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


Journal

Australian occupational therapy journal
ISSN: 1440-1630
Titre abrégé: Aust Occup Ther J
Pays: Australia
ID NLM: 15420200R

Informations de publication

Date de publication:
06 2019
Historique:
accepted: 13 12 2018
pubmed: 23 1 2019
medline: 9 6 2020
entrez: 23 1 2019
Statut: ppublish

Résumé

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 would be 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 (12 months) and six months later (18 months). 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 12 months, 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 18 months, 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.

Sections du résumé

BACKGROUND/AIM
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 would be maintained six months after the cessation of the program.
METHOD
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 (12 months) and six months later (18 months).
RESULTS
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 12 months, 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 18 months, 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).
CONCLUSION
Providing professional development was associated with increased intensity of practice in an inpatient, upper limb rehabilitation class. The increase was maintained six months later.

Identifiants

pubmed: 30666654
doi: 10.1111/1440-1630.12562
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

362-368

Informations de copyright

© 2019 Occupational Therapy Australia.

Auteurs

Emma J Schneider (EJ)

Discipline of Occupational Therapy, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.
Occupational Therapy Department, Alfred Health, Prahran, Victoria, Australia.

Natasha A Lannin (NA)

Discipline of Occupational Therapy, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.
Occupational Therapy Department, Alfred Health, Prahran, Victoria, Australia.
John Walsh Centre for Rehabilitation Research, Sydney Medical School (Northern), The University of Sydney, Sydney, New South Wales, Australia.

Louise Ada (L)

Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia.

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