Arm and hand skills: Training preferences after stroke

Purpose. An increasing demand for training after stroke has brought about the need to develop rehabilitation technology. This article reports an inquiry into skill preferences of persons after stroke regarding arm-hand training and examines the relationship between the use of the affected arm and the patient's training preference. Method. Data collection involved a semi-structured interview of 20 persons in the subacute and 20 persons in the chronic stage after stroke, based on an adaptation of the motor activity log. Results. Subacute and chronic patients after stroke agreed on seven out of 10 most preferred training skills. Patient preferences related mostly to 'manipulation in combination with positioning' and 'manipulation'. Eight motivation aspects for skill training were identified as being important. A positive correlation was found between skill preference scores and use of the impaired arm (r = 0.64) (p < 0.001). Conclusions. This study has resulted in an inventory of skills that persons after stroke prefer to train on. This list can be used for implementation of exercises in rehabilitation technology. Motivation for skill training pertains to optimising participation level, rather than function or activity level. This study suggests that client-centred assessment is advocated to set therapy goals that match patient training preferences.