The study aims to evaluate if an individualized home-based exercise program and psychological with behavioural strategies included enhance recovery and the use of the affected upper extremities.
From September 2023 to December 2023, chronic stroke individuals were recruited from the community to participate in an upper extremity rehabilitation program. The program required participants to undergo a four-week home-based exercise program and perform the exercises one hour daily.
The training plan for individual participants was made based on the evaluation results and the participant's efficacy. The exercises were chosen from the Grade Repetitive Arm Supplementary Program (GRASP) protocol, a recognised home-based training program focusing on essential principles and core components of UE rehabilitation. Participants' efficacy and barriers to performing the selected exercises were identified, and individual adaptation was made with the participant to ensure the participants could perform the exercises at home.
Outcome measures were collected at three time points (before the program, after the program, and at the 4-week follow-up). Motor function and hand function were evaluated using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), and Hand Grip Strength (HGS). The Rating of Everyday Arm Use in the Community and Home Scale (REACH) was used to evaluate participants' use of the affected upper extremities.
Eight participants were recruited and completed the exercise program. The FMA-UE (p=0.016) and REACH (p=0.006) found significant improvement in UL motor impairment and daily use between pre-intervention and follow-up. Improving trends were observed in UE function, as indicated by ARAT across the periods, and positive changes in HGS were found after intervention. Also, average exercise adherence was satisfactory (81%) as measured by the daily practice duration.
An individualized home-based rehabilitation program can facilitate arm recovery in chronic stroke individuals. Psychological and behavioural strategies employed have contributed to exercise adherence, the development of habitual exercise behaviours, and increases in daily arm use.
UE rehabilitation program with individualization and psychological and behavioural strategies is effective in promoting paretic arm recovery and arm use in chronic stroke individuals.
Paretic arm recovery
Promote use of paretic arm
