Expanding Rehabilitation Beyond the Clinic—Strategies to Increase Total Restorative Therapy Time for Adults with Hemiplegia

Background: Positive neuroplastic changes involving cortical reorganization after stroke are experience dependent and facilitated more effectively when rehabilitation occurs with high volume. Structured experiences to promote adaptive can be implemented during scheduled therapies in any setting. However, time spent supervised restorative therapy is limited regardless of Time therapeutic activity extended by a variety options that patients engage independently, low-cost, have evidence support their use as supplement physical occupational therapy. Purpose: The purpose this paper present four such for supplemental activities rehabilitation, including mental practice, mirror therapy, low cost virtual reality, community group exercise classes. A sample the supporting feasibility effectiveness presented. Practical guidelines implementation provided based on evidence. Recommendations: Evidence interventions used extend total an extension performed clinic. They feasible effective positive individuals hemiplegia. These strategies should across practice settings therapists, speech language pathologists.