Repetitions, duration and intensity of upper limb practice following the implementation of robot assisted therapy with sub-acute stroke survivors : An observational study

Journal article


Flynn, Nicholas, Froude, Elspeth, Cooke, Deirdre and Kuys, Suzanne. (2020). Repetitions, duration and intensity of upper limb practice following the implementation of robot assisted therapy with sub-acute stroke survivors : An observational study. Disability and Rehabilitation Assistive Technology. pp. 1-6. https://doi.org/10.1080/17483107.2020.1807621
AuthorsFlynn, Nicholas, Froude, Elspeth, Cooke, Deirdre and Kuys, Suzanne
Abstract

Background
Robot assisted upper limb (UL) therapy has been identified as an intervention with the potential to help improve the amount of practice performed by stroke survivors.

Objectives
This study aimed to measure the amount of UL practice (i.e., repetitions, duration, intensity) performed by subacute stroke survivors, in particular those with severe UL impairment, pre and post implementation of robot assisted upper limb therapy (RT-UL) into an inpatient rehabilitation setting.

Methods
Two observational study phases (pre-RT-UL and post-RT-UL) were undertaken of occupational therapy and physiotherapy sessions performed by subacute stroke survivors. Upper limb tasks observed and recorded in therapy were classified as either impairment-related therapy or activity-related.

Results
In the pre-RT-UL observational phase, 7 subacute stroke survivors were observed across 11 days involving 25 therapy sessions. Post-RT-UL, 12 subacute stroke survivors were observed across 12 days involving 29 therapy sessions. There were no significant differences in characteristics of patients observed in each phase (p > .05). The mean difference (95% CI) between pre and post RT-UL for repetitions (reps) (569 (1 to 1136) and intensity (7 (4–11)) reps/min of practice increased for all patients, including those with severe UL impairment (337 (37–638)) reps and 8 (2–14) reps/minute, with the duration of therapy unchanged.

Conclusions
This is the first study to have observed an increase in UL practice with the inclusion of RT-UL as part of routine clinical practice. This increase in practice is considered to be due to RT-UL providing highly supportive and expeditious semi-supervised practice. Notably, RT-UL was able to be implemented within the existing organisational structures with only basic training of therapy staff.

IMPLICATIONS FOR REHABILITATION
Robotics presents as a viable intervention to increase the amount and intensity of upper limb practice performed by stroke survivors in routine clinical practice

Robotics were able to be implemented within the existing organisational structures with only basic training of therapy staff

Keywordsrobotics; stroke rehabilitation; upper extremity; occupational therapy; physical therapy; implementation
Year2020
JournalDisability and Rehabilitation Assistive Technology
Journal citationpp. 1-6
PublisherTaylor and Francis Ltd
ISSN1748-3107
Digital Object Identifier (DOI)https://doi.org/10.1080/17483107.2020.1807621
Scopus EID2-s2.0-85089578113
Research or scholarlyScholarly
Page range1-6
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusIn press
Publication dates
Online18 Aug 2020
Publication process dates
Accepted05 Aug 2020
Deposited14 Jul 2021
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The measurement of visual ability in children with cerebral palsy : A systematic review
Deramore Denver, Belinda, Froude, Elspeth, Rosenbaum, Peter, Wilkes-Gillan, Sarah and Imms, Christine. (2016). The measurement of visual ability in children with cerebral palsy : A systematic review. Developmental Medicine and Child Neurology. 58(10), pp. 1016-1029. https://doi.org/10.1111/dmcn.13139
General versus spinal anaesthesia and postoperative delirium in an orthogeriatric population
Ilango, Sivarajah, Pulle, Ranjeev Chrys, Bell, Jack J. and Kuys, Suzanne Shanelle. (2016). General versus spinal anaesthesia and postoperative delirium in an orthogeriatric population. Australasian Journal on Ageing. 35(1), pp. 42 - 47. https://doi.org/10.1111/ajag.12212
A descriptive study of the participation of children and adolescents in activities outside school
Imms, Christine, Froude, Elspeth H., Adair, Brooke and Shields, Nora. (2016). A descriptive study of the participation of children and adolescents in activities outside school. BMC Pediatrics. 16(84), pp. 1 - 11. https://doi.org/10.1186/s12887-016-0623-9
Outdoor play decisions by caregivers of children with disabilities: A systematic review of qualitative studies
Sterman, Julia, Naughton, Geraldine Ann, Froude, Elspeth Heather, Villeneuve, Michelle, Beetham, Kassia, Wyver, Shirley and Bundy, Anita. (2016). Outdoor play decisions by caregivers of children with disabilities: A systematic review of qualitative studies. Journal of Developmental and Physical Disabilities. https://doi.org/10.1007/s10882-016-9517-x
Direct inpatient burden caused by foot-related conditions: A multisite point-prevalence study
Lazzarini, Peter A., Hurn, Sheree E., Kuys, Suzanne Shanelle, Kamp, Maarten C., Ng, Vanessa, Thomas, Courtney, Jen, Scott D., Kinnear, Ewan, d'Emden, Michael C. and Reed, Lloyd. (2016). Direct inpatient burden caused by foot-related conditions: A multisite point-prevalence study. BMJ Open. 6(6), pp. 1 - 15. https://doi.org/10.1136/bmjopen-2015-010811
Demographics and discharge outcomes of dysvascular and non-vascular lower limb amputees at a subacute rehabilitation unit : A 7-year series
Batten, Heather, Kuys, Suzanne, McPhail, Steven, Varghese, Paulose and Nitz, Jennifer. (2015). Demographics and discharge outcomes of dysvascular and non-vascular lower limb amputees at a subacute rehabilitation unit : A 7-year series. Australian Health Review. 39(1), pp. 76 - 84. https://doi.org/10.1071/AH14042
A systematic review of axillary web syndrome (AWS)
Yeung, W. M., McPhail, Steven M. and Kuys, Suzanne Shanelle. (2015). A systematic review of axillary web syndrome (AWS). Journal of Cancer Survivorship. 9(4), pp. 576 - 598. https://doi.org/10.1007/s11764-015-0435-1
Comparison of sit-to-stand strategies used by older adults and people living with dementia
Dolecka, Urszula, Ownsworth, Tamara and Kuys, Suzanne. (2015). Comparison of sit-to-stand strategies used by older adults and people living with dementia. Archives of Gerontology and Geriatrics. 60(3), pp. 528 - 534. https://doi.org/10.1016/j.archger.2014.12.007
Prevalence of foot disease and risk factors in general inpatient populations: A systematic review and meta-analysis
Lazzarini, Peter A., Hurn, Sheree E., Fernando, Malindu E., Jen, Scott D., Kuys, Suzanne S., Kamp, Maarten C. and Reed, Lloyd F.. (2015). Prevalence of foot disease and risk factors in general inpatient populations: A systematic review and meta-analysis. BMJ Open. 5(11), pp. 1 - 15. https://doi.org/10.1136/bmjopen-2015-008544
Clinically important improvements in motor function are achievable during inpatient rehabilitation by stroke patients with severe motor disability : A prospective observational study
Hayward, Kathryn, Kuys, Suzanne, Barker, Ruth and Brauer, Sandra. (2014). Clinically important improvements in motor function are achievable during inpatient rehabilitation by stroke patients with severe motor disability : A prospective observational study. NeuroRehabilitation. 34(4), pp. 773 - 779. https://doi.org/10.3233/NRE-141076
Embedding simulation in clinical training in occupational therapy project: National consultation report
Imms, Christine, Chu, Eli Mang Yee, Guinea, Stephen, Sheppard, Loretta, Froude, Elspeth Heather and Carter, Rob. (2014). Embedding simulation in clinical training in occupational therapy project: National consultation report Australian Catholic University.
Open access and the australian occupational therapy journal
Brown, Ted and Froude, Elspeth. (2014). Open access and the australian occupational therapy journal. Australian Occupational Therapy Journal. 61(2), pp. 37 - 37. https://doi.org/10.1111/1440-1630.12123
Gait speed in ambulant older people in long term care : A systematic review and meta-analysis
Kuys, Suzanne, Peel, Nancye, Klein, Kerenaftali, Slater, Alexandra and Hubbard, Ruth. (2014). Gait speed in ambulant older people in long term care : A systematic review and meta-analysis. Journal of the American Medical Directors Association (JAMDA) (print). 15(3), pp. 194 - 200. https://doi.org/10.1016/j.jamda.2013.10.015
The Queensland High Risk Foot Form (QHRFF) - Is it a reliable and valid tool for foot disease?
Lazzarini, Peter A., Ng, Vanessa, Kinnear, Ewan M., Kamp, Maarten C., Kuys, Suzanne S., Hurst, Cameron and Reed, Lloyd F.. (2014). The Queensland High Risk Foot Form (QHRFF) - Is it a reliable and valid tool for foot disease? Journal of Foot and Ankle Research. 7(7), pp. 1 - 18. https://doi.org/10.1186/1757-1146-7-7
The Queensland high risk foot form (QHRFF) - is it a reliable and valid clinical research tool for foot disease?
Lazzarini, Peter A., Ng, Vanessa, Kinnear, Ewan, Kamp, Maarten C., Kuys, Suzanne Shanelle, Hurst, Cameron and Reed, Lloyd. (2014). The Queensland high risk foot form (QHRFF) - is it a reliable and valid clinical research tool for foot disease? Journal of Foot and Ankle Research. 7(1), pp. 1 - 18. https://doi.org/10.1186/1757-1146-7-7
Use and validation of the balance outcome measure for elder rehabilitation in acute care
Kuys, Suzanne, Crouch, Tom, Dolecka, Urszula, Steele, Michael and Low Choy, Nancy. (2014). Use and validation of the balance outcome measure for elder rehabilitation in acute care. New Zealand Journal of Physiotherapy. 42(1), pp. 16 - 21.
Factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation
Eng, Xue Wen, Brauer, Sandra, Kuys, Suzanne, Lord, Matthew and Hayward, Kathryn. (2014). Factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation. Stroke Research and Treatment. https://doi.org/10.1155/2014/626538
Factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation
Eng, Xue Wen, Brauer, Sandra, Kuys, Suzanne Shanelle, Lord, Matthew and Hayward, Kathryn. (2014). Factors affecting the ability of the stroke survivor to drive their own recovery outside of therapy during inpatient stroke rehabilitation. Stroke Research and Treatment. https://doi.org/10.1155/2014/626538
Development and preliminary validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA)
Gesch, Janelle, Low Choy, Nancy, Weeks, Benjamin, Passier, Leanne, Nascimento, Margarida, Haines, Terry and Kuys, Suzanne. (2014). Development and preliminary validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA). Brain Impairment. 15(2), pp. 132 - 145. https://doi.org/10.1017/BrImp.2014.13
Preparatory teachers' perceptions of school readiness : a survey of Victorian teachers
Imms, Christine, Froude, Elspeth, Joffe, Beverly, Heine, Chyrisse, Merrigan, Celeste and Serry, Tanya. (2014). Preparatory teachers' perceptions of school readiness : a survey of Victorian teachers. The Australian Educational Researcher. 41(1), pp. 109 - 124. https://doi.org/10.1007/s13384-013-0126-8
Activity limitations experienced by people with stroke who received inpatient rehabiliation: Differences between 2001, 2005, and 2011
Kuys, Suzanne Shanelle, Bew, Paul, Lynch, Mary and Brauer, Sandy. (2014). Activity limitations experienced by people with stroke who received inpatient rehabiliation: Differences between 2001, 2005, and 2011. Archives of Physical Medicine and Rehabilitation. 95(4), pp. 741 - 746. https://doi.org/10.1016/j.apmr.2013.12.008
The health outcomes and costs of people attending an interdisciplinary chronic disease service in regional Australia: protocol for a longitudinal cohort investigation
Tyack, Zephanie, Frakes, Kerrie-Anne, Cornwell, Petrea, Kuys, Suzanne, Barnett, Adrian and McPhail, Steven. (2013). The health outcomes and costs of people attending an interdisciplinary chronic disease service in regional Australia: protocol for a longitudinal cohort investigation. BMC Health Services Research. 13(410), pp. 1 - 7. https://doi.org/10.1186/1472-6963-13-410
Foundations of the research foundation
Cusick, A., Curtin, M., Froude, Elspeth, Ziviani, Jenny, Stanley, M, Molineux, M and Hoffman, T. (2013). Foundations of the research foundation. Australian Occupational Therapy Journal. 60(6), pp. 377 - 377.
Physiotherapy students find guided journals useful to develop reflective thinking and practice during their first clinical placement : A qualitative study
Constantinou, Maria and Kuys, Suzanne. (2013). Physiotherapy students find guided journals useful to develop reflective thinking and practice during their first clinical placement : A qualitative study. Physiotherapy (print). 99(1), pp. 49 - 55. https://doi.org/10.1016/j.physio.2011.12.002
Feasibility of an interdisciplinary early intervention for patients with low levels of responsiveness following an acquired brain injury
Seeto, Treena, Kuys, Suzanne Shanelle, Budden, Cassandra, Griffin, Erin, Kajewski, Haylee and McPhail, Steven. (2013). Feasibility of an interdisciplinary early intervention for patients with low levels of responsiveness following an acquired brain injury. Brain Impairment. 14(2), pp. 213 - 221. https://doi.org/10.1017/BrImp.2013.20
Frequency of urinary incontinence in people with chronic heart failure
Hwang, Rita, Chuan, Francine, Peters, Robyn and Kuys, Suzanne. (2013). Frequency of urinary incontinence in people with chronic heart failure. Heart & Lung: the journal of acute and critical care. 42(1), pp. 26 - 31. https://doi.org/10.1016/j.hrtlng.2012.08.003
Feasibility of an interdisciplinary early intervention for patients with low levels of responsiveness following an acquired brain injury
Seeto, Treena, Kuys, Suzanne, Budden, Cassandra, Griffin, Erin, Kajewski, Haylee and McPhail, Steven. (2013). Feasibility of an interdisciplinary early intervention for patients with low levels of responsiveness following an acquired brain injury. Brain Impairment. 14(2), pp. 213 - 221. https://doi.org/10.1017/BrImp.2013.20
Writing for publication
Froude, Elspeth and Clemson, Lindy. (2013). Writing for publication. Australian Occupational Therapy Journal. 60(4), pp. 229 - 229. https://doi.org/10.1111/1440-1630.12075
Frequency of urinary incontinence in people with chronic heart failure
Hwang, Rita, Chuan, Francine, Peters, Robyn and Kuys, Suzanne Shanelle. (2013). Frequency of urinary incontinence in people with chronic heart failure. Heart & Lung: the journal of acute and critical care. 42(1), pp. 26 - 31. https://doi.org/10.1016/j.hrtlng.2012.08.003
Feasibility of gaming console exercise and its effect on endurance, gait and balance in people with an acquired brain injury
McClanachan, Nelson, Gesch, Janelle, Wuthapanich, Nampech, Fleming, Jennifer and Kuys, Suzanne Shanelle. (2013). Feasibility of gaming console exercise and its effect on endurance, gait and balance in people with an acquired brain injury. Brain Injury. 27(12), pp. 1402 - 1408. https://doi.org/10.3109/02699052.2013.823654
Feasibility of gaming console exercise and its effect on endurance, gait and balance in people with an acquired brain injury
McClanachan, Nelson, Gesch, Janelle, Wuthapanich, Nampech, Fleming, Jennifer and Kuys, Suzanne. (2013). Feasibility of gaming console exercise and its effect on endurance, gait and balance in people with an acquired brain injury. Brain Injury. 27(12), pp. 1402 - 1408. https://doi.org/10.3109/02699052.2013.823654
What are the key conditions associated with lower limb amputations in a major Australian teaching hospital?
Lazzarini, Peter, O'Rourke, Sharon, Russell, Anthony, Clark, Damien and Kuys, Suzanne Shanelle. (2012). What are the key conditions associated with lower limb amputations in a major Australian teaching hospital? Journal of Foot and Ankle Research. 5(12), pp. 1 - 9. https://doi.org/10.1186/1757-1146-5-12
What are the key conditions associated with lower limb amputations in a major Australian teaching hospital?
Lazzarini, Peter, O'Rourke, Sharon, Russell, Anthony, Clark, Damien and Kuys, Suzanne. (2012). What are the key conditions associated with lower limb amputations in a major Australian teaching hospital? Journal of Foot and Ankle Research. 5(1), pp. 1 - 9. https://doi.org/10.1186/1757-1146-5-12
Prospective study of the participation patterns of Grade 6 and Year 8 students in Victoria, Australia in activities outside of school
McMullan, Sarah, Chin, Rachel, Froude, Elspeth Heather and Imms, Christine. (2012). Prospective study of the participation patterns of Grade 6 and Year 8 students in Victoria, Australia in activities outside of school. Australian Occupational Therapy Journal. 59(3), pp. 197 - 208. https://doi.org/10.1111/j.1440-1630.2012.01013.x
Activity level of hospital medical inpatients: An observational study
Kuys, Suzanne S., Dolecka, Urszula E. and Guard, Amanda. (2012). Activity level of hospital medical inpatients: An observational study. Archives of Gerontology and Geriatrics. 55(2), pp. 417 - 421. https://doi.org/10.1016/j.archger.2012.02.008
Translating evidence into practice: the role of scholarly journals
Froude, Elspeth. (2012). Translating evidence into practice: the role of scholarly journals. Australian Occupational Therapy Journal. 59(3), pp. 171 - 171. https://doi.org/10.1111/j.1440-1630.2012.01021.x
Can Wii work it out?
Cyarto, Elizabeth V., Kuys, Suzanne, Henwood, Tim R. and Blackberry, Irene. (2011). Can Wii work it out? Telecommunications Journal of Australia. 61(3), pp. 37.1 - 37.12.
Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: A pilot randomized trial
Kuys, Suzanne S., Brauer, Sandra G. and Ada, Louise. (2011). Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: A pilot randomized trial. Clinical Rehabilitation. 25(4), pp. 316 - 326. https://doi.org/10.1177/0269215510382928
Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality : A pilot randomized trial
Kuys, Suzanne, Brauer, Sandra and Ada, Louise. (2011). Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality : A pilot randomized trial. Clinical Rehabilitation. 25(4), pp. 316 - 326. https://doi.org/10.1177/0269215510382928
Appropriate seating for medical patients: An audit
Kuys, Suzanne, Dolecka, Urszula and Morrison, Carol. (2011). Appropriate seating for medical patients: An audit. Australian Health Review. 35(3), pp. 316 - 319. https://doi.org/10.1071/AH10943
Changes in falls risk factors for geriatric diagnostic groups across inpatient, outpatient and domiciliary rehabilitation settings
Morrison, Gregory, Lee, Huang-Ling, Kuys, Suzanne, Clarke, Jane, Bew, Paul and Haines, Terry. (2011). Changes in falls risk factors for geriatric diagnostic groups across inpatient, outpatient and domiciliary rehabilitation settings. Disability and Rehabilitation. 33(11), pp. 900 - 907. https://doi.org/10.3109/09638288.2010.514019
Trial of an allied health workload allocation model
Simmons, Nadine and Kuys, Suzanne. (2011). Trial of an allied health workload allocation model. Australian Health Review. 35(2), pp. 168 - 175. https://doi.org/10.1071/AH09860
Leisure Participation Patterns of Children in Victoria Australia
Chin, Rachel, McMullen, Sarah, Froude, Elspeth Heather and Imms, Christine. (2011). Leisure Participation Patterns of Children in Victoria Australia. Australian Occupational Therapy Journal. 58(Suppl s1), pp. 101 - 101. https://doi.org/10.1111/j.1440-1630.2011.00938.x
Factors Influencing Children's Readiness to Enter School :Views From Early Childhood Educators
Froude, Elspeth Heather, Imms, Christine, Merrigan, C, Joffe, Beverly, Heine, Chyrisse and Serry, Tanya. (2011). Factors Influencing Children's Readiness to Enter School :Views From Early Childhood Educators. Australian Occupational Therapy Journal. 58(Suppl s1), pp. 23 - 23.
Test-retest reliability of the GAITRite system in people with stroke undergoing rehabilitation
Kuys, Suzanne, Brauer, Sandra and Ada, Louise. (2011). Test-retest reliability of the GAITRite system in people with stroke undergoing rehabilitation. Disability and Rehabilitation. 33(19-20), pp. 1848 - 1853. https://doi.org/10.3109/09638288.2010.549895
Appropriate seating for medical patients: An audit
Kuys, Suzanne S., Dolecka, Urszula E. and Morrison, Carol A.. (2011). Appropriate seating for medical patients: An audit. Australian Health Review. 35(3), pp. 316 - 319. https://doi.org/10.1071/AH10943
Gaming console exercise and cycle or treadmill exercise provide similar cardiovascular demand in adults with cystic fibrosis : A randomised cross-over trial
Kuys, Suzanne, Hall, Kathleen, Peasey, Maureen, Wood, Michelle, Cobb, Robyn and Bell, Scott. (2011). Gaming console exercise and cycle or treadmill exercise provide similar cardiovascular demand in adults with cystic fibrosis : A randomised cross-over trial. Journal of Physiotherapy. 57(1), pp. 35 - 40. https://doi.org/10.1016/S1836-9553(11)70005-4
Trial of an allied health workload allocation model
Simmons, Nadine and Kuys, Suzanne Shanelle. (2011). Trial of an allied health workload allocation model. Australian Health Review. 35(2), pp. 168 - 175. https://doi.org/10.1071/AH09860
Dose-response relationship between physiotherapy resource provision with function and balance improvements in patients following stroke : A multi-centre observational study
Haines, Terry, Kuys, Suzanne, Clarke, Jane, Morrison, Gregory and Bew, Paul. (2011). Dose-response relationship between physiotherapy resource provision with function and balance improvements in patients following stroke : A multi-centre observational study. Journal of Evaluation in Clinical Practice. 17(1), pp. 136 - 142. https://doi.org/10.1111/j.1365-2753.2010.01380.x
Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: A pilot randomized trial
Kuys, Suzanne, Brauer, Sandra and Ada, Louise. (2011). Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: A pilot randomized trial. Clinical Rehabilitation. 25(4), pp. 316 - 326. https://doi.org/10.1177/0269215510382928
Evaluation of the Australian adaptation of the Keeping It Together (KIT-Australia) information package with carers of children with special needs
Stewart, Janeen, Galvin, Jane, Froude, Elspeth and Lentin, Primrose. (2010). Evaluation of the Australian adaptation of the Keeping It Together (KIT-Australia) information package with carers of children with special needs. Australian Occupational Therapy Journal. 57(4), pp. 268 - 275. https://doi.org/10.1111/j.1440-1630.2010.00858.x
Children's participation in home, school and community life after acquired brain injury
Galvin, Jane, Froude, Elspeth and McAleer, Jennifer. (2010). Children's participation in home, school and community life after acquired brain injury. Australian Occupational Therapy Journal. 57(2), pp. 118 - 126. https://doi.org/10.1111/j.1440-1630.2009.00822.x
Facilitating access to evidence - a benefit to the profession
Froude, Elspeth and Craik, C.. (2010). Facilitating access to evidence - a benefit to the profession. Australian Occupational Therapy Journal. 57(6), pp. 355 - 355.
Writing for the reader
Froude, Elspeth. (2010). Writing for the reader. Australian Occupational Therapy Journal. 57(2), pp. 75 - 75.
Sensory processing abilities of children who have sustained traumatic brain injuries
Galvin, Jane, Froude, Elspeth and Imms, Christine. (2009). Sensory processing abilities of children who have sustained traumatic brain injuries. American Journal of Occupational Therapy. 63(6), pp. 701 - 709. https://doi.org/10.5014/ajot.63.6.701
The relationship between physical performance and self-perception in children with and without cerebral palsy
Ziebell, Melanie, Imms, Christine, Froude, Elspeth, McCoy, Anne and Galea, Mary. (2009). The relationship between physical performance and self-perception in children with and without cerebral palsy. Australian Occupational Therapy Journal. 56(1), pp. 24 - 32. https://doi.org/10.1111/j.1440-1630.2008.00775.x
An investigation of Bilateral Isokinematic Training and Neurodevelopmental Therapy in improving use of the affected hand in children with hemiplegia
Sheppard, Loretta, Mudie, Heather and Froude, Elspeth. (2007). An investigation of Bilateral Isokinematic Training and Neurodevelopmental Therapy in improving use of the affected hand in children with hemiplegia. Physical & Occupational Therapy in Pediatrics. 27(1), pp. 5 - 25.
Therapeutic practice resulted in moderate improvement in handwriting ability for children with poor handwriting when compared with sensorimotor intervention, but not when compared with a control group
Wallen, Margaret and Froude, Elspeth. (2007). Therapeutic practice resulted in moderate improvement in handwriting ability for children with poor handwriting when compared with sensorimotor intervention, but not when compared with a control group. Australian Occupational Therapy Journal. 54(3), pp. 239 - 244.