90 Chapter 4 Table 2. Themes involving rehabilitation processes. (continued) Main theme Brief description Sub-theme Description Exercise Exercise intensity in a CRE is as high as possible. This can be achieved by integrating task-oriented exercises, patient-regulated exercises and group training into the daily structure. Exercise intensity Exercise intensity should be as high as possible on all days of the week, based on the rehabilitant’s ability. Currently, this intensity is often not high enough. Exercise intensity comprises all activities as part of the rehabilitation. Rehabilitants, informal caregivers and staff should be aware that it is not only the moments with a therapist that are important for the rehabilitation; they need to integrate training into their daily routine. Task-oriented exercises Although you must sometimes start at the level of body functions, therapy in a rehabilitation setting aims at the participation level. Task-oriented exercise is in line with this. For example, tasks can be practiced in activities of daily living, at mealtimes and in hobbies. All staff must have the attitude and the time to stimulate rehabilitants to practice meaningful tasks, which are tailored to their home situation, throughout the day. Patient-regulated exercises Patient-regulated exercises can increase exercise intensity and stimulate the rehabilitants’ independence and self-management during rehabilitation. Homework exercises can increase the amount of patient-regulated exercise and can affect how rehabilitants continue to perform exercises after discharge. To stimulate patient-regulated exercise, 24/7 access to training facilities is desirable and informal caregivers and staff should stimulate rehabilitants to practice, although independent exercise is often at a lower intensity than supervised training. Group training Group training can be an effective way to increase exercise intensity, but it should be compatible with the goals of the rehabilitant. Training in groups stimulates contact with and learning from others, prevents loneliness, and stimulates rehabilitation. Therefore, it is important that staff members stimulate a positive group process on a rehabilitation ward.
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