Feasibility investigation of the accelerated skill acquisition program (ASAP): Insights into reach-to-grasp coordination of individuals with postacute stroke

Background: Skill acquisition, capacity building, and motivational enhancements are the basis of the Accelerated Skill Acquisition Program (ASAP) and form the foundation for effective incorporation of the paretic upper extremity into life activities. This is the first phase I trial to deliver ASAP d...

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Main Authors: Jarugool Tretriluxana, Nuttakarn Runnarong, Suradej Tretriluxana, Naraporn Prayoonwiwat, Roongtiwa Vachalathiti, Carolee Winstein
Other Authors: Mahidol University
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Published: 2018
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/32675
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spelling th-mahidol.326752018-10-19T12:42:13Z Feasibility investigation of the accelerated skill acquisition program (ASAP): Insights into reach-to-grasp coordination of individuals with postacute stroke Jarugool Tretriluxana Nuttakarn Runnarong Suradej Tretriluxana Naraporn Prayoonwiwat Roongtiwa Vachalathiti Carolee Winstein Mahidol University King Mongkut's Institute of Technology Ladkrabang University of Southern California Medicine Nursing Background: Skill acquisition, capacity building, and motivational enhancements are the basis of the Accelerated Skill Acquisition Program (ASAP) and form the foundation for effective incorporation of the paretic upper extremity into life activities. This is the first phase I trial to deliver ASAP during the postacute interval in mildly to moderately impaired stroke survivors and to include an assessment of paretic reach-to-grasp (RTG) coordination using RTG task and cross-correlation analyses. Methods: Two baseline and posttreatment evaluations consisted of RTG actions, the Wolf Motor Function Test (WMFT), and the Stroke Impact Scale (SIS). An individualized arm therapy program using ASAP principles was administered for a total of 30 hours, 2 hours per day, for 2 to 4 days per week over 5 weeks. Dependent measures were kinematics of RTG actions, RTG coordination, total time score of WMFT, and stroke recovery score of SIS. Results: All participants tolerated ASAP well, and none reported any adverse effects during or after the protocol. When the 2 baseline evaluations were compared, there were no changes in any RTG kinematics or RTG coordination. In contrast, after 30 hours of ASAP, total movement time and deceleration time of RTG actions markedly decreased, maximum reach (transport) velocity strikingly increased, and time of maximum aperture was accomplished later. Additionally, the maximal RTG correlation coefficient increased with a shorter associated time lag. A similar pattern was observed for the clinical outcome measures of WMFT and SIS. Conclusions: The findings demonstrate the feasibility of using an ASAP protocol for patients 1 to 3 months post stroke. Under ASAP, WMFT tasks and RTG actions were performed faster with higher peak transport velocity and a more coordinated RTG pattern. The next step is to determine whether the immediate gains in the skilled RTG actions persist 6 months alter. © 2013 Thomas Land Publishers, Inc. 2018-10-19T05:38:55Z 2018-10-19T05:38:55Z 2013-01-01 Article Topics in Stroke Rehabilitation. Vol.20, No.2 (2013), 151-160 10.1310/tsr2002-151 19455119 10749357 2-s2.0-84880690891 https://repository.li.mahidol.ac.th/handle/123456789/32675 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84880690891&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
Nursing
spellingShingle Medicine
Nursing
Jarugool Tretriluxana
Nuttakarn Runnarong
Suradej Tretriluxana
Naraporn Prayoonwiwat
Roongtiwa Vachalathiti
Carolee Winstein
Feasibility investigation of the accelerated skill acquisition program (ASAP): Insights into reach-to-grasp coordination of individuals with postacute stroke
description Background: Skill acquisition, capacity building, and motivational enhancements are the basis of the Accelerated Skill Acquisition Program (ASAP) and form the foundation for effective incorporation of the paretic upper extremity into life activities. This is the first phase I trial to deliver ASAP during the postacute interval in mildly to moderately impaired stroke survivors and to include an assessment of paretic reach-to-grasp (RTG) coordination using RTG task and cross-correlation analyses. Methods: Two baseline and posttreatment evaluations consisted of RTG actions, the Wolf Motor Function Test (WMFT), and the Stroke Impact Scale (SIS). An individualized arm therapy program using ASAP principles was administered for a total of 30 hours, 2 hours per day, for 2 to 4 days per week over 5 weeks. Dependent measures were kinematics of RTG actions, RTG coordination, total time score of WMFT, and stroke recovery score of SIS. Results: All participants tolerated ASAP well, and none reported any adverse effects during or after the protocol. When the 2 baseline evaluations were compared, there were no changes in any RTG kinematics or RTG coordination. In contrast, after 30 hours of ASAP, total movement time and deceleration time of RTG actions markedly decreased, maximum reach (transport) velocity strikingly increased, and time of maximum aperture was accomplished later. Additionally, the maximal RTG correlation coefficient increased with a shorter associated time lag. A similar pattern was observed for the clinical outcome measures of WMFT and SIS. Conclusions: The findings demonstrate the feasibility of using an ASAP protocol for patients 1 to 3 months post stroke. Under ASAP, WMFT tasks and RTG actions were performed faster with higher peak transport velocity and a more coordinated RTG pattern. The next step is to determine whether the immediate gains in the skilled RTG actions persist 6 months alter. © 2013 Thomas Land Publishers, Inc.
author2 Mahidol University
author_facet Mahidol University
Jarugool Tretriluxana
Nuttakarn Runnarong
Suradej Tretriluxana
Naraporn Prayoonwiwat
Roongtiwa Vachalathiti
Carolee Winstein
format Article
author Jarugool Tretriluxana
Nuttakarn Runnarong
Suradej Tretriluxana
Naraporn Prayoonwiwat
Roongtiwa Vachalathiti
Carolee Winstein
author_sort Jarugool Tretriluxana
title Feasibility investigation of the accelerated skill acquisition program (ASAP): Insights into reach-to-grasp coordination of individuals with postacute stroke
title_short Feasibility investigation of the accelerated skill acquisition program (ASAP): Insights into reach-to-grasp coordination of individuals with postacute stroke
title_full Feasibility investigation of the accelerated skill acquisition program (ASAP): Insights into reach-to-grasp coordination of individuals with postacute stroke
title_fullStr Feasibility investigation of the accelerated skill acquisition program (ASAP): Insights into reach-to-grasp coordination of individuals with postacute stroke
title_full_unstemmed Feasibility investigation of the accelerated skill acquisition program (ASAP): Insights into reach-to-grasp coordination of individuals with postacute stroke
title_sort feasibility investigation of the accelerated skill acquisition program (asap): insights into reach-to-grasp coordination of individuals with postacute stroke
publishDate 2018
url https://repository.li.mahidol.ac.th/handle/123456789/32675
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