Graded Repetitive Arm Supplementary Program
Script error: No such module "AfC submission catcheck". The Graded Repetitive Arm Supplementary Program (GRASP) is an exercise and behavioural change program to increase use and recovery of the upper extremities after a stroke.
History
GRASP was developed by Janice J Eng at the University of British Columbia and GF Strong Rehab Centre, in collaboration with graduate students and postdoctoral fellows, including Jocelyn Harris, Louise Connell, Chie-ling Yang and Lisa Simpson.
How it works
GRASP consists of an hour of daily repetitive homework exercises of the arm and hand, that challenge the person’s ability to reach, grasp and manipulate object. The program typically results in several hundred repetitions completed within an hour (Connell 2014).[1] In addition, participants are counselled to identify and practice activities during the day to transfer these skills to real-world activities (e.g., use their stroke-affected hand during dressing or to handle the utensils when eating their meals).
Settings
GRASP has been tested in several settings and formats, including an inpatient setting with weekly one-on-one therapist check-ins (Harris 2009), home setting with phone check-ins (Simpson 2017), community setting with weekly group meetings (Yang, Waterson, Eng 2021) and virtual setting with weekly videoconference group check-ins (Yang, Bird Eng 2021). GRASP has also been used in conjunction with neuromodulation stimulation (Yang 2023).
Benefits
GRASP has been shown to improve arm function, grip strength and arm use (Harris 2009).
Uptake and Implementation of GRASP
The wide dissemination of GRASP has been facilitated by the availability of free instructional manuals and videos (www.neurorehab.med.ubc.ca/GRASP). Over 100 countries utilize GRASP (Yang 2023). GRASP is recommended by the Canadian Stroke Best Practices to increase the treatment intensity during hospitalization and at home (Teasell 2019). A survey of UK therapists found that 35% of neuro physiotherapists and occupational therapists use the GRASP program with their stroke patients who have mild to moderate upper limb impairments (Stockley)
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- ↑ Connell, L. A.; McMahon, N. E.; Simpson, L. A.; Watkins, C. L.; Eng, J. J. (2014). "Investigating measures of intensity during a structured upper limb exercise program in stroke rehabilitation: an exploratory study". Arch Phys Med Rehabil. 95 (12): 2410–2419. doi:10.1016/j.apmr.2014.05.025. PMC 4485917. PMID 24946084.
