If you blithering idiots would write exact stroke protocols that specified exact number of repetitions survivors would start counting and do the work. Sedentary time wouldn't exist.
A Paradigm Shift for Acute Rehabilitation of Stroke
Abstract
Abstract
Current
best practice standards for rehabilitation after stroke call for
increasing the dose and intensity of interventions for optimal
therapeutic benefit. Despite this, those within inpatient rehabilitation
during the acute phase are often sedentary, and they receive a lower
dose and intensity of therapy than recommended. This may be due to the
lack of therapeutic opportunities outside of therapies, program
structure characteristics, or a lack of efficiency in therapeutic
encounters, all of which have the potential to reduce therapeutic
outcomes. Circuit class therapies and group therapies provide a method
of increasing the dose and intensity of therapy provided, and may reduce
redundancy and inefficiency within programs, but do not satisfy the
3-hour rule under the current Prospective Payment System in the United
States. The Centers for Medicare and Medicaid Services require that
individual therapy be the primary mode of intervention provision, which
limits programs from providing these evidence-based interventions, at a
higher volume in a group or circuit format. Providing an enriched
environment outside of structured therapies should be mandated to
maximize benefits experienced by patients and reduce sedentary time.
Empirical study is required to determine which interventions may be
effectively delivered when provided via a nonindividual basis, and to
explore the feasibility and fiscal implication of alternative models of
care. Reform of regulatory standards may be required to align with best
practice standards.(We don't need standards you lazy bastards, we need protocols. Do you not understand how recovery occurs?)
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