Perceived Facilitators and Barriers for Actual Arm Use during Everyday Activities in Community Dwelling Individuals with Chronic Stroke

Grace J. Kim, Shir Lebovich, Debbie Rand

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Our aim was to gain a deeper understanding of perceived predictors for actual arm use during daily functional activities. Methods: Qualitative study. Semi-structured interview data collected from individuals with chronic stroke living in the community. Codebook thematic analysis used for the data analysis. Results: Six participants 5–18 years post stroke with moderate to severe UE impairment. Three domains were identified: Person, Context, and Task. Themes for the Person domain included mental (cognitive effort, lack of acceptance), behavioral (routines/habits, self-evaluation), and physical (stiffness/fatigue). Themes for the Context domain included social environment (being in public, presence, and actions of others) and time constraints (being in a hurry). Themes for the task domain included necessity to complete bilateral and unilateral tasks, and safety (increased risk of accidents). Conclusion: Actual arm use is a complex construct related to the characteristics of the person, contextual environment, and the nature of the task. Facilitators included cognitive effort, routines/habits, self-evaluation, and the perceived necessity. Barriers included in lack of acceptance, stiffness/fatigue, being in public, being in a hurry, and risk of ac-cidents. Social support was both a facilitator and a barrier. Our results support the growing call to adopt a broader biopsychosocial framework into rehabilitation delivery.

Original languageEnglish
Article number11707
JournalInternational Journal of Environmental Research and Public Health
Volume19
Issue number18
DOIs
StatePublished - Sep 2022

Keywords

  • actual arm use
  • home-based rehabilitation
  • real-world use
  • stroke
  • upper extremity

All Science Journal Classification (ASJC) codes

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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