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 randomised 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 6 weeks, with additional self-practice recommended for 42 hours (i.e. 1 hour every day). As part of a feasibility randomised 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 1-hour therapist-delivered sessions was 157 (IQR: 96-211). The amount of self-practice was poorly documented. Where recorded, median amount of practice was 30 minutes (IQR: 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 TIDieR reporting guidelines. The intervention has been piloted, found to be acceptable and feasible in the home setting.
TBI Rehabilitation 