# Coaching stroke survivors to persevere with practice: An observational behavioural mapping study

## TL;DR

This study observes how therapists use coaching to help stroke survivors keep practicing during hospital rehabilitation.

## Contribution

The study introduces a behavioral mapping tool to quantify therapists' coaching strategies for promoting perseverance in stroke survivors.

## Key findings

- Coaching to promote perseverance was used in 76.7% of observed 3-minute session epochs.
- Monitoring practice quality was the most common strategy, while using a support person was the least common.
- Coaching for long-term independence was less frequently observed than therapist-dependent methods.

## Abstract

To quantitatively describe therapists’ use of coaching with stroke survivors, in a hospital-based rehabilitation setting, to promote perseverance with longer-term practice.

Prospective observational behavioural mapping study.

Rehabilitation unit of a regional public hospital in Queensland, Australia.

A custom-designed behavioural mapping tool was used to collect rehabilitation session contextual data and therapists' use of coaching. Data were captured in 3-minute epochs for a maximum of 30 minutes. Data were analysed using descriptive statistics.

Thirty-six rehabilitation sessions, including 34 participants (therapists n = 22, stroke survivors n = 12) were observed. Rehabilitation sessions were mostly inpatient (n = 33, 91.7%), one-on-one (n = 30, 83.3%), and conducted in the physiotherapy (n = 160, 45.5%) or occupational therapy (n = 155, 44.0%) gym. Strategies to promote perseverance were used in 76.7% (n = 267) of observed epochs. The most frequently used strategy was monitoring the quality of practice and the least frequently used strategy was utilising a support person to facilitate practice.

Coaching that may promote perseverance with practice was regularly used by therapists during hospital-based rehabilitation sessions. Coaching that may enable longer-term perseverance beyond a therapist-dependent rehabilitation model was less commonly observed.