Can Occupational Therapy Take A HIT? A Guide to High-Intensity Training in Stroke Rehabilitation

Objective: Stroke has been considered a leading cause of functional impairment (Tsao et al., 2022). Recent evidence has supported a treatment approach that increases dosage (Scheets et al., 2021). High-intensity training (HIT) has shown promising evidence for functional recovery poststroke (Crozier et al., 2018). There have been minimal programs related to Occupational therapy (OT) and HIT have been created (Lamoureux, 2023). This doctoral capstone focused on program development of the OT-based HIT program. Theoretical frameworks included the Model of Human Occupation and Motor Learning Theory to provide a foundational structure. Methods: A needs assessment was performed at the Saint George Regional Hospital NeuroSpecialty Rehabilitation Center. Methods included interviews, observation, and quality improvement questionnaires from clinician input. The program was evaluated for perceived feasibility and quality using a SWOT analysis. Findings: The SWOT analysis indicated two overarching themes: patient empowerment and reluctance to change. Information acquired through feedback from these questionnaires and findings was disseminated into meaningful content. The program was redesigned based on input from the participants. No differences were seen in Likert Scale responses within the quality improvement questionnaire between participants with or without formal training with HIT. Conclusion: Findings from this capstone project and experience suggested that the OT-based HIT program was perceived as a viable program that can contribute to the quality of the profession, clearly delineating physical therapy and OT-driven HIT regarding scope of practice. Future projects and research are needed to understand the program’s feasibility with patient care.