Using the TIDieR checklist to standardize the description of a functional strength training intervention for the upper limb after stroke

Background and Purpose: Published reports of intervention in randomized controlled trials are often poorly described. The Template for Intervention Description and Replication (TIDieR) checklist has been recently developed to improve the reporting of interventions. The aim of this article is to describe a therapy intervention used in the stroke rehabilitation trial, "Clinical Efficacy of Functional Strength Training for Upper Limb Motor Recovery Early After Stroke: Neural Correlates and Prognostic Indicators" (FAST-INdICATE), using TIDieR. Methods: The functional strength training intervention used in the FAST-INdICATE trial was described using TIDieR so that intervention can be replicated by both clinicians, who may implement it in practice, and researchers, who may deliver it in future research. The usefulness of TIDieR in the context of a complex stroke rehabilitation intervention was then discussed. Results and Discussion: The TIDieR checklist provided a systematic way of describing a treatment intervention used in a clinical trial of stroke rehabilitation. Clarification is needed regarding several aspects of the TIDieR checklist, including in which section to report about the development of the intervention in pilot studies, results of feasibility studies; overlap between training and procedures for assessing fidelity; and where to publish supplementary material so that it remains in the public domain. Summary: TIDieR is a systematic way of reporting the intervention delivered in a clinical trial of a complex intervention such as stroke rehabilitation. This approach may also have value for standardizing intervention in clinical practice. Video abstract is available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A131)

Pilot study for a randomised controlled trial of home based reach to grasp training for people after stroke: Instruction manual for exercise manual

This is the instruction manual for the exercise manual produced to describe the intervention in the 'Reach to Grasp pilot study' as clearly as possible

Pilot study for a randomised controlled trial of home based reach to grasp training for people after stroke: Exercise manual

As part of the 'Reach to Grasp pilot study', an exercise manual was produced to describe the intervention as clearly as possible. An instruction manual describing the intervention is available on the repository also

Feedback Device for Improvement of Coordination of Reach-to-Grasp After Stroke

This article was published in the journal, Archives of Physical Medicine and Rehabilitation [Elsevier / © American Congress of Rehabilitation Medicine]. The definitive version is available at: http://dx.doi.org/10.1016/j.apmr.2011.07.204Objective To describe a novel feedback device (Grasp Rehabilitation Accessory for Stroke Patients [GRASP]) that gives feedback on the time lag between the start of hand opening and the start of transport during reach-to-grasp movements, and to report the results of a preliminary series of single case studies to assess the utility of the device for improving the coordination of arm and hand at the beginning of a reach-to-grasp movement

FAST INdiCATE Trial protocol. Clinical efficacy of functional strength training for upper limb motor recovery early after stroke : neural correlates and prognostic indicators

© 2013 The Authors. International Journal of Stroke published by John Wiley & Sons Ltd on behalf of World Stroke Organization. Funded by: Efficacy and Mechanism Evaluation programme. Grant Number: 10/60/30 Medical Research Council (MRC)Peer reviewedPublisher PD

Directions in retraining reaching

Despite the growing amount of movement science and professional literature, rehabilitation for stroke is commonly based instead on accepted practice or custom. Therefore, this review article was undertaken to further the development of a sound theoretical background for intervention with stroke patients. We first report the key findings from the literature concerned with normal reaching, then discuss evidence relevant to training reaching after stroke. The review finishes with an extraction of those clinical implications that have the firmest scientific evidence at present. In this way, scientifically based directions for retraining reaching and for research in this area are provided. Current research indicates that effective training strategies are likely to include voluntary activation of whole movements with meaningful goals, and sufficient practice to achieve skill learning. Practice should be varied to suit different environmental contexts and the inclusion of strategies such as using electromyographic biofeedback, bilateral movements and constraining the unaffected arm is beneficial

Coordination between reaching and grasping in patients with hemiparesis and healthy subjects

Objective: To investigate the coordination of reach-to-grasp components in hemiparetic and healthy subjects. Design: Split-plot repeated-measures design with 3 factors (group, object size, movement speed). Setting: Movement laboratory. Participants: Twelve hemiparetic and 12 age-matched healthy subjects. Interventions: Not applicable. Main Outcome Measures: We used motion analysis to collect information on the kinematic variables of movement duration, peak velocity, peak deceleration, and maximum aperture, and the time of peak velocity, peak deceleration, and maximum aperture expressed as a percentage of movement duration during 32 reaching movements by each subject. We examined the coordination between the 2 components in 2 ways. First, we investigated the correlation between time of hand opening and start of hand transport, and between time of maximum aperture and time of peak deceleration. Second, we compared movements at preferred and fast speeds (manipulation of transport component) and to 2 different-sized cups (manipulation of grasp component). Results: Both groups demonstrated a temporal coupling between grasp and transport components at the start of the reach and at the time of maximum aperture. Both groups increased the aperture of grasp for larger cups and increased the maximum grip aperture, and had a shorter deceleration phase for faster movements. The deceleration phase of the hemiparetic patients was longer than that of the healthy subjects, however, and the components were not as tightly coupled. Conclusions: The hemiparetic patients, who had a moderate amount of functional recovery, were similar to healthy subjects in their ability to control reach-to-grasp components. Their performance was not as skilled, however