How do you determine your dose?

#ds286 repetition

It has been a rather chaotic few months, but our condo in Seattle sold and we are now settled in an apartment in Minneapolis. The residency has started (practice paperwork is very different here).

Last Tuesday I met with Dr. Kimberley and discussed two papers. The first was an observation of the number of repetitions performed during stroke rehab, and the second was looking at stroke and TBI. They were both interesting reads and provoked good discussion (her expertise is in neuro). Why do new grads and the most experienced do the least number of repetitions, and no one approaches anywhere near the number of repetitions recommended for neuro rehab/ recovery? They definitely got me thinking, and examining my own practice pattern and approach.

We also talked about various aspects of skilled nursing and ortho, and are talking about doing a single-subject design looking at dose/ repetitions in their rehab. I just finished my draft of Aging in America (I may post it here), so my plan for tomorrow evening is searching the literature for hip fracture rehab, starting with the recent Cochrane review. Stay tuned!

Addendum: the two papers we discussed were:

  1. Lang CE, MacDonald JR, Reisman DS, Boyd L, Jacobson Kimberley T, Schindler-Ivens SM, HOrnby TG, Ross SA, Scheets PL.  Observation of amounts of movement practice provided during stroke rehabilitation.  Arch Phys Med Rehabil 2009;90:1692-8.
  2. Jacobson Kimberley T, Samargia S, Moore LG, Shakya JK, Lang CE.  Comparison of amounts and types of practice during rehabilitation for traumatic brain injury and stroke.  J Rehabil Res Dev. 2010;47:851-62.

 

Photo credit: #ds286 repetition, originally uploaded by rosipaw

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