Article

PURPOSE: To classify the self-identified goals of individuals post-stroke with
chronic upper extremity (UE) paresis, and determine if age,
UE functional
capacity and pre-stroke hand dominance influence overall goal selection. METHOD:
Sixty-five subjects participated. Using the Canadian Occupational Performance
Measure (COPM) to establish treatment goals, the top five goals were categorized
using the Occupational Therapy Practice Framework into five categories:
activities of daily living (ADLs), instrumental activities of daily living
(IADLs), leisure, work and general UE movement. A Chi-square analysis determined
if age, UE functional capacity (measured by the Action Research Arm Test) and UE
hand dominance influenced individual goal selection. RESULTS: The majority of
goals were in the ADL (37%) and IADL (40%) categories.
A small percentage (12%)
was related to general UE movement. Individuals with moderate UE functional
capacity identified more ADL goals than those with higher UE functional capacity.
There was not a difference between age and UE dominance across all five goal
areas. CONCLUSIONS: Individuals with chronic UE paresis had specific goals that
were not influenced by age or hand dominance, but partially influenced by
severity. General UE movement goals were identified less than goals related to
specific activities. Implications for Rehabilitation Considering the specificity
of individual goals following stroke, it is recommended that clinicians regularly
utilize a goal setting tool to help establish client goals. It is recommended
that clinicians further inquire about general goals in order to link upper
extremity deficits to functional activity limitations.
Age, upper extremity
functional capacity and hand dominance have little influence on the
rehabilitation goals for individuals with chronic paresis after stroke.

Langue : ANGLAIS