Home-based Arm and Hand Exercise Program for Stroke: A Multisite Trial

Scale-out of a Home-based Arm and Hand Exercise Program for Stroke: A Multisite Implementation-efficacy Trial

The goal of this multisite clinal trial is to evaluate the implementation of the home-based Graded Repetitive Arm Supplementary Program (GRASP) at rehabilitation clinics across several hospitals. The main questions it aims to answer is:

• the efficacy of the home-based GRASP program relative to the conventional occupational therapy intervention on improving health outcomes, including UE motor function, daily function, quality of life, and motor control strategies.

Stroke participants will be randomly assigned to either the Home-based GRASP group or the conventional occupational therapy home program group. Each group will undergo an 4 to 6-week intervention (3 sessions/week) with evaluations conducted before, immediately after, and 3 months post-trial, assessing clinical and kinematic measures. Interviews and surveys will be conducted to gain insights into the perspectives of patients regarding the implementation of the home-based GRASP program.

Inclusion Criteria:

• are aged 20 years or older
• have upper extremity hemiparesis due to the first-ever stroke
• have some voluntary movement in the affected UE
• are able to follow 2-step instructions

Exclusion criteria:

• orthopedic conditions affecting the arm/hand or other neurological conditions
• severe pain that prevents movement in the affected arm and hand
• unstable medical status