In-Home, Client-Based Intensive Therapy Intervention for Upper Extremity Hemiparesis After Stroke

Well then write up a fucking protocol on this and get it distributed to ALL 10 million yearly stroke survivors. Anything less than that and you don't belong in the stroke field. We need to trim a lot of incompetent stroke 'professionals' and we need to start somewhere. 

In-Home, Client-Based Intensive Therapy Intervention for Upper Extremity Hemiparesis After Stroke

Janet L. Poole, PhD, OTR/L, FAOTA; Tonya Carbajal, MOT, OTR/L; Abigail Cole, MOT, OTR/L; Amanda Ginther, MOT, OTR/L; Sarah Streng, MOT, OTR/L; Jesse Quinlan, MOT, OTR/L; Miranda Rouw, MOT, OTR/L; Stephanie L. Singleton, OTD, OTR/L; Betty Skipper, PhD

• Annals of International Occupational Therapy.
• https://doi.org/10.3928/24761222-20180723-01
• Posted August 1, 2018

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Abstract

Introduction:This study evaluated an in-home, client-centered intensive therapy intervention to improve performance and satisfaction with daily activities, upper extremity function, and quality of life.

Methods:This study included six participants with varying levels of upper extremity motor impairment. Age ranged from 23 to 77 years, and time since stroke was 8 to 92 months. The intensive therapy intervention was guided by goals identified with the Canadian Occupational Performance Measure. Therapy was conducted in participants' homes 3 to 4 hours per day, 5 days per week, for 2 weeks.

Results:Generalized least squares analysis for longitudinal data was performed with the Scheffé adjustment for pairwise comparisons. Overall, participant scores improved significantly on the Canadian Occupational Performance Measure, the Fugl-Meyer Assessment motor section, and the Stroke Impact Scale 3.0 from preintervention to immediately postintervention (p %lt; .05). The exception was the Stroke Impact Scale hand domain. Improvements were maintained for all measures from immediately postintervention to 2-month follow-up (p < .05).

Conclusion:The results suggest that an in-home, client-based intensive therapy intervention may lead to improved performance and satisfaction with upper extremity function after stroke. Limitations included a small sample size, varying degrees of motor function, and lack of a control group. Larger randomized controlled trials are needed to confirm the findings and the efficacy of this intervention. [Annals of International Occupational Therapy. 201X; XX(X):XX–XX.]