Evidence map›Paper›PMID 39414298›Full record

ArticleBMJ open2024

Post-rehabilitation programme to support upper limb recovery in community-dwelling stroke survivors: a mixed methods cluster-feasibility controlled trial.

Katy Pedlow, Niamh C Kennedy, Natalie Klempel, Janice J Eng, Gary Adamson, Jenny Hylands, Noelene Hughes, Zoe Campbell, Suzanne McDonough

Registry-linked trialAbstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05090163 (Prep Plus), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT05090163 nacompletednot on this map

Prep Plus: Supporting Upper Limb Practice in Community Dwelling Stroke Survivors

TypeinterventionalSponsorUniversity of UlsterRan2022 to 2023Enrolled74ConditionsStrokeArmsPREP Plus, PREP
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Katy PedlowUlster University, Belfast, UK K.Pedlow@ulster.ac.uk.ORCID http://orcid.org/0000-0002-7127-9032
Niamh C KennedyUlster University, Belfast, UK.ORCID http://orcid.org/0000-0001-7492-0828
Natalie KlempelUlster University, Belfast, UK.ORCID http://orcid.org/0000-0001-7937-6470
Janice J EngDepartment of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
Gary AdamsonUlster University, Belfast, UK.
Jenny HylandsUlster University, Belfast, UK.
Noelene HughesNorthern Ireland Chest Heart and Stroke, Belfast, UK.
Zoe CampbellNorthern Ireland Chest Heart and Stroke, Belfast, UK.
Suzanne McDonoughPhysiotherapy, Royal College of Surgeons in Ireland Faculty of Medicine and Health Sciences, Dublin, Ireland.ORCID http://orcid.org/0000-0003-3758-3302

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLess than 50% of stroke survivors regain their pre-stroke level of upper limb function, compounded with a lack of long-term rehabilitation options available. The Graded Repetitive Arm Supplementary Programme (GRASP) is an evidence-based upper limb programme delivered as a standalone programme to stroke survivors. To improve access to such a programme, there is the potential to combine it with a high-utility community-based exercise programme, such as the post-rehabilitation enablement programme (PREP). We aimed to establish if this was feasible to deliver alongside the experience of stroke survivors and therapists, identify any refinements the intervention and the acceptability of the intervention and trial procedures.

methodsA cluster feasibility-controlled trial was conducted using both quantitative and qualitative outcome measures with stroke survivors who were discharged from NHS care. Participants completed PREP for 6 weeks (control), with the intervention group also completing GRASP. The GRASP intervention was refined in between five iterative testing cycles. Focus groups with participants explored the acceptability and feasibility. Individual interviews with intervention therapists explored how feasible it was to embed the intervention into practice, and determine the feasibility of a future larger, mixed methods, randomised controlled trial. Clinical endpoints for upper limb and overall function were explored through the Rating of Everyday Arm use in the Community and Home, 10-metre walk test (10MWT) and quality of life via the Shortened Edinburgh Warwick questionnaire. No further suggestions for intervention design were noted after cycle 4.

resultsRecruitment (n=72) and retention levels (84.7%) were high with 61 participants (mean age of 66 years and 49 weeks post-stroke) completing the study. Participants and therapists reported positive acceptability of the intervention with goal setting and family support noted as beneficial. The home exercise programme was noted as challenging. Participants within both groups demonstrated improvements in clinical measures, with the intervention group demonstrating a greater improvement within the Rating of Everyday Arm-use in the Community and Home and the 10MWT.

conclusionThis study successfully recruited and retained stroke survivors into an upper limb community-based programme. It poses a feasible delivery mechanism to combine evidence-based upper limb approaches with established physical activity programmes in a future large scale and fully powered study. TRIAL REGISTRATION NUMBER: NCT05090163.

Indexed as

Exercise TherapyFeasibility StudiesIndependent LivingRecovery of FunctionStroke RehabilitationUpper ExtremityAgedFemaleFocus GroupsHumansMaleMiddle AgedQuality of LifeStrokeSurvivorsCommunity-Based Participatory ResearchREHABILITATION MEDICINEStroke

Identifiers

PMID39414298
PMCPMC11481143

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.