Ethics: The study was approved by the following Human Research Ethics Committees

(HREC): Selleck Vandetanib Alfred Health HREC; Bendigo Health HREC; Eastern Health HREC; Echuca Regional Health HREC; Goulburn Valley HREC; La Trobe University Faculty HREC; Peninsula Health HREC; Tasmania Health and Medical Human Research Ethics Council; St Vincent’s Health HREC; Southern Health HREC; Melbourne Health HREC. This study was a de-identified analysis of data collected within usual clinical care. Support: Funding sources for this research were the National Health and Medical Research Council of Australia (NHMRC Post Doctoral Fellowship for Dr Natalie de Morton, Grant no. 519555) and Eastern Health Allied Health Research Scholarship for Natasha Brusco. Competing interests: None declared. “
“Accurate quantification of the nature and dose of the interventions provided in rehabilitation settings selleck is an important challenge for both clinicians and researchers. For rehabilitation participants to reacquire skilled motor performance, a significant amount of repetitive task practice is required (Butefisch et al 1995, Classen et al 1998). Studies

of neural plasticity have shown that repetitive task training can change cortical organisation (Plautz et al 2003) however, the dose of repetitive task practice often available in therapy sessions is unlikely to be sufficient to induce cortical changes (Lang et al 2009). Some rehabilitation units seek to maximise the dose of repetitive task practice by the prescription of task-related exercises to be undertaken daily during the inpatient stay in the rehabilitation gymnasium (Olivetti et al 2007, Sherrington et al 2003). Unfortunately, therapists’

estimates of the amount of exercise that occurs in rehabilitation have been shown to be poor (Bagley et al 2009, Collier and Bernhardt 2008, Lang et al 2007). More accurate knowledge of exercise dosage may assist in intervention prescription and assessment of goal achievement. Thus a method for objectively recording the amount of exercise that participants complete is required. Mephenoxalone Establishing the effectiveness of different components of rehabilitation or ‘unpacking the black box’ has been identified as a key research area (Langhorne and Duncan 2001) and establishing the impact of a higher dose versus lower doses of rehabilitation intervention is an important aspect of this investigation (Kwakkel et al 2004). Guidelines for complex interventions suggest that a clear description of the intervention needs to be provided to enable others to replicate the intervention clinically, replicate the study, and combine evidence (Craig et al 2008). To date, the standard method used to quantify exercise dosage is the time rehabilitation participants spend in therapy (Cooke et al 2010, French et al 2008, Galvin et al 2008, Kwakkel et al 2004).