An Occupational Therapy Functional Upper Limb Group Programme on the Acute Stroke Unit: A 3 Month Pilot

Abstract

Abstract Background The 2023 National Clinical Guidelines for Stroke recommend that stroke survivors with motor recovery goals should receive a minimum of 3 hours of rehabilitation 5/7 days a week (National Clinical Guideline for Stroke for the UK and Ireland, 2023). Schneider et al (2019) deem it feasible for stroke survivors to undertake extra upper limb practice (including group sessions) to support in achieving upper limb motor recovery goals. With staffing limitations, creative methods of intervention delivery must be adopted to enhance usual intervention sessions. Methods In an Irish hospital, a pilot project hypothesised the benefit of two one-hour Occupational Therapy functional upper limb group intervention sessions to support adherence to effective weekly dosage of upper limb motor recovery. An audit was completed on dosage of usual Occupational Therapy intervention, prior to group formation. Seven patients were identified with an average daily dosage of 35.4 minutes of usual intervention (5/7 days a week). Two one-hour group sessions were adopted in conjunction with usual therapy. Group intervention dosage was recorded. Patient self-reported satisfaction was obtained using a ten-point Likert scale. Results A total of twenty-nine patients, over 3 months, attended Occupational Therapy upper limb group interventions during an admission on the Acute Stroke Unit. The addition of two one-hour group intervention sessions supported an average actual increase in dosage of 113 extra minutes per week (36.15% increase). There was a 95% self-reported satisfaction rate among patients. Conclusion The addition of two one-hour Occupational Therapy functional upper limb groups increased upper limb motor recovery dosage by 113 minutes per week. Group intervention was a feasible tool that can be used on an Acute Stroke Unit in conjunction with usual therapy to support motor recovery guideline adherence and patient satisfaction. Despite these efforts, patients are not receiving the recommended daily intensity as highlighted by National Clinical Guidelines.