H-GRASP: the feasibility of an upper limb home exercise program monitored by phone for individuals post stroke.
Lisa A Simpson, Janice J Eng, May Chan
PMID 27017890WHAT IT FOUND
In 6 of 8 people post stroke who finished a home arm exercise program with weekly phone calls, arm function, use, strength and self-perceived performance improved.
Retention and adherence were below target, and no control group limits interpretation.
Key findings
01Six of eight participants completed the home program, and all six who completed it said it was beneficial and would recommend it.
02Arm function, affected arm use and grip strength improved from baseline to after the program.
03Two participants had pain during the program, but both were able to meet exercise targets and complete it without pain by the end.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only eight people were studied and there was no independent control group, so improvements cannot be attributed to H-GRASP. Only six of eight participants completed the program, and one person dropped out because the exercises were not challenging enough. Adherence and arm use were measured by participant self-report, not objective devices. Participants were recruited from outpatient rehabilitation and may have been more motivated than the general stroke population. The program was designed for mild to moderate impairment, so it says little about people with severe arm impairment. Only two participants received caregiver assistance, so the role of caregiver support is unclear. Effect sizes may be overinflated because there was no control group.
The easy way to misread this
Do not read the improvements as proof that H-GRASP works. The study had eight participants, no independent control group, and only six completed the program, so it cannot show that the phone-monitored home exercises caused the gains.