Do clients complete physiotherapist prescribed exercises outside of structured therapy time on a rehabilitation unit?

Mr John Cannell1, Ms Amy Rathjen1, Mr Clint Freeman1

1Tasmanian Health Services North, Launceston, Australia

Physical activity during inpatient rehabilitation is crucial to improve client’s physical capacity and ability to regain independence. Activity levels outside of therapy sessions has been shown to be low in multiple published observational studies. In 2016, John L Grove (JLG) Rehabilitation Unit confirmed these findings in their own 1 day observational audit covering 0730 – 1700 hours. This showed their clients spent 67% of the audit in their bedrooms and were only physically active for 12% of bedroom observations.

 Since October 2015, to foster more activity outside of therapy, the Physiotherapists prescribed suitable clients with a customised independent and or supervised exercise program. Completion of these programs outside of structured therapy sessions were encouraged by the rehabilitation staff.

 De-identified information was collated on each program’s completion before inclusion in the client’s medical records. Ninety weeks of completion rates and repetitions of independent and supervised exercise programs (up to July 2017) have been included in this analysis.

 Each week, an average of 12.1/20 JLG clients were provided with programs. These contained an average of [supervised; independent] [1.2; 3.9] prescribed exercises. The overall average number of exercises attempted each day was [0.4 (24%); 1.1 (27%)]. There was a weekly trend of the highest attempts on Saturday [0.5 (31%); 1.5 (37%)], steadily dropping through to lowest on Friday [0.2 (17%); 0.7 (19%)]. The average daily repetitions per client in the first half of the analysis [14; 53] increased in the second half [201; 130] when walking steps or metres were included. The highest combined client weekly repetition totals in the first half of analysis [2643; 13989] increased accordingly in the second half [30560; 29865].

 Encouraging and supporting exercise outside of structured therapy is a shared team role. Understanding which exercises clients are prepared to practice may improve the percentage of exercises completed.


John is the Clinical Lead Physiotherapist – Rehabilitation for THS-N.

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