A biomechanical analysis of the effectiveness of the Graded Repetitive Arm Supplementary Program (GRASP) for chronic stroke rehabilitation

Purpose
The Graded Repetitive Arm Supplementary Program (GRASP) is used widely to reduce arm impairment from stroke. Evidence for its effectiveness in chronic stroke survivors is based on studies that used clinical measures and different treatment lengths. This study aimed to examine whether GRASP changes movement quality by conducting a biomechanical analysis of chronic stroke survivors’ movements prior to, during and after GRASP; assess whether changes in kinematic and clinical measures are associated and an intervention duration shorter eight-weeks could be similarly effective.

Materials and methods
Chronic stroke survivors (n = 27) completed the baseline measures, GRASP for eight weeks and post-measures. They practiced one-hour daily at home for six days/week and visited the University weekly, where arm movements were recorded.

Results
There were significant GRASP related improvements in movement duration and smoothness in the affected arm. Significant improvements in arm function, self-efficacy and quality of life were also observed, but these did not consistently significantly correlate with kinematic changes. There was no evidence to support shortening the program.

Conclusion
Kinematic changes in movement patterns were evident across the GRASP program as were benefits on clinical measures, but additional research is needed to determine the benefits of GRASP for chronic stroke rehabilitation.