2016 Volume 12 Issue 1 Pages 43-51
Rehabilitation for stroke patients requires a large amount of high-quality, intensive training. However, for most patients, use of the paralyzed upper limb is avoided in daily life outside of rehabilitation therapy. The purpose of this study was to devise a menu of tasks for improving upper limb function in patients with hemiplegia after stroke. Participants included 39 occupational therapists with experience in treating patients with hemiplegia after stroke. The tasks were organized and rewritten as 26 items on a questionnaire. Participants were asked to consider the tasks for inclusion in the upper limb function task menu. The participants identified the lowest possible Brunnstrom recovery stage (BRS) for the upper limb and fingers required to complete each task. In accordance with the Delphi method, this study was conducted in three rounds. The final round included 32 occupational therapists with an average of 4.40 ± 3.00 years of experience. The mean score (±SD) for evaluation of the tasks in this round was 3.85 ± 0.63 and the median value was 3.85. The same mean value of 3.0 was chosen to represent recommendation to adopt a task. In the final round, 100.0% (26/26) of the tasks were selected for adoption. The mean value (±SD) for the lowest BRS for the paralyzed upper limb was 4.26 ± 0.41 (median, 4.15) and that for the fingers was 4.57 ± 0.46 (median, 4.62). Results indicated that these tasks would be useful for upper limb functional training for stroke patients. The most important aim of occupational therapy is to make patients aware of what movement is possible. The role of occupational therapists is to provide task-specific training by using a feasible upper limb function task menu that demonstrates ability to improve upper limb function in patients undergoing occupational therapy after a stroke.
