A professional development program increased the intensity of practice undertaken in an inpatient, upper limb rehabilitation class: A pre-post study.

Abstract

Increasing the intensity of practice is associated with improved upper limb outcomes, yet observed intensity levels during rehabilitation are low. The purpose of this study was to investigate: whether a professional development program would increase the intensity of practice undertaken in an inpatient, upper limb rehabilitation class; and whether any increase wouldbe maintained six months after the cessation of the program. A pre-post study was conducted within an existing inpatient, upper limb rehabilitation class in a metropolitan hospital. Staff received a professional development program which included: a two day theoretical, practical and clinical training workshop covering evidence-based practice for upper limb rehabilitation after stroke; and three 1-hour meetings to revise evidence-based practice and discuss implementation of strategies. Intensity of practice, as measured by the proportion of practice time per class (%) and the number of repetitions per practice time (repetitions/min) observed during the 60-minute classes during one week, was recorded at baseline, end of program (12months) and six months later (18months). Twenty-two (100%) staff attended at least one professional development program session; outcomes were measured across n=15 classes (n=30 patients). Between baseline and 12months, the mean proportion of practice time per class increased by 52% (95% confidence interval (CI) 33-70; P<0.001) and the mean number of repetitions per practice time increased by 5.1 repetitions/min (95% CI 1.7-8.4; P<0.01). Between baseline and 18months, the mean proportion of practice time per class increased by 53% (95% CI 36-69; P<0.001) and the mean number of repetitions per practice time increased by 3.9 repetitions/min (95% CI 1.9-5.9; P<0.001). Providing professional development was associated with increased intensity of practice in an inpatient, upper limb rehabilitation class. The increase was maintained six months later.