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

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.