Could self-directed gaming device (GripAble) enhance the practice of self-directed arm exercise and upper limb (UL) activity in people recovering from stroke in the community?
Funding:
BNSSG ICB Research Capability Funding.
What is the problem?
Clinical guidelines for stroke recommend that people with stroke (PwS) should complete at least 3 hours of rehabilitation every day even when discharged from hospital. They should be provided with resources to help them practice on their own and for carers to support them. To help stroke survivors, we need exercise resources that are suitable for their needs and are designed based on these.
Only about 1 in 8 people who have a weak arm after stroke make a full recovery. Reduced ability to use their arm for daily activities is devastating and leads to increased dependence, restriction of social activities and poorer quality of life. Almost two-thirds of stroke survivors leave hospital with a disability, and the annual cost of both paid and unpaid care is almost £21 billion. Current practice in the UK indicates too few rehabilitation sessions are dedicated to the UL and within sessions too few repetitions are achieved.
Recovery of the UL is best achieved through training that involves repetition of daily tasks and targeted exercises. Self-practice refers to approaches for promoting independent activity away from health care professional’s support. Self-directed gaming devices (GripAble) could enable PwS and their carers to feel supported within the home environment and ultimately improve arm function.
What is the aim of the research?
To develop a training package to support PwS and carers/family members engage in self-directed practice using technology-based interventions (GripAble gaming device) to improve adherence to rehabilitation and enhance UL function.
How will this be achieved?
There will be a rapid review of current evidence for adherence, barriers, facilitators for gaming interventions. Qualitative interviews with people with stroke (PwS), care givers from the Bristol, North Somerset and South Gloucestershire (BNSSG) area will then be conducted regarding barriers, facilitators, challenges, solutions for using GripAble gaming device. For this purpose, PwS, carers living in their own home who participated in our previous recently conducted GripAble study and NHS hospitals in southwest England (who use GripAble devices in their practice) will be invited to take part. Our patient group will include a range of patients (stratified based on age, gender, disability (mild, moderate stroke), ethnicity, socio-economic background).
Evidence from the review and the interview information will be used to draw up storyboards for how the training package will look. We will convene co-design groups, comprising of patients, family members and HCPs, to re-design the storyboards, to inform the training package that we will produce.
We will continue to consult with our group of patient partners over the study period. Findings will be shared with this group and stroke survivors through stroke charities, at conferences and in academic publications. The developed training package will inform of our future project that will explore best way to implement the GripAble intervention into clinical practice.
Who is leading the research?
Mr Alex Pearce, Research Associate, University of the West of England.
Further information
For more information or to get involved with this project, please contact bnssg.research@nhs.net.