Treatment components for upper limb rehabilitation after stroke: a survey of UK national practice

Abstract

Purpose: The aim of this study was to delineate the type of treatment currently provided to rehabilitate the upper limb following stroke in order to inform the treatment protocol for a control arm of a future pragmatic clinical trial of assistive technologies. Method: A national survey of stroke teams was conducted. Using open-ended, free script questions, the survey was designed to capture the important components of treatment that are most commonly used to treat patients described as mild, moderate or severely impaired following stroke. Stroke teams were targeted within the 28 geographical areas covered by the Stroke Improvement Networks. Result: Treatment descriptions were returned by 53 stroke teams from 20 of the 28 geographical areas. In total, 998 treatment components were provided – 289 for mildly, 403 for moderately and 306 for severely impairment patients following stroke). These captured five substantive treatment categories in terms of most active, moderately active and non-active patient participation in treatment as well as assistive technologies and other. Conclusion: From the treatment components described, the highest number of treatment components was listed for the moderately impaired patient. The treatment components used by the units surveyed are quite consistent with the 2012 Clinical Guidelines for Stroke.Implications for RehabilitationThe survey captured five substantive categories of treatment that describe most active patient participation, moderately active patient participation, non-active patient participation, assistive technology and other.Overall, the treatment components described by the units are quite consistent with the 2012 UK Clinical Guidelines for Stroke.Assistive technologies were not widely used in the units surveyed but when used constraint-induced movement therapy was most commonly used with mildly impaired patients and electrical stimulation was most common with moderately and severely impaired patients.