Upper Extremity Task-Specific Training: Manual Development and Implementation Research within Inpatient Rehabilitation

2021 ◽  
pp. 1-17
Author(s):  
Eron Bozec ◽  
Jaime Gorska ◽  
Namrata Grampurohit
Keyword(s):  
Upper Extremity ◽  
Implementation Research ◽  
Inpatient Rehabilitation ◽  
Training Manual ◽  
Specific Training

Implementation Challenges With Evidence-Based Practice Within Inpatient Rehabilitation to Incorporate Task-Specific Training

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512510266p1-7512510266p1
Author(s):  
Eron Bozec ◽  
Namrata Grampurohit ◽  
Jaime Gorska
Keyword(s):  
Implementation Research ◽  
Inpatient Rehabilitation ◽  
Barriers And Facilitators ◽  
Training Manual ◽  
Evidence Based ◽  
Specific Training ◽  
Implementation Barriers ◽  
Study Objective ◽  
Implementation Challenges ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The study objective was to examine the implementation barriers and facilitators after a year of training and use of a task-specific training manual in inpatient rehabilitation. The Consolidated Framework for Implementation Research provided structure for the survey of OTs. Stakeholders reported confidence in evidence incorporation, and the barriers related to ease of selection and use of this intervention need to be addressed. Primary Author and Speaker: Eron Bozec Additional Authors and Speakers: Namrata Grampurohit Contributing Authors: Namrata Grampurohit, Jaime Gorska

Implementation of a Shoulder Program for Post-Stroke Upper Extremity Complications in Inpatient Rehabilitation

2019 ◽  
Vol 100 (10) ◽  
pp. e89-e90
Author(s):  
Priyanka Kapoor ◽  
Joanna Allbright ◽  
Librada Callender ◽  
Molly Trammell
Keyword(s):  
Upper Extremity ◽  
Inpatient Rehabilitation ◽  
Post Stroke

Meeting Personnel Training Needs: The Deaf-Blind Self-Study Curriculum Project

1995 ◽  
Vol 89 (3) ◽  
pp. 235-243 ◽  
Author(s):  
K.M. Huebner ◽  
C. Kirchner ◽  
J.G. Prickett
Keyword(s):  
Training Needs ◽  
Training Manual ◽  
Test Evaluation ◽  
Specific Training ◽  
Primary Target ◽  
Knowledge And Attitudes ◽  
Self Study ◽  
Service Training ◽  
Curriculum Project ◽  
Study Manual

The federal Office of Special Education Programs funded a consortium-based project that produced a self-study manual, a videotape and discussion guide, a reprints collection, annotated bibliographies, and an in-service training manual. This article highlights the field-test evaluation of these materials by teachers, which provides a glimpse into the professional situation of the primary target group—teachers without specific training for teaching students who are deaf-blind. The teachers’ pre- and posttest knowledge and attitudes about teaching these students are also analyzed.

scholarly journals Effect of Gravity and Task Specific Training of Elbow Extensors on Upper Extremity Function after Stroke

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Mohamed E. Khallaf
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Motor Planning ◽  
Control Group ◽  
Elbow Extension ◽  
Specific Training ◽  
Extremity Function ◽  
Upper Extremity Function ◽  
Hemiparetic Stroke ◽  
Nine Hole Peg Test

Background.In individuals with hemiparetic stroke, reaching with the paretic arm can be impaired by abnormal muscle coactivation. Prior trails for improving upper extremity functions after stroke have underestimated the role of gravitational force in motor planning and execution.Objective.The aims this trial were to study the effect of gravity as a facilitator for elbow extension and to estimate the immediate and retention effects of task specific training of elbow extensors on upper extremity function after stroke.Methods.Twenty-six right handed patients with first ever stroke represented the sample of the study. The participants were randomly assigned into two equal groups. The study group received treatment through two phases. Phase one included training for the elbow extensors in an antigravity position. Phase two included a set of task specific exercise for 16 weeks. The control group received traditional passive stretch and range of motion exercises. Manual dexterity and upper limb function were assessed by Nine-Hole Peg Test and Fugl-Meyer upper extremity. Goniometry was used for measuring elbow extension and forearm supination active ranges of motion.Results.Significant improvements were observed in Nine-Hole Peg Test, Fugl-Meyer upper extremity, and ranges of motion at postintervention and follow-up compared to preintervention at P≤0.05.Conclusions.The results of this study provide an evidence that antigravity positions can be used as a centrally presented facilitator of elbow extension. Additionally, task specific training was effective in improving upper extremity function and elbow extension range of motion.

Abstract WMP89: Bilateral Priming Followed by Task Specific Training Can Improve Moderate to Severe Post-Stroke Upper Extremity Hemiparesis

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Mary E Stoykov ◽  
Daniel M Corcos
Keyword(s):  
Upper Extremity ◽  
Activity Index ◽  
Stroke Survivors ◽  
Specific Training ◽  
Post Intervention ◽  
Transcallosal Inhibition ◽  
Motor Priming ◽  
Point Increase ◽  
Priming Technique

INTRODUCTION: Priming techniques to facilitate improved motor performance have been examined in stroke rehabilitation research. Reported techniques include transcranial electric (TES) or magnetic (TMS) stimulation, both of which are costly and approved only for research purposes. Here, we examine a motor priming technique which is cost-effective and clinically feasible. This priming technique consists of continuous, symmetrical, rhythmic, wrist flexion and extension. A novel device, the “rocker,” is used which has a mechanical linkage promoting symmetry of both arms. Previous studies examining bilateral priming plus task specific training (TST) found the combination to be more effective than TST alone. However, there have been no studies that: 1) compare bilateral priming to a unilateral version of the same, and 2) examine priming in severely impaired stroke survivors. Hypothesis: The objective of this pilot study was to test our hypothesis that bilateral priming combined with task specific training (TST) would be effective in stroke survivors with severe upper limb impairment. Methods: We collected pilot data in 6 individuals with severe upper extremity hemparesis receiving either bilateral priming or unilateral priming followed by TST. The entire intervention was approximately 4 weeks with a total of 30 hours of priming plus training. Participants were tested at pre-/post-intervention, and at 4-week follow-up. Behavioral Measures included a bilateral motor function measure (Chedoke Arm and Hand Activity Index, CAHAI) and a unilateral measure (Fugl-Meyer Test of Upper Extremity Function, FMUE). Transcallosal inhibition (TCI) persistence was measured using TMS. Results: At post intervention, the bilateral priming group demonstrated a 9 point increase (improvement) as compared to the unilateral one (3.67 point increase) in the CAHAI. The FMUE change scores were 6.0 and 3.66 for the bilateral and unilateral priming groups respectively. Gains persisted at 4-week follow-up. Transcallosal inhibition was more normalized in the bilateral priming group at discharge. Conclusion: In conclusion, we found preliminary evidence to support our hypothesis that bilateral priming plus TST is effective for individuals with severe hemiparesis.

scholarly journals Immersive Virtual Reality to Improve Outcomes in Veterans With Stroke: Protocol for a Single-Arm Pilot Study (Preprint)

2021 ◽  
Author(s):  
Johanna E Tran ◽  
Christopher A Fowler ◽  
Jemy Delikat ◽  
Howard Kaplan ◽  
Marie M Merzier ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pilot Study ◽  
Upper Extremity ◽  
Stroke Rehabilitation ◽  
Inpatient Rehabilitation ◽  
The United States ◽  
Rehabilitation Program ◽  
Neurologic Recovery ◽  
Research Activities ◽  
Hand Dexterity

BACKGROUND Over the last decade, virtual reality (VR) has emerged as a cutting-edge technology in stroke rehabilitation. VR is defined as a type of computer-user interface that implements real-time simulation of an activity or environment allowing user interaction via multiple sensory modalities. In a stroke population, VR interventions have been shown to enhance motor, cognitive, and psychological recovery when utilized as a rehabilitation adjunct. VR has also demonstrated noninferiority to usual care therapies for stroke rehabilitation. OBJECTIVE The proposed pilot study aims to (1) determine the feasibility and tolerability of using a therapeutic VR platform in an inpatient comprehensive stroke rehabilitation program and (2) estimate the initial clinical efficacy (effect size) associated with the VR platform using apps for pain distraction and upper extremity exercise for poststroke neurologic recovery. METHODS This study will be conducted in the Comprehensive Integrated Inpatient Rehabilitation Program at the James A Haley Veterans’ Hospital. Qualitative interviews will be conducted with 10 clinical staff members to assess the feasibility of the VR platform from the clinician perspective. A prospective within-subject pretest-posttest pilot design will be used to examine the tolerability of the VR platform and the clinical outcomes (ie, upper extremity neurologic recovery, hand dexterity, pain severity) in 10 veteran inpatients. A VR platform consisting of commercially available pain distraction and upper extremity apps will be available at the participants’ bedside for daily use during their inpatient stay (approximately 4-6 weeks). Clinician interviews will be analyzed using qualitative descriptive analysis. Cohen <i>d</i> effect sizes with corresponding 95% CIs will be calculated for upper extremity neurologic recovery, hand dexterity, and pain. The proportion of participants who achieve minimal clinically important difference after using the VR platform will be calculated for each clinical outcome. RESULTS This study was selected for funding in August 2020. Institutional review board approval was received in October 2020. The project start date was December 2020. The United States Department has issued a moratorium on in-person research activities secondary to COVID-19. Data collection will commence once this moratorium is lifted. CONCLUSIONS Our next step is to conduct a large multi-site clinical trial that will incorporate the lessons learned from this pilot feasibility study to test the efficacy of a VR intervention in inpatient rehabilitation and transition to home environments. When VR is used in patients’ rooms, it serves to provide additional therapy and may reduce clinician burden. VR also presents an opportunity similar to home-based practice exercises. VR can be implemented in both clinical settings and people’s own homes, where engagement in ongoing self-management approaches is often most challenging. This unique experience offers the potential for seamless transition from inpatient rehabilitation to the home. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/26133

scholarly journals Feasibility of High-Repetition, Task-Specific Training for Individuals With Upper-Extremity Paresis

2014 ◽  
Vol 68 (4) ◽  
pp. 444 ◽  
Author(s):  
Kimberly J. Waddell ◽  
Rebecca L. Birkenmeier ◽  
Jennifer L. Moore ◽  
T. George Hornby ◽  
Catherine E. Lang
Keyword(s):  
Upper Extremity ◽  
Specific Training ◽  
High Repetition ◽  
Repetition Task

scholarly journals Declines in motor transfer following upper extremity task-specific training in older adults

2019 ◽  
Vol 116 ◽  
pp. 14-19 ◽  
Author(s):  
Christopher S. Walter ◽  
Caitlin R. Hengge ◽  
Bergen E. Lindauer ◽  
Sydney Y. Schaefer
Keyword(s):  
Older Adults ◽  
Upper Extremity ◽  
Specific Training ◽  
Motor Transfer
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