Relationships between Occupational Therapy Practitioner Characteristics and Home Exercise Program Prescription for Clients with Neurological Injuries.
Rachel Proffitt
PMID 31411911WHAT IT FOUND
Most OTs prescribe home exercises focused on range of motion and fine motor tasks rather than daily living activities.
While experience level did not change exercise dosage, treatment setting strongly influenced which activities were chosen and when programs were started.
Key findings
01Active range of motion, fine motor activities, and active assist range of motion were the most frequently selected home exercise activities, while video games were the least common.
02There was no statistically significant relationship between treatment setting or years in practice and the dosage of home exercise programs prescribed.
03Respondents in acute care settings were more likely to prescribe home exercise programs to all clients regardless of diagnosis, whereas those in home health and community settings were less likely to do so but more likely to prescribe them earlier in treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The response rate was low (18%), which may limit the generalizability of the findings to all occupational therapy practitioners. Data on HEP dosage was self-reported and coded into minutes per week, which may not accurately capture the intensity or true nature of the exercises. Respondents provided minimal demographic information, preventing a more granular analysis of factors influencing prescription habits. The study relied on survey questions that may not have captured the clinical reasoning behind why specific activities were chosen.
The easy way to misread this
Do not interpret the lack of difference in HEP dosage across settings or experience levels as evidence that current prescribing practices are optimal or standardized. The study highlights a prevalence of preparatory activities over functional tasks, but it does not evaluate the effectiveness of these programs for patient outcomes.