Therapists' Use of the Graded Repetitive Arm Supplementary Program (GRASP) Intervention: A Practice Implementation Survey Study

Louise A. Connell; Naoimh E. McMahon; Caroline L. Watkins; Janice J. Eng

doi:10.2522/ptj.20130240

Abstract

Background Only a small percentage of research is ever successfully translated into practice. The Graded Repetitive Arm Supplementary Program (GRASP) is a stroke rehabilitation intervention that anecdotally has had rapid translation from research to clinical practice. This study was conducted to explore the characteristics of this practice implementation.

Objectives The aims of this study were: (1) to explore the extent of practice implementation of GRASP in the United Kingdom; (2) using an implementation framework, to explore UK therapists' opinions of implementing GRASP; and (3) if GRASP is found to be used in the United Kingdom, to investigate differences in opinions between therapists who are using GRASP in practice and those who are not.

Design A cross-sectional study design was used.

Methods Data were collected via an online questionnaire. Participants in this study were members of the College of Occupational Therapy Specialist Section Neurological Practice and the Association of Chartered Physiotherapists Interested in Neurology.

Results Of the 274 therapists who responded to the survey, 61 (22.3%) had experience of using GRASP, 114 (41.6%) knew of GRASP but had never used it, and 99 (36.1%) had never heard of GRASP. Therapists displayed positive opinions toward the implementation of a manual with graded progressions of structured upper limb exercises for people after stroke. Opinions were different between therapists who had used GRASP and those who had not.

Limitations The findings of this study may be limited by response bias.

Conclusions GRASP is a relatively new stroke rehabilitation intervention that has made impressive translation into the knowledge and practice of UK therapists. Therapists' opinions would suggest that GRASP is both an acceptable and feasible intervention and has the potential to be implemented by a greater number of therapists in a range of settings.

Footnotes

Dr Connell, Dr Watkins, and Dr Eng provided concept/idea/project design, project management, and consultation (including review of manuscript before submission). Dr Connell, Ms McMahon, and Dr Watkins provided writing and data collection and analysis. Dr Connell and Dr Watkins provided fund procurement. Dr Watkins provided facilities/equipment and institutional liaisons. The authors acknowledge the Association of Chartered Physiotherapists Interested in Neurology and the College of Occupational Therapy Specialist Section Neurological Practice for the assistance given in disseminating the survey to members of the therapy professions and the therapists who took the time to complete the survey.
This study was approved by the University of Central Lancashire Research Ethics Committee.
A poster presentation of this work was given at the UK Stroke Forum Conference; December 5–7, 2013; North Yorkshire, United Kingdom.
The work presented here is the first phase of a 3-year National Institute for Health Research (United Kingdom)–funded project that aims to develop a feasible structured upper limb exercise program in UK stroke rehabilitation units. The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the National Health Service or the National Institute for Health Research.