Effects of an intensive, task-specific rehabilitation program for individuals with chronic stroke: a case series.

Abstract

The purpose of this case series was to determine feasibility and evaluate changes in activity and participation outcomes in persons with chronic stroke after an intensive, task-specific rehabilitation program incorporating whole-body and client-centred interventions. Participants with chronic stroke (N = 12) who were ambulatory and had at least minimal arm/hand function were recruited. The program included whole-body goal-focused activities, gait training and strengthening exercises for 4 h, 5 days per week for 2 weeks. Daily educational sessions and a home activities program were also included. Activity-based measures including the Wolf motor function test, Berg balance scale, timed up and go test and 6-min walk test and participation-based measures including the Stroke Impact Scale and Canadian Occupational Performance Measure were collected at pre-test, immediate post-test and 5-month retention. The effect of the intervention on participation-based outcomes was much greater than on the activity-based outcomes. Minimal detectable differences in self-perceived participation were reported for most participants. The intensive, task-specific intervention was a feasible program for these participants with stroke. Although minimal changes in activity-based outcomes were found, the participants perceived improvements in participation with personal goal-related activities that resulted in large effect sizes that were maintained for 5-months after the intervention.