch, Simone, Ada, Louise, Canning, Colleen, Al-Zharani, Matar and Dean, Catherine. (2012) The strength of the ankle dorsiflexors has a significant contribution to walking speed in people who can walk independently after stroke : an observational study. Archives of Physical Medicine and Rehabilitation. 93(6), pp. 1072 - 1076. https://doi.org/10.1016/j.apmr.2012.01.005
Group exercise can improve participants' mobility in an outpatient rehabilitation setting: A randomized controlled trial
Sherrington, Catherine, Pamphlett, Patricia I., Jacka, Jennifer A., Olivetti, Lynnette M., Nugent, Julie A., Hall, Jillian M., Dorsch, Simone Lise, Kwan, Marcella Mun-San and Lord, Stephen R.. (2008) Group exercise can improve participants' mobility in an outpatient rehabilitation setting: A randomized controlled trial. Clinical Rehabilitation. 22(6), pp. 493 - 502. https://doi.org/10.1177/0269215508087994
Strengthening interventions increase strength and improve activity after stroke: a systematic review
Ada, Louise, Dorsch, Simone Lise and Canning, Colleen G.. (2006) Strengthening interventions increase strength and improve activity after stroke: a systematic review. Australian Journal of Physiotherapy. 52(4), pp. 241 - 248. https://doi.org/10.1016/S0004-9514(06)70003-4