Improving upper extremity function in chronic stroke using occupational therapy task-oriented approach

Main Article Content

Phonprapai Pongtham
Waranya Chingchit
Jananya P Dhippayom

Abstract

Background: Recovery of upper extremity function in chronic stroke requires functional rehabilitation.


Objectives: The objective of this study was to investigate the effects of task-oriented occupational therapy on the upper extremity function of chronic stroke clients.


Materials and methods: Twenty participants were selected for the study, which was carried out through purposeful sampling process. The participants were then divided into two groups: the intervention and the control groups. Both groups were given a conventional rehabilitation program. The intervention group was also provided with occupational therapy task-oriented training within the duration of 6 weeks, with the consistency of 3 sessions a week, and 1 hour each session. The training program was individually designed based on an analysis of the three most important activities identified by the participants from the Canadian Occupational Performance Measure (COPM). Each training session consisted of task-oriented training (75%) and supplementary exercise (25%). The Functional Test of the Hemiparetic Upper Extremity-Thai version (FTHUE-Thai Version) and COPM were used as outcome measurements before and after the training programs.


Results: The FTHUE-Thai version study showed that the intervention group had significant improvement in the function of paretic upper extremity (p<0.05). The COPM’s report found a dramatical change in performance and satisfaction of the intervention group after the training program (p<0.05). These changes were also significantly different when compared between groups (p<0.05).


Conclusion: This study indicated the effect of occupational therapy task-oriented training based on client-centered approach on improving functions of paretic upper extremities, occupational performance, and satisfaction in people with chronic stroke.

Article Details

How to Cite
Pongtham, P., Chingchit, W., & P Dhippayom, J. (2021). Improving upper extremity function in chronic stroke using occupational therapy task-oriented approach. Journal of Associated Medical Sciences, 55(1), 52–59. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/252539
Section
Research Articles

References

Organisation WH. Global health estimates 2016: deaths by cause, age, sex, by country and by region, 2000-2016. Geneva. 2018.

Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: findings from the global burden of disease study 2010. Lancet 2014; 383(9913): 245e55.

Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet 2011; 377: 1693-702.

Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009; 8(8): 741-54.

Cramer S, Nelles G, Benson R, Kaplan J, Parker R, Kwong K, et al. A functional MRI study of subjects recovered from hemiparetic stroke. Stroke. 1997; 28(12): 2518-27.

Mayo NE, Wood-Dauphinee S, Ahmed S, Carron G, Higgins J, Mcewen S, et al. Disablement following stroke. Disabil Rehabil. 1999; 21(5-6): 258-68.

Murphy M, Willén C, Sunnerhagen K. Kinematic variables quantifying upper-extremity performance after stroke during reaching and drinking from a glass. Neurorehabilitation and Neural Repair. 2010; 25(1): 71-80.

Hatem S, Saussez G, della Faille M, Prist V, Zhang X, Dispa D, et al. Rehabilitation of motor function after stroke: a multiple systematic review focused on techniques to stimulate upper extremity recovery. Front Hum Neurosci. 2016; 10.

French B, Thomas L, Leathley M, Sutton C, McAdam J, Forster A, et al. Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis. J Rehabil Med. 2010; 42(1): 9-14.

Dewey H, Sherry L, Collier J. Stroke rehabilitation 2007: what should it be?. Int J Stroke. 2007; 2(3): 191-200.

Pollock A, Farmer S, Brady M, Langhorne P, Mead G, Mehrholz J, et al. Interventions for improving upper limb function after stroke. Cochrane Database Syst Rev. 2014.

Pollock A, Farmer S, Brady M, Langhorne P, Mead G, Mehrholz J, et al. Interventions for improving upper limb function after stroke. Cochrane Database of Systematic Reviews. 2014.

Mathiowetz V, Niken DM, Gillen G, Task-oriented approach to stroke rehabilitation. In: Gillen G, Niken DM, editors. Stroke rehabilitation: A function-based approach 5th ed. USA: ELSEVIER; 2020. pp. 59-79.

Rensink M, Schuurmans M, Lindeman E, Hafsteinsdóttir T. Task-oriented training in rehabilitation after stroke: systematic review. J Adv Nurs. 2009; 65(4): 737-54.

Preissner K. Use of the occupational therapy task-oriented approach to optimize the motor performance of a client with cognitive limitations. Am J Occup Ther. 2010; 64(5): 727-34.

Sabari J, Cappasso N, Feld-Glazman R. Optimizing motor planning and performance in clients with neurological disorders. In: Radomski M, Latham C, editors. Occupational therapy for physical dysfunction 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014. pp. 614-74

Almhdawi K, Mathiowetz V, White M, delMas R. Efficacy of occupational therapy task-oriented approach in upper extremity post-stroke rehabilitation. Occup Ther Int. 2016; 23(4): 444-56.

Thant A, Wanpen S, Nualnetr N, Puntumetakul R, Chatchawan U, Hla K, et al. Effects of task-oriented training on upper extremity functional performance in patients with sub-acute stroke: a randomized controlled trial. J Phys Ther Sci. 2019; 31(1): 82-7.

da Silva E, Ocamoto G, Santos-Maia G, de Fátima Carreira Moreira Padovez R, Trevisan C, de Noronha M, et al. The effect of priming on outcomes of task-oriented training for the upper extremity in chronic stroke: a systematic review and meta-analysis. Neurorehabil Neural Repair. 2020; 34(6): 479-504.

Bosch J, O’Donnell M, Barreca S, Thabane L, Wishart L. Does task-oriented practice improve upper extremity motor recovery after stroke? a systematic review. ISRN Stroke. 2014; 2014: 1-10.

Almhdawi K. Effects of occupational therapy task-oriented approach in upper extremity post-stroke rehabilitation [Dissertation]. University of Minnesota: University of Minnesota Digital Conservancy database; 2011.

Timmermans A, Spooren A, Kingma H, Seelen H. Influence of task-oriented training content on skilled arm-hand performance in stroke: a systematic review. Neurorehabil Neural Repair. 2010; 24(9): 858-70.

Gray J. Putting occupation into practice: occupation as ends, occupation as means. Am J Occup Ther. 1998; 52(5): 354-64.

Mathiowetz V. Task-oriented approach to stroke rehabilitation. In: Gillen G, editors. Stroke rehabilitation: A function-based approach 4th ed. USA: ELSEVIER; 2016. pp. 59-78

Baptiste, S. Client-centered assessment: The Canadian occupational performance measure. In: Hemphill-Pearson BJ, editors. Assessments in occupational therapy mental health an integrative approach 2nd ed. USA: SLACK Incooporated. 2008. pp. 35-47

Dhippayom JP, Trevittaya P, Rattakorn P. Occupations after stroke in stroke survivors’ and their family caregivers’ perception: similarities or differences?. J Assoc Med Sci 2018; 51(1): 32-7.

Fong K, Ng B, Chan D, Chan E, Ma D, Au B, et al. Development of the Hong Kong version of the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK). Hong Kong J Occup Ther. 2004; 14(1): 21-9.

Pingmuang P, Chinchai P, Dhippayom JP. Internal consistency and inter-rater reliability of the Functional Test for The Hemiplegic Upper Extremity in persons with hemiplegia-Thai version. ASEAN J Rehabil Med. 2016; 26(2): 39-46

Carey L, Matyas T, Oke L. Sensory loss in stroke patients: Effective training of tactile and proprioceptive discrimination. Arch Phys Med Rehabil. 1993; 74(6): 602-11.

Yekutiel M, Guttman E. A controlled trial of the retraining of the sensory function of the hand in stroke patients. J Neurol Neurosurg Psychiatry. 1993; 56(3): 241-4.

Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci. 2004; 22(3-5): 281-99.

Lang CE, Birkenmeier RL. Upper-extremity task-specific training after stroke or disability: A manual for occupational therapy and physical therapy. USA: AOTA Pres; 2014.

Legg LA, Lewis SR, Schofield-Robinson OJ, et al. Occupational therapy for adults with problems in activities of daily living after stroke. Cochrane DB Syst Rev 2017; 24.

Cott C. Client-centred rehabilitation: client perspectives. Disabil Rehabil. 2004; 26(24): 1411-22.