Evaluation of the enhanced upper limb therapy programme within the Robot-Assisted Training for the Upper Limb after Stroke trial: descriptive analysis of intervention fidelity, goal selection and goal achievement

Helen Bosomworth*, Helen Rodgers, Lisa Shaw, Leanne Smith, Lydia Aird, Denise Howel, Nina Wilson, Natasha Alvarado, Sreeman Andole, David L Cohen, Jesse Dawson, Cristina Fernandez-Garcia, Tracy Finch, Gary A Ford, Richard Francis, Steven Hogg, Niall Hughes, Christopher I Price, Laura Ternent, Duncan L TurnerLuke Vale, Scott Wilkes, Hermano I Krebs, Frederike van Wijck

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
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Abstract

OBJECTIVE: To report the fidelity of the enhanced upper limb therapy programme within the Robot-Assisted Training for the Upper Limb after stroke (RATULS) randomized controlled trial, the types of goals selected and the proportion of goals achieved.

DESIGN: Descriptive analysis of data on fidelity, goal selection and achievement from an intervention group within a randomized controlled trial.

SETTING: Out-patient stroke rehabilitation within four UK NHS centres.

SUBJECTS: 259 participants with moderate-severe upper limb activity limitation (Action Research Arm Test 0-39) between one week and five years post first stroke.

INTERVENTION: The enhanced upper limb therapy programme aimed to provide 36 one-hour sessions, including 45 minutes of face-to-face therapy focusing on personal goals, over 12 weeks.

RESULTS: 7877/9324 (84%) sessions were attended; a median of 34 [IQR 29-36] per participant. A median of 127 [IQR 70-190] repetitions were achieved per participant per session attended. Based upon the Canadian Occupational Performance Measure, goal categories were: self-care 1449/2664 (54%); productivity 374/2664 (14%); leisure 180/2664 (7%) and 'other' 661/2664 (25%). For the 2051/2664 goals for which data were available, 1287 (51%) were achieved, ranging between 27% by participants more than 12 months post stroke with baseline Action Research Arm Test scores 0-7, and 88% by those less than three months after stroke with scores 8-19.

CONCLUSIONS: Intervention fidelity was high. Goals relating to self-care were most commonly selected. The proportion of goals achieved varied, depending on time post stroke and baseline arm activity limitation.

Original languageEnglish
Pages (from-to)119-134
Number of pages16
JournalClinical Rehabilitation
Volume35
Issue number1
Early online date11 Sep 2020
DOIs
Publication statusPublished - 1 Jan 2021

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