Effects of an intensive, task-specific rehabilitation program for individuals with chronic stroke: A case series

Abstract

Purpose. The purpose of this case series was to determine feasibility and evaluate changes in activity and participation outcomes in persons with chronic stroke after an intensive, task-specific rehabilitation program incorporating whole-body and client-centred interventions.

Method. Participants with chronic stroke (N = 12) who were ambulatory and had at least minimal arm/hand function were recruited. The program included whole-body goal-focused activities, gait training and strengthening exercises for 4 h, 5 days per week for 2 weeks. Daily educational sessions and a home activities program were also included. Activity-based measures including the Wolf motor function test, Berg balance scale, timed up and go test and 6-min walk test and participation-based measures including the Stroke Impact Scale and Canadian Occupational Performance Measure were collected at pre-test, immediate post-test and 5-month retention.

Results. The effect of the intervention on participation-based outcomes was much greater than on the activity-based outcomes. Minimal detectable differences in self-perceived participation were reported for most participants.

Conclusions. The intensive, task-specific intervention was a feasible program for these participants with stroke. Although minimal changes in activity-based outcomes were found, the participants perceived improvements in participation with personal goal-related activities that resulted in large effect sizes that were maintained for 5-months after the intervention.

Keywords:

• Chronic stroke
• intense
• task-specific
• rehabilitation
• client-centred

Acknowledgments

This study was supported by a Lilly Endowment Inquery Collaborative Grant. The authors thank Jennifer Cieslak, OTR; Kathy Hill, OTR; Forest Lamborn, OTR; Melissa Snyder, DPT and Courtney Whitehead, OTR for their valuable contributions to the implementation of the intervention program. Sylvester Carter PT, MHS is kindly acknowledged for conducting standardized outcome measures on all participants. Prior to this study, the primary author worked as needed as a consultant for Mobility Research, the company that manufactures the body weight support unit used in this study.