No abstract

Activating therapy advanced stroke patients' cognitive and physical functional recovery and supported their return to independent life at home more than did traditional physiotherapy. In this respect activating therapy seems to have a beneficial influence on long-term stroke rehabilitation.

No abstract

The interaction between clinical educators and students is regarded as the strongest element in developing expertise and in forming students' professional identity in clinical education. Although clinical education has been studied in physiotherapy, the natural interaction between clinical educators and students has remained unanalyzed. The aim of this study was to examine how supervised learning sessions during patient treatment were constructed. The focus was on the forms of interaction between clinical educators and students in natural contexts. By videotaping 12 natural patient treatment sessions, which simultaneously comprised part of the clinical education of physiotherapy students, and by using qualitative discourse analysis, three supervision discourses emerged from the data: "directing the interaction," "making limited room for the student," and "encouraging the student's participation." This study revealed that clinical educators have a dominant role in constructing supervised learning sessions during patient treatment. Depending on how the interaction is constructed, it is possible to support or prevent student participation in decision making as well as to promote or reject the rehearsal of critical thinking or self-directed learning among students. This study highlighted the importance of interactional skills in supervision practices. More research into constructing learning sessions in clinical education is needed.

Reintegration into society is one of the main purposes of post-stroke rehabilitation. The experiences of clients returning home after a stroke have been studied before. There is, however, little knowledge about activities carried out during home-based rehabilitation interventions and about the involvement of clients in the process. This study focused on clients' experiences of a 3-month individualised, home-based rehabilitation programme supervised by a multidisciplinary team. The data were collected in 2009-2010, and it was based on interviews with 14 clients (48-83 years of age) conducted approximately 7 months after stroke. In the thematic analysis, five main topics describing the goals and functions of the home-based rehabilitation were identified as follows: (i) learning strategies for solving problems in daily activities at home and in the community; (ii) receiving exercise coaching; (iii) exploring community services and facilities; (iv) having a dialogue with professionals; and (v) engaging in activities aimed at returning to work. Implementing rehabilitation activities in the home environment seemed to enhance the participants' active involvement and their ability to evaluate themselves and to set goals for their recovery. Work was an important goal for clients of working age, but work-related tasks were not sufficiently integrated with home-based rehabilitation. A challenge for local communities is to provide health promotion and recreation services that are also suitable for persons with limited functioning.