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Research Article  |   September 1996
The Effects of an Occupationally Embedded Exercise on Bilaterally Assisted Supination in Persons with Hemiplegia
David L. Nelson; Kathy Konosky; Kathleen Fleharty; Ruth Webb; Kristin Newer; Virginia P. Hazboun; Cheryl Fontane; Brian C. Licht
Author Affiliations
  • David L. Nelson, PhD, OTR, FAOTA, is Professor, Department of Occupational Therapy, School of Allied Health, Medical College of Ohio, Toledo, Ohio 43699
  • Kathy Konosky, MS, OTR, is Clinical Specialist, Occupational Therapy Division, Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor, Michigan
  • Kathleen Fleharty, OTR, is Occupational Therapist, Mercy Home Health, Sacramento, California
  • Ruth Webb, MA, OTR, is Occupational Therapist in independent practice, Wichita Falls, Texas
  • Kristin Newer, OTR, is Private Contractor to school systems and clinics in Southeastern Michigan
  • Virginia P. Hazboun, OTR, is Clinical Instructor, Occupational Therapy, Rancho Los Amigos Medical Center, Downey, California, and is in private practice, Bellflower, California
  • Cheryl Fontane, OTR, is Occupational Therapist, French Hospital–Transitional Care, San Luis Obispo, California
  • Brian C. Licht, MS, OTR/L, is Occupational Therapist, Work Fitness Center, Moline, Illinois
Article Information
Complementary/Alternative Approaches / Research
Research Article   |   September 1996
The Effects of an Occupationally Embedded Exercise on Bilaterally Assisted Supination in Persons with Hemiplegia
American Journal of Occupational Therapy, September 1996, Vol. 50, 639-646. doi:10.5014/ajot.50.8.639
American Journal of Occupational Therapy, September 1996, Vol. 50, 639-646. doi:10.5014/ajot.50.8.639
Abstract

Objectives. Occupationally embedded exercise is a central idea in the profession of occupational therapy. This experiment compared the effect of an occupationally embedded exercise involving a simple dice game with a rote exercise in persons with stroke with pronator spasticity. Both exercise conditions involved bilaterally assisted supination, consistent with the neurodevelopmental model of practice.

Methods. The sample consisted of 14 men and 12 women post-cerebrovascular accident with a mean age of 68.4 years (SD = 11.2) at six clinical sites in California, Texas, and Michigan. Subjects had pronator spasticity, full passive range for supination after a brief warm-up, and no functional supination. After random assignment for experimental condition, the subjects engaged in two sets of 10 repetitions of bilaterally assisted supination in either the occupationally embedded condition (dice game) or the rote condition (no game). A pen recorder electronically documented degrees of rotation of the handle that was grasped during the exercise.

Results. The occupationally embedded exercise resulted in significantly more handle rotation (requiring more supination) than the rote exercise, t (24) = 2.28, P (one tailed) < .05. The effect size was large.

Conclusion. This study advances the experimental analysis of therapeutic occupation in the area of occupationally embedded exercise. Clinicians are urged to consider the multidimensional nature of occupationally embedded exercise.