title: Understanding upper extremity home programs and the use of gaming technology for persons after stroke.
abstract: BACKGROUND
  Many persons post-stroke continue to have difficulty using their more involved upper extremity and home programs may be poorly adhered to limiting the amount of practice an individual receives. More information on the experience of traditional home program and the acceptability of a novel home intervention was sought.
  
  
  OBJECTIVE
  To qualitatively describe 1) upper extremity use at home, 2) previous home exercise or activity programs, and 3) the acceptability of a novel upper extremity home program, NeuroGame Therapy (NGT), that combines surface electromyography (sEMG) biofeedback and a commercial computer game.
  
  
  METHODS
  A purposeful sample of ten persons with moderate to severe upper extremity motor impairment used the NGT intervention in their home for four weeks and completed nested (pre and post) one-on-one interviews. Written transcripts from the interviews were coded and themes were identified to address stated objectives.
  
  
  RESULTS
  Participants reported that while use of their upper extremity in daily activities was recommended it occurred infrequently. Most participants described previous home programs as being non-specific, were often not carried out as recommended or were self-modified. Participants found NGT to be engaging and motivating, but reported minimal changes in the functional uses of their upper extremity.
  
  
  CONCLUSIONS
  These findings suggest that after stroke upper extremity use may be infrequent and home program approaches could be re-examined. NGT was reported to be an acceptable home intervention, but it will require further development and study to understand its value and role in post-stroke rehabilitation.
authors.affiliation: University of Washington, School of Medicine, Department of Rehabilitation Medicine, 1959 N.E. Pacific St., Seattle, WA 98195, USA; Duquesne University, Department of Occupational Therapy, Rangos School of Health Sciences, 600 Forbes Ave, Pittsburgh, PA 15282, USA. Electronic address: donosobrowne@duq.edu.
authors.forename: Elena V
authors.initials: EV
authors.lastname: Donoso Brown
authors.affiliation: University of Washington, School of Medicine, Department of Rehabilitation Medicine, 1959 N.E. Pacific St., Seattle, WA 98195, USA; University of Alabama at Birmingham, Department of Occupational Therapy, School of Health Professions, SHPB 353, 1720 2nd Ave South, Birmingham, AL 35294-1212, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Dudgeon
authors.affiliation: University of Washington, School of Medicine, Department of Rehabilitation Medicine, 1959 N.E. Pacific St., Seattle, WA 98195, USA.
authors.forename: Karli
authors.initials: K
authors.lastname: Gutman
authors.affiliation: University of Washington, School of Medicine, Department of Rehabilitation Medicine, 1959 N.E. Pacific St., Seattle, WA 98195, USA; University of Washington, School of Medicine, Department of Physiology & Biophysics, 1959 N.E. Pacific St., Seattle, WA 98195, USA.
authors.forename: Chet T
authors.initials: CT
authors.lastname: Moritz
authors.affiliation: University of Washington, School of Medicine, Department of Rehabilitation Medicine, 1959 N.E. Pacific St., Seattle, WA 98195, USA.
authors.forename: Sarah Westcott
authors.initials: SW
authors.lastname: McCoy
mesh_terms: D000328:Adult; D000368:Aged; D006233:Persons with Disabilities; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D010342:Patient Acceptance of Health Care; D011998:Recreation; D012648:Self Care; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D034941:Upper Extremity; D018910:Video Games
keywords: Home exercise program; Qualitative research; Rehabilitation; Stroke; Video games