Task-specific training methods to improve the upper limb function in stroke survivors

After a stroke, the upper extremity is often affected which may result in a decrease in functioning. Task-specific training is necessary to improve the upper limb function after a stroke. Due to the increase in number of patients and less available healthcare personnel, we need to find different ways to provide task-specific training. This thesis describes two methods of training, namely group training and home training, to train the upper limb function with minimal therapist resources.
Within a rehabilitation centre, a standardized group training is able to provide a lower workload for therapists, while providing evidence-based training to a group of patients. We developed a circuit class based training program which entails activities of daily life. When a patient is able to return home, training must continue to prevent non-use of the arm in daily life. Therefore, a home-based training program using an assistive device and telerehabilitation system was investigated. Patients were able to significantly improve their upper limb function, effects were even retained six months after the cessation of the training. These results showed the added benefit of assistive device training. Patients found this way of training enjoyable, however several device flaws were encountered.
This thesis showed that task-specific training can be provided in different forms, such as group training or using assistive training devices, and they are effective in improving the upper limb function. We advise to involve patients more during the development of assistive training devices and training programs, to match the training to the patients’ wishes and needs.