Upper limb recovery after stroke: The stroke survivors' perspective

Barker, Ruth; Brauer, Sandra G.

doi:10.1080/09638280500075717

Cited by 190 publications

(191 citation statements)

References 21 publications

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“…[64][65][66][67] Basic assumptions of qualitative interviewing such as an expectation of sustained narrative engagement, ability to express oneself in 'own terms' , referential meaning and particularisation of context and experience are all potentially subverted by the communication challenges faced by those with aphasia/dysarthria. Also, communication strengths might lie in modalities other than the fluent, spoken word, which is generally expected for qualitative data.…”

Section: Data Collection: Interviewing Approach and Instrument Designmentioning

confidence: 99%

Clinical effectiveness, cost-effectiveness and service users’ perceptions of early, well-resourced communication therapy following a stroke: a randomised controlled trial (the ACT NoW Study).

Bowen

Hesketh²,

Patchick³

et al. 2012

Health Technol Assess

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on behalf of the ACT NoW investigatorsHow to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There a...

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Section: Data Collection: Interviewing Approach and Instrument Designmentioning

confidence: 99%

Clinical effectiveness, cost-effectiveness and service users’ perceptions of early, well-resourced communication therapy following a stroke: a randomised controlled trial (the ACT NoW Study).

Bowen

Hesketh²,

Patchick³

et al. 2012

Health Technol Assess

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“…Therefore, intensive mobility training and early task oriented training with the affected arm may not be a priority [7,8], although recovery of function at all stages is possible [9]. The neural damage specifically involving the cortico-spinal tract reinforced with an emphasis on mobility, spontaneous preference to use the unaffected limb for independence in activities of daily living and the non-use of the affected upper limb may explain the limited and slower recovery of the dexterity of the upper limb.…”

Section: Introductionmentioning

confidence: 99%

JSU-Diagram: A Guideline for Treatment of the Upper Limb in Stroke Patients

Michielsen¹

2015

Int J Phys Med Rehabil

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Recovery of efficient, functional use of the upper limb post stroke can contribute to an increased quality of life. Early implementation of well-structured upper limb treatment after stroke may affect recovery of upper limb function and dexterity. The JSU (Jessa Sint-Ursula) diagram should be considered a guideline to work on the objectives needed to shape the rehabilitation of the upper limb at various stages of recovery. The diagram starts with upper limb rehabilitation from day one, even in the absence of sufficient trunk control and aims at offering a logical theoretical strategy for improving the recovery of function of the upper limb.

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“…(P4). Similarly Barker and Brauer (2005) found in their study that survivors perceived more time being spent in providing rehabilitation for the lower than upper limb. Sensory impairment and its impact is clearly important to stroke survivors, an observation confirmed in the study by Connell and Adams (2011) who emphasised the need for assessment of sensation and that clinicians recognise this impairment as an issue of concern to those who experience it.…”

Section: Discussionmentioning

confidence: 65%

“…Potentially increasing therapists' knowledge, skills and confidence may increase their efficiency for choosing and using standardised measures and ULPSSI interventions as was similarly proposed with reducing time barriers to utilising EBP skills such as searching and evaluating evidence (McCluskey, 2004). The development of decision-making aids as well as increasing the stroke survivor and or caregiver/family involvement with such areas as self-management and home programs may decrease the therapists' time demands (Barker & Brauer, 2005;Kuipers & Grice, 2009). Evaluation of the effectiveness of these methods needs to be undertaken.…”

Section: Interventions For Ulpssimentioning

confidence: 99%

“…Even when therapists feel confident with their knowledge of interventions, client's short length of stay and lack of time that therapists have to provide rehabilitation seems to limit ULPSSI being adequately addressed. This might be addressed by a change in focus for therapy to incorporate self-management techniques (Barker & Brauer, 2005). Therapists in this study were providing some education regarding home programs and sensory re-education which 196 may be the start of this approach.…”

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confidence: 99%

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Understanding and supporting occupational therapists clinical decision-making for the management of upper limb post stoke sensory impairment

Doyle¹

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BackgroundStroke survivors form the largest client group seen by occupational therapists and a large proportion of these stroke survivors experience upper limb post-stroke sensory impairments (ULPSSI) which impact upper limb function and participation. This thesis addresses the clinical decision-making (CDM) of occupational therapists when managing ULPSSI. No appraised and synthesised summary of the research evidence related to the effectiveness of interventions for ULPSSI is available to support therapists' CDM.Information on occupational therapists' practice choices and decisions about managing ULPSSI and the survivors' perspective on ULPSSI is scant. This information could support occupational therapists CDM when addressing ULPSSI and potentially improve stroke survivors' outcomes. Thesis AimsThis thesis aims to:1. Synthesise the effectiveness of interventions for ULPSSI; 2. Explore how occupational therapists make and manage decisions regarding ULPSSI management; 3. Describe practice choices occupational therapists commonly make when managing ULPSSI and the sources of information they use to make these decisions; 4. Compare current assessment choices and intervention practices with recommendations from the research evidence and clinical practice guidelines; 5. Describe the stroke survivors' perspective with regard to ULPSSI; and 6. Design and pilot an evidence-based, theory-driven educational intervention to support occupational therapists' CDM when addressing ULPSSI. Thesis MethodsFive distinct studies addressed the above aims. A Cochrane systematic review evaluated the evidence for the effectiveness of ULPSSI interventions.iii  Twelve occupational therapists participated in a qualitative descriptive study exploring therapists' practice choices and CDM related to ULPSSI. Based on the qualitative study, a survey of 187 occupational therapists described therapists' current practice choices regarding ULPSSI management and factors impacting CDM. A qualitative descriptive study using semi-structured interviews with 15 stroke survivors explored their experience of ULPSSI and the associated rehabilitation encounter. Finally, based on the need for training expressed by the survey participants, a one group pre-and post-test design, feasibility study evaluated the effect of a one day, theory-based educational intervention on 19 occupational therapists' knowledge, perceived behavioural control, attitudes and intended behaviour regarding ULPSSI management, research utilisation, and shared decision-making. Workshop content incorporated information from the prior research studies forming this thesis. ResultsA Cochrane systematic review located 13 randomised controlled trials (RCTs) addressing ULPSSI interventions, with benefit shown from individual RCTs evaluating mirror therapy, a graded thermal stimulation, and intermittent pneumatic compression. Other single RCTs reporting statistically significant results for repetitive peripheral magnetic stimulation, early intensive task-orientated training and graded...

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Upper limb recovery after stroke: The stroke survivors' perspective

Cited by 190 publications

References 21 publications

Clinical effectiveness, cost-effectiveness and service users’ perceptions of early, well-resourced communication therapy following a stroke: a randomised controlled trial (the ACT NoW Study).

Clinical effectiveness, cost-effectiveness and service users’ perceptions of early, well-resourced communication therapy following a stroke: a randomised controlled trial (the ACT NoW Study).

JSU-Diagram: A Guideline for Treatment of the Upper Limb in Stroke Patients

Understanding and supporting occupational therapists clinical decision-making for the management of upper limb post stoke sensory impairment

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