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What is the tool?
Explanation of the REACH
How was the tool made?
Why was the tool made?
How it will be used in practice
How it Will be Used in Practice
Case Scenario:
60 year old right hand dominant man who had experienced Left parietal stroke causing right sided weakness in arm and leg. During initial assessment of patient you establish that patient is using his less affected side minimally during two handed tasks to help the non-affected side. You come to a conclussion that the non-affected side is doing most of the work during ADL assessment, but the patient does assist with their affected side.
What Stage is the patient?
AROM: Elbow, Wrist, Hand
Educate regarding positioning and handling of R arm - Hemi arm protocol
Upper extremity functional activities: wash cloth wringing , opening jars, etc...
REACH proven to have strong correlation with the Chedoke-McMaster Arm and Hand Subscale!
Edema management: Encourage active movement, retrograde message, etc..
REACH=Functionally Based
Chedoke=Performance Based
Rating of Everyday Arm-Use in the Community and Home (REACH)
Simpson, L. A., Eng, J. J., Backman, C. L., Miller, W. C. (2013)
An Evidence Based Occupational Therapy Toolkit for Assessment and Treatment for the Upper Extremity Post-Stroke
Semenko, B. et al., (2015)
Graded Repetitive Arm Supplementary Program (GRASP)
=
Rating of Everday Arm-Use in the Community and Home (REACH)
Provides a rich description of how the affected limb should be used post-stroke outside of the clinical setting (in the community)
Includes 6 stages (Stages 0-5), where stage 0 = No use of affected limb and stage 5 = full use of affected limb
Used as an educational handout for patients being discharged rather than treatment
*Stroke Upper Extremity Evidence Based Tool will be used for treatment purposes*