Self-management of upper limb recovery after stroke: how effectively do occupational therapists and physiotherapists train clients and carers?

Bower, Kylie, Gustafsson, Louise, Hoffmann, Tammy, and Barker, Ruth (2012) Self-management of upper limb recovery after stroke: how effectively do occupational therapists and physiotherapists train clients and carers? British Journal of Occupational Therapy, 75 (4). pp. 180-187.

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Abstract

Aim: A self-management approach to upper limb management following stroke has received little attention in the literature. The aim of the study was to investigate the impact of occupational therapists' and physiotherapists' standard practice on clients' and carers' self-management of upper limb recovery.

Method: Fifteen clients, 7 carers, 11 occupational therapists and 7 physiotherapists were recruited. Therapists described five self-administered tasks they expected clients and carers were doing, using the Goal Attainment Scale (GAS). For each task, clients' and carers' performances were then evaluated using the GAS and their self-efficacy was rated on a 10-point Likert scale. A survey questionnaire investigated their perceptions of the training provided, with respect to a self-management approach.

Results: At least a quarter of the self-administered tasks related to upper limb activity, strengthening and secondary prevention were performed below therapists' expectations. In contrast, mean self-efficacy ratings across these tasks were high (clients = 7.8-9.5, carers = 8.5-8.9). Seventy per cent of the self-management training strategies listed in the survey questionnaire were considered missing by more than 40% of carers.

Conclusion: There is a need for therapy resources that enhance the content and delivery of self-management training related to upper limb management following stroke, particularly for carers.

Item ID: 22635
Item Type: Article (Research - C1)
ISSN: 1477-6006
Keywords: upper limb, stroke, self-management
Funders: National Stroke Foundation Clinical Research Development Award, Occupational Therapists Board of Queensland
Date Deposited: 01 Aug 2012 09:26
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1106 Human Movement and Sports Science > 110603 Motor Control @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110317 Physiotherapy @ 33%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920111 Nervous System and Disorders @ 34%
92 HEALTH > 9202 Health and Support Services > 920201 Allied Health Therapies (excl. Mental Health Services) @ 33%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920403 Disability and Functional Capacity @ 33%
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