11 General introduction 65 years, approximately 1.5% of the Dutch population over 65 years was referred for geriatric rehabilitation in 2021.11 Geriatric rehabilitation has both short term and long term beneficial effects on functional improvement, preventing admission to nursing homes and reducing mortality.12 In 2012, on average 73% of the rehabilitants in geriatric rehabilitation are discharged to their own living situation, although this percentage varies depending on the diagnosis between 63% for rehabilitants after stroke and 81% for rehabilitants with an orthopedic trauma.13In 2019 the average percentage of rehabilitants able to go back to their own living situation has already risen to 80%.14 In 2019 about 30% of the rehabilitants in Dutch geriatric rehabilitation were rehabilitating after an orthopedic trauma, 17% after stroke and 14% after elective orthopedic surgery. Other indications included e.g. rehabilitation for organ disorders like cardiac arrest or respiratory diseases, amputation or oncology. The average length of stay on a rehabilitation ward was 43 days for all diagnoses groups, varying between 30 days after elective surgery and 67 days after amputation.15 Geriatric rehabilitation in the Netherlands is typically provided by an interdisciplinary team. This rehabilitation team in general consists of nurses, elderly care physicians, physiotherapists, and occupational therapists. Depending on the rehabilitants’ needs and goals a psychologist, social worker, dietitian, or speech and language therapist can also be part of the team.4,13 The average amount of treatment hours for rehabilitants in geriatric rehabilitation depends on the diagnosis group and is related to the length of stay, varying between 21 hours in 30 days after elective surgery and 55 hours in 67 days after amputation.15 Introduction of the research topic Studies from about ten years ago showed that during inpatient rehabilitation for stroke the amount of time spent on therapeutic activities ranged from 9% to 56% of the working hours, with rehabilitants with higher functional levels spending more time on therapeutic activities.16-22 These differences between the percent1
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