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

Turton, Ailie J.; Van Vliet, Paulette; Turton, Ailie; Cunningham, Paul; van Vliet, Paulette M.; Van Wijck, Frederike

Authors

Ailie J. Turton

Paulette Van Vliet

Ailie Turton Ailie.Turton@uwe.ac.uk
Senior Lecturer in Occupational Therapy

Paul Cunningham Paul6.Cunningham@uwe.ac.uk
Senior Lecturer in Neuro Rehab Physio Therapy

Paulette M. van Vliet

Frederike Van Wijck



Abstract

© The Author(s) 2015. This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is to transparently describe the process of developing a complex intervention for people after stroke as part of a feasibility randomised controlled trial. 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

Journal Article Type Article
Publication Date Aug 1, 2016
Journal Clinical Rehabilitation
Print ISSN 0269-2155
Electronic ISSN 1477-0873
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 30
Issue 8
Pages 731-740
APA6 Citation Van Vliet, P., Turton, A. J., Cunningham, P., Turton, A., Van Wijck, F., & van Vliet, P. M. (2016). Task-specific reach-to-grasp training after stroke: Development and description of a home-based intervention. Clinical Rehabilitation, 30(8), 731-740. https://doi.org/10.1177/0269215515603438
DOI https://doi.org/10.1177/0269215515603438
Keywords stroke, hand, arm, upper limb, physical therapy, occupational therapy, rehabilitation, home, reach, grasp, repetitive, task-specific training, practice
Publisher URL http://dx.doi.org/10.1177/0269215515603438
Additional Information Additional Information : The dataset for this study is available from the UWE Research Data Repository: http://researchdata.uwe.ac.uk/178/

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