How coaching supports stroke survivors to keep practising their recovery activities

First published online 8 Dec 2024.

Why this study was done

Recovering from a stroke takes time, effort, and a lot of practice. Stroke survivors need to keep practicing exercises long after they leave the hospital to regain function and independence. But many struggle to keep going once they’re on their own. This study looked at how therapists in a hospital setting use coaching strategies to help stroke survivors stay motivated and continue practicing over the long term.

What the study did

The researchers observed 36 therapy sessions involving 12 stroke survivors and 22 therapists at a rehabilitation hospital in Queensland, Australia. They used a custom tool to record what therapists did every 3 minutes during each session, focusing on:

• The setting and type of therapy
• Coaching strategies used to encourage perseverance
• Use of motor learning principles (like giving feedback or setting goals)

What the study found

Coaching was common but practice was mostly therapist led. Coaching strategies were used in about 77% of the observed time.

The most common strategies were:

• Monitoring the quality of practice
• Setting up exercises
• Tracking how much practice was done

The least used strategies were:

• Setting long-term goals
• Helping patients practice outside of therapy
• Involving family or support people

Goal setting was limited

• Goals were set in only half the sessions.
• Most goals were short-term, therapist-driven, and not created in collaboration with the patient.

Motor learning techniques were used

• Therapists often gave verbal instructions and feedback.
• Feedback was mostly general encouragement, not specific advice on performance.
• Performance was usually measured by counting repetitions.

What this means

Therapists are doing a good job of guiding stroke survivors during therapy sessions. But they’re not doing as much to help stroke survivors continue practicing on their own or with support from family. This could make it harder for stroke survivors to stay motivated and keep improving after they leave the hospital.

To help stroke survivors recover more fully, therapists should focus more on coaching strategies that prepare them for independent practice — like setting meaningful goals, involving family, and encouraging practice in everyday life.

This study was conducted by:

Dr. Bridee Neibling, Dr. Moira Smith, Prof. Ruth N Barker, A.Prof. Kathryn S Hayward

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Disclaimer: The QDRN has utilised generative AI to refine the wording of this plain language summary. All content has been checked for accuracy, appropriate tone and clarity and approved by the author.