Evaluation of the ELEMENTS tablet for post-stroke rehabilitation

The study is comprised of two cohorts: (1) hospital or inpatient based rehabilitation patients and (2) community based rehabilitation patients. Both cohorts will complete 30 min of individual therapy sessions (conventional or experimental), 3 times weekly, prescribed by a senior Occupational/Physical Therapist specialist. The inpatient cohort will complete the interventions for 4 weeks as an inpatient and then an additional 8 weeks once discharged into the community and will be supported by a Specialist Occupational/Physical Therapist if and when required. The community based cohort will complete 8 weeks of therapy only and participants allocated to this group will complete all the therapy sessions in their own homes. For the experimental intervention we will use the ELEMENTS-T tablet, an electronic device containing a computer software providing a mix of goal-directed and exploratory upper-limb movement and cognitive interactive tasks. The software will provide exercises of moderate intensity. Adherence to the therapy program will be monitored and recorded online, participants will be contacted by phone if/when required. Participants will complete all therapy session in hospital (inpatient cohort) and later at home (Community based cohort). For the conventional intervention we will use the Graded Repetitive Arm Supplementary Program (GRASP), an evidence based exercise program designed for Stroke patients at the University of British Columbia https://neurorehab.med.ubc.ca/grasp/. This program provides a moderately intensive level of exercises and focus on part practice of the upper limb addressing strength, dexterity and rang of motion. Participants will keep track and evidence of adherence to this program on a table and will receive regular phone calls to assess and monitor adherence. Both cohorts will receive initially a 30 minute education session from a Senior Therapist and will be expected to complete the prescribed tasks in a self directed manner thereafter if able. Those participants requiring assistance with set up will have access to this from a family member or therapist, however they will be expected to complete all tasks with little to no intervention from another.