What is the The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) for Stroke

Upper extremity Rehabilitation

Dr Winstein and her colleagues working from several sites in the US present their protocol for a randomized controlled trial called an Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE).

Contributing to this study will be teams from the Division of Biokinesiology and Physical Therapy University of Southern California, Department of Neurology, Keck School of Medicine, USA MEDCOM WRAMC, Department of Rehabilitation Medicine, Emory University School of Medicine, Centre for Rehabilitation Medicine, Atlanta, National Rehabilitation Hospital, Washington, DC, Long Beach Memorial Medical Center, Long Beach, CA.
The interest in upper extremity rehabilitation is due to the fact that Residual disability after stroke being large with 65% of patients at 6 months unable to incorporate the impaired upper extremity into daily activities. There is an absence of any consensus on the essential elements or dose of task-specific training therefore the trial will set out to determine the effectiveness of a specific multidimensional task-based program governed by a comprehensive set of evidence-based principles.
The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Stroke initiative compares an Accelerated Skill Acquisition Program (ASAP) to control occupational and physical therapy of the upper extremity.    One of ASAP’s eight overlapping operating principles includes the fact that exercise practice needs to be challenging and meaningful practice and assure active patient involvement and opportunities for self-direction and drive task-specific self-confidence
Outcome measures include the Wolf motor function test (WMFT) and Stroke impact scale (SIS).



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