Purpose: To explore therapists' experiences on what elements arm-hand rehabilitation should contain, their importance, and the information needed to apply them in clinical practice.
Materials and methods: This qualitative study, with an exploratory approach, used focus group discussions with purposive sampling. Based on Braun and Clarke's methodology, inductive thematic analysis was employed to develop themes, subthemes, and categories. The study included seven physiotherapists and seven occupational (≥2 year experience) therapists from three spinal cord rehabilitation wards in Belgium and the Netherlands.
Results: The data analysis revealed five major themes, i.e., gathering knowledge, the process of thinking and acting, practice beyond therapy, and motivation. The first theme involves collecting information about the person and their client system. The second focuses on the goal-setting process for a patient-tailored therapy plan, described in the third theme as goal task-oriented with an individualized therapy dose. The fourth theme highlights meaningful activities to enhance performance beyond therapy, while the fifth emphasizes maintaining motivation through rehabilitation.
Conclusion: Therapists highlight centralizing the person and their social environment in arm-hand rehabilitation, leading to a personalized goal-setting process and a patient-tailored therapy plan incorporating meaningful tasks. This approach can increase therapy dose and improve patients' motivation.
Keywords: Spinal cord injuries; goal-oriented training; neurological rehabilitation; practice-based evidence; task-oriented training; therapist’s perspectives; upper extremity.
Motivation is an important factor in engagement in the rehabilitation process and can be facilitated by therapists through setting personal and realistic goals in order to create a patient-tailored therapy plan for individuals with a cervical spinal cord injury.Incorporating meaningful tasks leads to more engagement in therapy and training moments beyond therapy in rehabilitation.Person and client system need to be central in the arm-hand rehabilitation processTherapy dose needs to be adapted to the patient’s personal load capacity; therefore, therapists need an objective way to measure the load capacity of a patient.