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Objectives

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

REACH Reliality and Validity

Upper extremity functional activities: wash cloth wringing , opening jars, etc...

Chedoke-McMaster Arm and Hand Subscale is a well known and well studied subscale of arm and hand function

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

Why was it made?

How was it Made?

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)

  • Time efficiency for both OT and OTA (OTA Flow Sheets)
  • Provide quick resource to establish stage of hand and arm function and appropriate interventions for each individual stage
  • Help use evidence based practice in treatment

Graded Repetitive Arm Supplementary Program (GRASP)

  • PROM, AAROM, and AROM omitted (captured in other areas of tool)
  • Strengthening exercises not included

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Explanation of REACH

What is the Stroke Upper Extremity Best Practices Tool

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

  • A treatment tool that was derived from the REACH scale and can be used with any patient that is experiencing arm/hand weakness or impairment
  • Tool establishs the stage that the hand and arm function are at (REACH) and also provides appropriate interventions for each stage
  • Developed to be used as OTA flow sheet (what treatments OT would like OTA to do with patients)

Used as an educational handout for patients being discharged rather than treatment

*Stroke Upper Extremity Evidence Based Tool will be used for treatment purposes*

Stroke Upper Extremity Evidence Based Tool

(Student Project)

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