Date Presented 04/03/2025
This study used the Research Treatment Specification System (RTSS) to investigate interventions used by OT practitioners to treat stroke patients with upper extremity hemiparesis in an outpatient rehabilitation center.
Primary Author and Speaker: Abigail R. Halsey
Additional Authors and Speakers: Vanessa Kruk, Lauren Wengerd
PURPOSE: The purpose of this study was to investigate the types of treatment activities OT practitioners use to address stroke-related UE hemiparesis in an outpatient rehabilitation setting. We also sought to identify the most addressed functional deficits for adult stroke survivors with UE hemiparesis.
METHODS: A video-based observational study design was used to assess the practice patterns of OT practitioners working in outpatient rehabilitation. We enrolled two groups of participants: OT participants and patient participants with a diagnosis of stroke. We used the Rehabilitation Treatment Specification System (RTSS), a recently developed framework for describing rehabilitation interventions, to guide our analyses. Briefly, the RTSS describes three types of potential treatment activities: 1) Organ Function, which includes interventions targeting an organ system or physiological function, 2) Skills and Habits, which includes functional and task-oriented activities, and 3) Representations which are activities that attempt to influence a patient’s motivation, attitude, or knowledge.
RESULTS: Treatment activities belonging to the Skills and Habits group were most observed, followed by Organ Function, then Representations. Skills and Habits interventions made up 59% of the overall treatment observed and occurred in 26/30 (87%) sessions. While Representations activities occurred in 14/30 sessions (47%), they occurred for very short amounts of time and accounted for only 3.0% of the overall treatment time observed.
CONCLUSIONS: These results demonstrate that OT practitioners are increasingly using task-oriented training, such as those that fall under the Skills and Habits category of the RTSS, to address UE hemiparesis in stroke survivors. These findings could be used to inform future research directions in stroke rehabilitation and help provide a rationale for the types of interventions provided in control groups of randomized controlled trials in this field.
References
Hart, T., Whyte, J., Dijkers, M., Packel, A., Turkstra, L., Zanca, J., … Van Stan, J. (2019). Manual of Rehabilitation Treatment Specification. (Journal Article). Retrieved from http://mrri.org/innovations/manual-for-rehabilitation-treatmentspecification/
Lohse, K. R., Pathania, A., Wegman, R., Boyd, L. A., & Lang, C. E. (2018). On the reporting of experimental and control therapies in stroke rehabilitation trials: A 160 systematic review. Archives of Physical Medicine and Rehabilitation, 99(7), 1424–1432.
Van Stan, J. H., Dijkers, M. P., Whyte, J., Hart, T., Turkstra, L. S., Zanca, J. M., & Chen, C. (2019). The Rehabilitation Treatment Specification System: Implications for improvements in research design, reporting, replication, and synthesis. Archives of Physical Medicine and Rehabilitation, 100(1), 146–155.
