GRASP – Arm Function Post-stroke
We know more repetitive practice can improve arm function post-stroke, but how can we deliver more therapy without great expense or resources? Dr. Eng and her doctoral student, Jocelyn Harris developed the Graded Repetitive Arm Supplementary Program (GRASP), which is a patient self-managed arm and hand exercise program. Her team showed that this novel method of service delivery improved arm function over a control group in a multi-site randomized controlled trial. Due to evidence provided from this study, a supplementary arm exercise program is now recommended by the Canadian Stroke Best Practice Guidelines. Funded by Heart and Stroke Foundation of BC and Yukon. For more information, please visit the GRASP page of this website.
Improving Cognition through Exercise
Studies show that 43 to 78% of individuals with stroke have cognitive impairments. Can we improve memory and thinking abilities with exercise? Dr. Eng and her post-doctoral fellow Debbie Rand led this study which showed that an exercise and leisure program could improve memory and executive functioning in individuals with chronic stroke. Funded by the Canadian Stroke Network and Canadian Institutes of Health Research.
FAME – Mobility Function Post-stroke
Secondary complications such as heart disease, falls and fractures are common after stroke. This paper describes a series of clinical trials which Dr. Eng and her team have undertaken to develop the Fitness and Mobility Exercise Program (FAME). These studies showed that FAME can improve health, including mobility, cardiovascular fitness, bone health, postural reflexes, balance and muscle strength in individuals with stroke. For more information, visit the FAME page of this website.
Brain Plasticity and Arm Use
Dr. Eng’s team has previously shown that many people with stroke do not use their hand and arm in everyday activities, despite having the ability to do so. Does everyday use of the arm affect the re-organization and activation of the brain? Dr. Eng and her graduate student Kristen Kokotilo led this study which showed that individuals who use their stroke-affected arm less (measured by wrist-watch accelerometers over a week) tend to show higher levels of activation of the non-affected motor cortex (i.e., compensatory activation). Dr. Eng hopes that their future studies can determine the amount and types of movement that most effectively influence brain reorganization.
Activity during Rehabilitation
How much activity do stroke patients experience during inpatient stroke rehabilitation? Dr. Eng and her post-doctoral fellow Debbie Rand showed that the amount of arm and leg activity is very low during stroke rehabilitation (either in structured therapy or during the rest of the day). The amount of activity did not increase substantially over the 4 weeks from admission to discharge. This study led to the development of the GRASP program to increase arm activity.