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

Article


Bosomworth, H., Rodgers, H., Shaw, L., Smith, L., Aird, L., Howe, D., Wilson, N., Alvarado, N., Andole, S., Cohen, D., Dawson, J., Fernandez-Garcia, C., Finch, T., Ford, G. A., Francis, R., Hogg, S., Hughes, N., Price, C. I., Ternent, L., Vale, L., Turner, D., Wilkes, S., Krebs, H. I. and van Wijck, F. 2020. 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. Clinical Rehabilitation. https://doi.org/10.1177/0269215520953833
AuthorsBosomworth, H., Rodgers, H., Shaw, L., Smith, L., Aird, L., Howe, D., Wilson, N., Alvarado, N., Andole, S., Cohen, D., Dawson, J., Fernandez-Garcia, C., Finch, T., Ford, G. A., Francis, R., Hogg, S., Hughes, N., Price, C. I., Ternent, L., Vale, L., Turner, D., Wilkes, S., Krebs, H. I. and van Wijck, F.
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.

JournalClinical Rehabilitation
ISSN1477-0873
Year2020
PublisherSAGE Publications
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Anyone
Supplemental file
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Digital Object Identifier (DOI)https://doi.org/10.1177/0269215520953833
Publication dates
Online11 Sep 2020
Publication process dates
Accepted10 Jul 2020
Deposited11 Sep 2020
FunderNational Institute for Health Research Health Technology Assessment programme
Copyright holder© 2020 The Authors
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