Task-specific reach-to-grasp training after stroke: development and description of a home-based intervention

Paul Cunningham*, Ailie J. Turton, Frederike Van Wijck, Paulette Van Vliet

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To describe and justify the development of a home-based, task-specific upper limb training intervention to improve reach-to-grasp after stroke and pilot it for feasibility and acceptability prior to a randomized controlled trial.

INTERVENTION DESCRIPTION: The intervention is based on intensive practice of whole reach-to-grasp tasks and part-practice of essential reach-to-grasp components. A 'pilot' manual of activities covering the domains of self-care, leisure and productivity was developed for the feasibility study. The intervention comprises 14 hours of therapist-delivered sessions over six weeks, with additional self-practice recommended for 42 hours (i.e. one hour every day). As part of a feasibility randomized controlled trial, 24 people with a wide range of upper limb impairment after stroke experienced the intervention to test adherence and acceptability. The median number of repetitions in one-hour therapist-delivered sessions was 157 (interquartile range IQR 96-211). The amount of self-practice was poorly documented. Where recorded, the median amount of practice was 30 minutes (interquartile range 22-45) per day. Findings demonstrated that the majority of participants found the intensity, content and level of difficulty of the intervention acceptable, and the programme to be beneficial. Comments on the content and presentation of the self-practice material were incorporated in a revised 'final' intervention manual.

DISCUSSION: A comprehensive training intervention to improve reach-to-grasp for people living at home after stroke has been described in accordance with the Template for Intervention Description and Replication (TIDieR) reporting guidelines. The intervention has been piloted, and found to be acceptable and feasible in the home setting.

TRIAL REGISTRATION: ISRCTN56716589.

Original languageEnglish
Pages (from-to)731-40
Number of pages10
JournalClinical Rehabilitation
Volume30
Issue number8
Early online date3 Sep 2015
DOIs
Publication statusPublished - 1 Aug 2016

Keywords

  • feasibility studies
  • hand strength
  • home care services
  • humans
  • motor activity/physiology
  • stroke rehabilitation
  • upper extremity
  • stroke
  • hand
  • arm
  • upper limb
  • physical therapy
  • occupational therapy
  • rehabilitation
  • home
  • reach
  • grasp
  • repetitive
  • task-specific training
  • practice

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