The American Journal of Occupational Therapy 369 Occupational Therapy Activities and Intervention Techniques for Clients With Stroke in Six Rehabilitation Hospitals Nancy K. Latham, Diane U. Jette, Wendy Coster, Lorie Richards, Randall J. Smout, Roberta A. James, Julie Gassaway, Susan D. Horn OBJECTIVE. To prospectively monitor occupational therapy activities and intervention techniques used dur- ing inpatient stroke rehabilitation in order to provide a description of current clinical practice. METHODS. Data were collected prospectively from 954 clients with stroke receiving occupational therapy from six U.S. rehabilitation hospitals. Descriptive statistics summarized frequency, intensity, and duration of occupational therapy sessions; proportion of time spent in 16 therapeutic activities; and proportion of those activities that included any of 31 interventions. RESULTS. Clients received on average 11.8 days (SD = 7.2) of occupational therapy, with each session last- ing on average 39.4 min (SD = 16.9). Upper-extremity control (22.9% of treatment time) and dressing (14.2% of treatment time) were the most frequently provided activities. Interventions provided most frequently during upper-extremity control activities were strengthening, motor learning, and postural awareness. CONCLUSION. Occupational therapy provided reflected an integration of treatment approaches. Upper- extremity control and basic activities of daily living were the most frequent activities. A small proportion of ses- sions addressed community integration. Latham, N. K., Jette, D. U., Coster, W., Richards, L., Smout, R. J., James, R. A., Gassaway, J., & Horn, S. D. (2006). Occupational therapy activities and intervention techniques for clients with stroke in six rehabilitation hospitals. American Journal of Occupational Therapy, 60, 369–378. S troke is the third largest cause of death and one of the leading causes of long- term disability in the United States (Centers for Disease Control and Prevention, 2000). Significant progress has been made in stroke care over the past 30 years and as a result the proportion of people who survive a stroke has increased (Centers for Disease Control and Prevention, 2000). It is now well established that differences in post-stroke care and rehabilitation have a significant effect on out- come, with one systematic review finding that clients who received organized inpa- tient care in a stroke unit were more likely to be alive, independent, and living at home 1 year after the stroke (Stroke Unit Trialists’ Collaboration, 2003). However, despite evidence that post-stroke care influences outcomes, the ideal activities or approaches to treatment that should be included in stroke rehabilitation are still not well established (Wade & de Jong, 2000). Occupational therapists play an important role in post-stroke rehabilitation. The National Board for Certification in Occupational Therapy (NBCOT) Practice Analysis reported that cerebrovascular accident was the most frequent diagnosis seen by their survey respondents (NBCOT, 2004). Several recent systematic reviews suggest that occupational therapy after a stroke improves the performance of some functional tasks and reduces some impairments (Ma & Trombly, 2002; Steultjens et al., 2003; Trombly & Ma, 2002). However, most trials provide few details about the range of occupational therapy interventions and activities that were used across the rehabilitation episode. Few observational studies exist that describe the nature of occupational thera- py interventions currently being used for stroke rehabilitation in the United States. Most studies to date have been conducted in countries outside the United States (Alexander, Bugge, & Hagen, 2001; Ballinger, Ashburn, Low, & Roderick, 1999; Nancy K. Latham, PhD, is Research Assistant Professor, Health and Disability Research Institute, Boston University, 53 Bay State Road, Boston, Massachusetts 02215; nlatham@bu.edu Diane U. Jette, DSc, PT, is Professor and Program Director, Physical Therapy Program, Simmons College, Boston, Massachusetts. Wendy Coster, PhD, OTR, is Associate Professor and Program Director, Therapeutic Studies and Occupational Therapy, Boston University, Boston, Massachusetts. Lorie Richards, PhD, OTR, is Research Health Scientist, Veterans Affairs Research Service at the Brain Rehabilitation Research Center, North Florida/South Georgia Department of Veterans Affairs Medical Center, Gainesville, Florida; and Associate Professor, Occupational Therapy Department, University of Florida, Gainesville, Florida. Randall J. Smout, MS, is Senior Analyst, International Severity Information Systems, Inc., Salt Lake City, Utah. Roberta A. James is Data Systems Specialist, International Severity Information Systems, Inc., Salt Lake City, Utah. Julie Gassaway, MS, RN, is Director of Project/Product Development, International Severity Information Systems, Inc., Salt Lake City, Utah. Susan D. Horn, PhD, is Vice President for Research, International Severity Information Systems, Inc., Salt Lake City, Utah. DownloadedFrom:http://ajot.aota.org/pdfaccess.ashx?url=/data/journals/ajot/930161/on10/17/2018TermsofUse:http://AOTA.org/terms