A technology-enriched approach to increasing rehabilitation dose after stroke: Clinical feasibility study.

There was no control group or randomisation, so the study cannot show that the gym caused any change in function or rehabilitation dose. Usual physiotherapy, occupational therapy and speech therapy were not recorded, so the 52.0-minute sessions cannot be used to state total daily therapy dose. Only 60 patients from one acute stroke unit were consented, and 32 of 94 eligible patients were not approached. Functional outcomes were incomplete: 58 of 59 completing participants had mobility data and 32 of 59 had Therapy Outcome Measure data. Staff acceptance was based on interviews with nine staff, not on patient or carer experience, which was not analysed in this paper. Participants were sub-acute in-patients, and 41 of 60 needed equipment for transfers, so results may not apply to community or very early or very late stroke. The sessions were supervised mainly by assistant rehabilitation practitioners, not registered therapists, so the staffing model may not match all services.

The authors declared no potential conflicts of interest. Funding came from Chest Heart and Stroke Scotland, EPSRC and Sir Jules Thorn Charitable Trust, grant 20SMRD3.

Do not treat the 52.0-minute figure as proven extra daily rehabilitation or as evidence of better recovery. The study recorded average session length, not total therapy time, had no control group, and the authors did not attribute functional change to the gym.