Abstract 2381: Standardising The Approach To Evidence-based Physiotherapy For Upper Limb Rehabilitation Following Stroke
Objective: Increasing the amount of practice performed by the upper limb is a critical element of stroke recovery and task-specific training is an effective method of achieving this. There is a need to standardise the application of task-specific training to individuals with differing levels of impairment and that allows for individual progress.
Design: Secondary analysis of a standardised task-specific training protocol in a previously-reported randomised controlled trial.
Setting: University, outpatient clinical trial.
Participants: Referred sample of 0 participants in the sub-acute phase following stroke completed the study.
Interventions: A clinical algorithm was devised based on the ICF framework. It involved assessment of 18 critical impairments of upper limb function and application of task-specific exercises appropriate to the level of impairment. These tasks were consistent with recent evidence-based guidelines and were constantly re-evaluated and task difficulty progressed.
Main Outcome Measures: Action Research Arm Test, Fugl-Meyer Assessment, Motor Activity Log.
Results: All participants attended the nine sessions of training over the three week intervention period (100% compliance). No adverse events were reported. There were significant improvements in functional ability and use of the affected arm (P < 0.001) and pinch strength and tapping speed (P < 0.01).
Conclusions: This evidence-based upper limb clinical algorithm provides a framework for standardising task-specific physiotherapy following stroke based on the assessment of functioning of the individual following stroke in day-to-day life. This approach is appropriate for patients with different functional levels and may be used in rehabilitation to standardise groups of self-directed practice sessions or standardise the intervention and progressions in rehabilitation studies.
- © 2012 by American Heart Association, Inc.