Can home-training provide the same results as training in the clinic?

May 30, 2018

Upper body weakness is a significant hurdle for many patients after stroke, affecting up to 80% of individuals. Recently, mirror therapy has emerged as a novel upper body rehabilitation technique, with current evidence showing promise for stroke patients. Task-specific training is another recommended approach for stroke rehabilitation, emphasizing active, repetitive practice of functional activities. This approach is based on challenging, practical, and goal-directed actions under varying conditions and with feedback. Both mirror therapy and task-specific training encourage stroke patients to engage with their rehabilitation, leading to positive outcomes.

Historically, both mirror therapy and task-specific training were studied in standard rehabilitation environments. However, given the ease of implementing these tactics, researchers wondered why they aren’t used at home. Home-based rehabilitation allows you to practice functional activities in a comfortable environment that may also present challenges unique to your recovery. Knowing that you can reliably achieve specific everyday tasks in your home can bring you confidence that you might not realize in the clinic or rehab center.

Watch this online exercise class with exercises you can do at home

Rehabilitation at home

Researchers from Taiwan investigated whether home-based mirror therapy and task-specific training produced outcomes comparable with traditional clinic-based practice. The researchers randomly assigned participants to either home-based or clinic-based therapy. They received 12 training sessions for four weeks. Each session consisted of 30-45 minutes of mirror therapy followed by 45-60 minutes of task-specific training in both groups. Mirror therapy activities included range of motion, manipulating objects, performing functional tasks, and sensory stimulation. Task-specific therapy included opening drawers, towel wringing, folding clothes, laundry-based maneuvers, walking, and transferring between positions. After a 4-week period, the group that received home-based rehabilitation first received the clinic-based rehabilitation and vice versa.

Is training at home effective?

The results showed that home-based and clinic-based rehabilitation each provide benefit, however, to different aspects of your health. Home-based training improved patients upper body use for everyday tasks compared to clinic-based patients. It also resulted in patients exhibiting more lower body strength when transferring from a sitting position to standing. In contrast, the clinic-based patients had more benefits to their overall quality of life versus the home-based group. Both groups shared overall benefits to their level of impairment. They also all gained confidence in their ability to care for themselves, be productive, and partake in leisurely activities.

Given the mixed results, the jury is still out on home-based therapy. While training at home does produce specific benefits, it seems it is still best when combined with traditional clinical training. However, its clear that if you can do some extra practice at home, you can certainly see some considerable benefits!

The lead author of the original article was Yu-wei Hsieh, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

What you can do with this information

Editorial note:

Training at home produces some clear benefits but is best when combined with clinical training.

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