ArticleImplementation science : IS2014
A formative evaluation of the implementation of an upper limb stroke rehabilitation intervention in clinical practice: a qualitative interview study.
Article in Implementation science : IS, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07146789 (Effectiveness of the Home-Based Graded Repetitive Arm Supplementary Program Combined With Occupational Therapy Versus Conventional Occupational Therapy Alone on Quality of Life and Upper Limb Function After Stroke), which is not on this map. Cited by 45 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of the Home-Based Graded Repetitive Arm Supplementary Program Combined With Occupational Therapy Versus Conventional Occupational Therapy Alone on Quality of Life and Upper Limb Function After Stroke: A Randomized Controlled Trial
Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it, 94 citations in OpenAlex.
- Optimising adherence to inpatient rehabilitation trial protocols: A mixed-methods systematic review.Clinical trials (London, England) · 2025Pooled it
- Healthcare professionals' perceived barriers and facilitators of implementing clinical practice guidelines for stroke rehabilitation: A systematic review.Clinical rehabilitation · 2023Pooled it
- Factors affecting the delivery of complex rehabilitation interventions in research with neurologically impaired adults: a systematic review.Systematic reviews · 2020Pooled it
- A systematic review of the use of the Consolidated Framework for Implementation Research.Implementation science : IS · 2016Pooled it
- Trial
- Effects of transcranial random noise stimulation combined with Graded Repetitive Arm Supplementary Program (GRASP) on motor rehabilitation of the upper limb in sub-acute ischemic stroke patients: a randomized pilot study.Journal of neural transmission (Vienna, Austria : 1996) · 2019Trial
- Trial
- Article
- Implementing pharmacogenetic-guided prescribing in general practice: a qualitative process evaluation.Implementation science communications · 2026Article
- What influenced the use of embedded genetic expertise by non-genetic clinicians: a qualitative study using the diffusion of innovations theory and theoretical domains framework.Implementation science communications · 2026Article
- Healthcare providers' experience of delivering a heart rate variability feedback intervention to individuals living with spinal cord injury to inform implementation into usual care.BMC health services research · 2026Article
- Article
- Exploring factors influencing implementation across the explanatory-to-pragmatic trial continuum: a sequential qualitative integration of delivering higher-intensity walking exercise within inpatient stroke rehabilitation.Implementation science communications · 2026Article
- Article
- Translational framework for implementation evaluation and research: implementation strategies derived from normalization process theory.Implementation science : IS · 2025Article
- Article
- Article
- Implementation of neurological group-based telerehabilitation within existing healthcare during the COVID-19 pandemic: a mixed methods evaluation.BMC health services research · 2023Article
- Evaluating the Dissemination and Implementation Impact of a Rehabilitation Intervention: The Graded Repetitive Arm Supplementary Program (GRASP).Physiotherapy Canada. Physiotherapie Canada · 2023Article
- Goal-setting and personalization under the International Classification of Functioning, Disability, and Health framework: Community reintegration program for post-stroke patients.Frontiers in rehabilitation sciences · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe Graded Repetitive Arm Supplementary Program (GRASP) is a hand and arm exercise programme designed to increase the intensity of exercise achieved in inpatient stroke rehabilitation. GRASP was shown to be effective in a randomised controlled trial in 2009 and has since experienced unusually rapid uptake into clinical practice. The aim of this study was to conduct a formative evaluation of the implementation of GRASP to inform the development and implementation of a similar intervention in the United Kingdom.
methodsSemi-structured interviews were conducted with therapists who were involved in implementing GRASP at their work site, or who had experience of using GRASP. Normalisation Process Theory (NPT), a sociological theory used to explore the processes of embedding innovations in practice, was used to develop an interview guide. Intervention components outlined within the GRASP Guideline Manual were used to develop prompts to explore how therapists use GRASP in practice. Interview transcripts were analysed using a coding frame based on implementation theory.
resultsTwenty interviews were conducted across eight sites in British Columbia Canada. Therapists identified informal networks and the free online availability of GRASP as key factors in finding out about the intervention. All therapists reported positive opinions about the value of GRASP. At all sites, therapists identified individuals who advocated for the use of GRASP, and in six of the eight sites this was the practice leader or senior therapist. Rehabilitation assistants were identified as instrumental in delivering GRASP in almost all sites as they were responsible for organising the GRASP equipment and assisting patients using GRASP. Almost all intervention components were found to be adapted to some degree when used in clinical practice; coverage was wider, the content adapted, and the dose, when monitored, was less.
conclusionsAlthough GRASP has translated into clinical practice, it is not always used in the way in which it was shown to be effective. This formative evaluation has informed the development of a novel intervention which aims to bridge this evidence-practice gap in upper limb rehabilitation after stroke.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.