OBJECTIVE. The purpose of this study was to describe current occupational therapy practices in the usage and prescription of and clinical reasoning process supporting home exercise programs (HEPs) for clients with neurological injuries (CWNIs).

METHOD. A survey was distributed via mail to 2,000 members of the American Occupational Therapy Association. The survey questions concerned basic demographics, current HEP practices, and attitudes toward using HEPs with CWNIs.

RESULTS. In the 360 returned surveys, occupational therapists reported numerous benefits of using HEPs and were able to clearly articulate their clinical reasoning. Commonly reported HEP activities were preparatory in nature, and the most frequently prescribed dosage was 16–30 min daily. Most therapists relied on the same clinical reasoning process but varied in implementation methods.

CONCLUSION. This study’s results highlight the gaps between evidence and practice. The active ingredients in HEPs for CWNIs need to be more clearly defined and described.