A 12 month follow up of the re-education of arm and hand function following stroke (Reach) randomised controlled trial : a mixed methods study

Luckie, H

Abstract

Functional electrical stimulation (FES) has shown promise as a treatment for upper limb rehabilitation following stroke, although current devices are limited in functionality. To address this a new movement-triggered FES device was developed and trialled in people with chronic stroke in the REAcH study.

Studies of long term effects of FES have been limited both in time (up to 9-months post intervention) and scope (focusing only on quantitative outcomes). Therefore, this mixed methods study followed up a sub-set of participants in the REAcH study at the Salford site at 12 months post intervention with the aims of: 1. Identifying whether changes in impairment, function and Quality of Life seen during REACH were maintained at 12 months. 2. Whether the changes in outcomes could be attributed to the nature of the intervention. 3. Exploring the experiences of the participants’ upper limb post stroke recovery during the REAcH study and over the 12 month follow up period.

Measures taken during the REACH study were repeated 12 months following the end of the intervention period, and semi-structured interviews were carried out. Statistical and thematic analysis were used to present data.

The nine participants recruited showed no statistically significant differences in all but two domains of the SIS, participation (p=0.03) and recovery (p = 0.006) at the end of intervention which were maintained at follow up. Some changes in study measures were seen at an individual level, which in cases were maintained, or showed continued improvement over the 12 month follow up. Thematic analysis identified long term positive outcomes from exercise and FES interventions in chronic stroke as well as non-physical issues which influence upper limb recovery. A degree of mismatch between quantitative and qualitative measures was noted, in line with recent research. Consideration of inclusion of both measures in future studies can assist to fully evaluate the effect of an intervention.

Citation

Luckie, H. A 12 month follow up of the re-education of arm and hand function following stroke (Reach) randomised controlled trial : a mixed methods study. (Dissertation). University Of Salford

• Thesis Type: Dissertation
• Deposit Date: Mar 20, 2017
• Publicly Available Date: Mar 20, 2017