A Comparison of Time Use on an Acute Rehabilitation Unit: Subjects With and Without a Stroke

Physical Activity Levels During Acute Inpatient Admission After Hip Fracture are Very Low

“…Secondly, ensuring that every patient has access to their own appropriate gait aid at the bedside would encourage those patients who are mobile, to ambulate more frequently. However, hospital environments are restrictive (Tinson ), and a low functional level may limit their ability to initiate self‐directed physical activity (Bear‐Lehman et al ., ). Other strategies may involve a change in the nursing culture to encourage physical activity and facilitating patients or care givers to take responsibility for their own therapy and recovery (De Weerdt and Feys ).…”

Time Use of Stroke Patients with Stroke Admitted for Rehabilitation in Skilled Nursing Facilities

“…Several authors investigated the time use of stroke patients in different rehabilitation settings concerning therapeutic and nontherapeutic activities and reported varying results. Therapeutic activities in these studies included all therapeutic treatment and care activities that health care professionals, including nurses, carried out with the patient (Bear‐Lehman, Bassile & Gillen, ; Bernhardt, Chitravas, Meslo, Thrift & Indredavik, ; Huijben‐Schoenmakers, Gamel & Hafsteinsdottir, ; inson, ; de Weerdt et al., ; de Wit et al., ). In rehabilitation wards, stroke patients spent 23.4%–27.5% of the day on therapeutic activities (de Wit et al., ), whereas in hospitals, this time varied between 13.7%–75% of the day (Bear‐Lehman et al., ; Tinson, ).…”

“…Therapeutic activities in these studies included all therapeutic treatment and care activities that health care professionals, including nurses, carried out with the patient (Bear‐Lehman, Bassile & Gillen, ; Bernhardt, Chitravas, Meslo, Thrift & Indredavik, ; Huijben‐Schoenmakers, Gamel & Hafsteinsdottir, ; inson, ; de Weerdt et al., ; de Wit et al., ). In rehabilitation wards, stroke patients spent 23.4%–27.5% of the day on therapeutic activities (de Wit et al., ), whereas in hospitals, this time varied between 13.7%–75% of the day (Bear‐Lehman et al., ; Tinson, ). Only one small study investigated the time use of elderly stroke patients in nursing homes and showed that elderly stroke patients spend only a limited amount of time (20%) on therapeutic activities, whereas 80% of the day was spent on nontherapeutic activities.…”

Is There a Role for Meaningful Activity in Stroke Rehabilitation?

“…Behavioural mapping tools are commonly used in studies to explore the impact of therapy practices in terms of where clients are, who they are with, their activity level, type of activity, and posture on weekdays and/or weekends when in acute stroke care or rehabilitation. [13][14][15][16][17] Time use studies have found that stroke clients in rehabilitation are likely to spend between 1 and 3 hours of their day in therapy depending on staffing levels and organisational structure. 17 Research has also identified that intensity of practice outside of therapy is necessary for improvement during rehabilitation 18 and that there is a strong need for rehabilitation services to reverse the trend of clients left sitting inactive and alone for vast periods of their days.…”

“…19 One study found that clients with stroke spent more time inactive and alone on a rehabilitation unit than clients from other diagnostic groups. 13 It was hypothesised for this study that participants with stroke who were engaged in an occupation-based group program would spend significantly more time in therapy and more time in activity and interacting with others outside of formal therapy time than clients who received standard care.…”