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
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