Stroke rehabilitation: Does the therapy area provide a physical challenge?

It has been previously shown that stroke patients undergoing rehabilitation perform most physical activity under the supervision of a therapist when in the therapy area and very little activity when elsewhere. The aim of this paper was to identify conditions surrounding the performance of physical activity in the therapy area, in order to design strategies which would increase physical activity throughout the rehabilitation unit. Sixteen hemiplegic patients were observed in the therapy area. They were most active when with a therapist, whereas when alone, nearly two-thirds of their time was spent inactive. It appears that it is too difficult for patients to bridge the gap between fully-supervised and unsupervised practice. Strategies to provide patients with semi-supervised practice as a way of increasing the amount of overall physical activity, such as group sessions, are explored.