Upper Extremity Task-Specific Training: Manual Development and Implementation Research within Inpatient...

Area of Science:

• Neurology
• Occupational Therapy
• Rehabilitation Medicine

Background:

• Task-specific training is crucial for upper extremity (UE) functional recovery in neurologic conditions.
• Manualization and structured implementation are key to consistent delivery of therapeutic interventions.
• Inpatient rehabilitation settings require adaptable and effective training protocols.

Purpose of the Study:

• To develop and implement a structured, manualized program for neurologic upper extremity task-specific training.
• To identify and address barriers to implementation within an inpatient rehabilitation setting.
• To refine the training manual based on stakeholder feedback and practical application.

Main Methods:

• Utilized the Consolidated Framework for Implementation Research (CFIR) for study design.
• Engaged 31 diverse stakeholders (occupational therapists, assistants, educators) in manual refinement and barrier analysis.
• Conducted a year-long training and implementation period followed by feedback collection for revisions.

Main Results:

• Achieved consensus on manual usability, applicability, and implementation through iterative revisions.
• Identified key implementation barriers including intervention complexity and insufficient idea sharing.
• Lack of external motivators was reported as a significant challenge.

Conclusions:

• A manualized, task-specific UE training program can be developed and implemented in inpatient rehabilitation.
• Stakeholder engagement is vital for refining interventions and overcoming identified barriers.
• Future occupational therapy implementation research should consider strategies to address complexity and enhance motivation.