Research PaperUnderstanding upper extremity home programs and the use of gaming technology for persons after stroke
Section snippets
Design
This initial study of NGT was designed to collect both quantitative and qualitative data on the effectiveness and acceptability of this home approach for adults post-stroke. The quantitative study used a repeated measures design (A1, A2, B1, A3; A = Assessment, B = Intervention) and results are reported in a separate paper.30 A qualitative descriptive approach as described by Sandelowski31, 32 was used to answer questions on the nature of home programs and the acceptability of NGT. This method
Pre-intervention interview
Participants had been asked to describe how they used their affected arm/hand in daily activities in order to understand their functional ability. Two themes emerged regarding upper extremity use in daily activities: 1) that it was infrequent; and 2) that participants felt they should be doing more. Nine participants were able to name at least one functional activity in which they tried to use the affected limb, such as turning on and off light switches or incorporating the affected limb into
Discussion
Key findings highlight the difficulties and opportunities in augmenting or improving home programs in general and the uses of NGT specifically. Participants were able to identify activities during which they used their affected upper extremity, but reported that these activities occurred infrequently and were challenging. Participants described that they should be trying to use their arm more everyday. But they were provided with home programs that they often recalled as non-specific
Conclusion
Adult participants with hemiparesis following stroke were interviewed about home exercise/activity programs in general and the use of NGT specifically. They reported difficulty using their hemiparetic upper extremity for functional activity, but understood that using their affected upper extremity was an important part of continuing motor recovery. Most participants had been provided with a home exercise program in the past, but had difficulty recalling details about it, performing it
Acknowledgment
Jill Jandreau, MS, PT was one of the designated interviewers who contributed to data collection.
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Presentation of this Material: The contents of this paper were presented October 19th to the first author's doctoral committee and the general public as part of a dissertation defense. Material was also presented to the University of North Carolina faculty and students of the Occupational Therapy and Occupational Science Division and Duquesne University staff as part of a job talk. A proposal for a poster for the American Occupational Therapy Association Conference has been accepted for the 2015 conference.
Funding: The project was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1RR025014, the Bayley Family Foundation and, and a Washington Research Foundation gift to the Center for Sensorimotor Neural Engineering (CNSE), a National Science Foundation Engineering Research Center (EEC-1028725). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies including NIH and NSF.
Conflicts of interest: Authors Sarah McCoy and Chet Moritz had a potential intellectual property interest in the reported work, which was managed by the University of Washington. The source of the conflict has been dissolved.