GRASP (Graded Repetitive Arm Supplementary Program) Stroke Program

Gym In Motion is pleased to have been licensed by the University of British Columbia to present their GRASP Program and to use the various GRASP manuals. University of British Columbia owns the GRASP Program

 Neurorehabilitation Research Program is directed by Dr. Janice Eng at the Rehabilitation Research Program, GF Strong Rehab Centre. Dr. Eng’s research develops novel rehabilitation interventions to improve important aspects of functioning and health of individuals with neurological conditions. Research studies range from exploratory mechanistic studies, to clinical trials and knowledge translation.

Overview of GRASP

GRASP is a self-directed arm and hand exercise program which is supervised by a trainer, but done independantly by the participant (and with their family or carer if possible). GRASP has been shown to improve arm and hand function and strength after stroke. GRASP prescribes one hour of daily GRASP exercise, plus encourage the patient to use the stroke affected arm and hand as much as possible.

Brain Repair after Stroke

Following a stroke, brain structures and pathways are damaged. It can take hundreds, if not housands of challenging repetitions of practice to improve activation of the brain and to relearn movements. In rehabilitation therapy sessions, stroke patients may need to work on many functions such as walking, balance, speech and cognition, and may have a little time left to practice reaching and grasping. GRASP is a supplementary program that adds over 300 challenging repetitions per session and has been shown to improve arm and hand function after a stroke.

Goals of GRASP

• Increase the potential for recovery of the hand and arm through challenging repetitions of practice and encouraging use of the stroke affected hand in everyday activities
• Facilitate the eventual transition to self-managed exercise programs post-discharge
• Prevents the "learned non-use" syndrome often found after stroke
• Engage the client and family in the herapy process and place an expectation of active participation on the patient

GRASP Research Evidence

The GRASP Program was originally developed in Vancouver, Canada by Janice Eng, PhD, PT/OT and Jocelyn Harris, PhD, OT with valuable assistance from Andrew Dawson, MD, FRCP and Bill Miller, PhD, OT and with funding from the Heart and Stroke Foundation of BC and Yukon. The following table summarises the findings. A number of advances in GRASP have been made with assistance from Louise Connell, phD, PT and Lisa Simpson MSc, OT.

Summary of Findings

We showed in 103 stroke inpatients within their first 4 weeks of stroke that the GRASP Program (Hospital Version) improved arm and hand function (Chedoke Arm and Hand Activity Inventory, Action Research Arm Test), grip strength and amount of use. GRASP can result in more than 300 hand and arm repetitions per session. In addition, a small study (n=8) showed that community dwelling individuals with stroke within their first year post stroke benefited from a weekly phone monitored and motivated Home Version of GRASP over 2 months.