The Critical Period After Stroke Study (CPASS) Upper Extremity Treatment Protocol.
Jessica Barth, Shashwati Geed, Abigail Mitchell and 4 others
PMID 37744191WHAT IT FOUND
Forty-nine participants completed at least 15 hours of a 20-hour upper-extremity shaping protocol within 42 days after stroke, mostly in outpatient settings, using activities they chose for daily life.
Key findings
01Forty-nine participants completed at least 15 hours of study therapy within 42 days, averaging 20.0 hours, 32.4 days, and 1.9-hour sessions.
02Most therapy hours were delivered in the outpatient clinic, and 63% of participants received treatment at a single location.
03Participants practiced upper-extremity activities across all 5 domains, and social activities received the least percentage of therapy hours.
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
The analysis was done at one centre by a small therapist group, so other services may not deliver it the same way. This report describes treatment delivery and adherence, not whether the protocol improved arm function. Adherence was defined by completed hours, so the optimal dose or intensity was not tested. The per-protocol analysis excluded people who did not complete enough therapy, which may make delivery look easier than it would be in all patients. The CPASS training was given in addition to standard rehabilitation, so its separate contribution cannot be judged.
The easy way to misread this
Do not read this as evidence that the protocol improves arm function or that the treatment dose is optimal. The CPASS training was delivered in addition to standard rehabilitation, and this paper reports delivery and adherence, not primary outcome results.