A number of studies have suggested that early intensive rehabilitation will promote recovery after stroke. If this is so then how far does current National Health Service provision succeed in delivering this? This observational study looks at how 15 stroke patients in a general hospital spent their days. Only 12.9% of the working day, or 62 minutes, were spent in therapy. Patients spent most of their working day, 38.6%, in 'recreation', and most of this time was spent on the ward. For much of this time they could have been available for therapy sessions or involved in self-directed exercise. The impact of a new regime aimed at increasing intensity of therapy for the hemiplegic arm is examined.

This study investigates the validity of actometers as a method of monitoring arm movement in everyday life after stroke. Ten stroke patients with impaired arm function and 10 normal people of similar age wore actometers on each wrist for up to 10 hours on two separate days. The actometers successfully detected reduced average activity of the affected arm after stroke. They also gave higher average readings for the dominant arm of normal subjects when compared to the nondominant side. However, there were suggestions of limits to the validity of the actometers: not every stroke patient or normal subject produced the expected results; test-retest reliability was only moderate; and stroke patients showed only a weak relationship between actometer readings and performance on arm function tests. The low cost and unobtrusiveness of actometers means that despite limitations on their validity, actometers may be a valuable tool in rehabilitation therapy.