Keele Research Repository

Purpose
Forty percent of stroke survivors have a persistent lack of function in the upper limb, causing significant disability. Most personal-care tasks and meaningful activities require bi-manual function of both upper limbs. However, lower-limb mobility is often viewed as the priority in stroke services. Perspectives of stroke survivors on priorities for upper-limb recovery and therapy have not been investigated in detail. Therefore, this study aimed to explore their views.

Materials and methods
Thirteen stroke survivors each engaged in up to four semi-structured interviews over 18 months. A phenomenological approach guided the research.

Results
Three themes were identified. Priorities change on coming home: recovery of walking is a priority early after stroke but upper-limb recovery becomes equally important over time, particularly once living at home. Limited therapy services: therapy has a short duration, prioritizes lower-limb mobility, and is short-lived in the community; people feel abandoned by services. Active partners in recovery: stroke survivors want intermittent access to review and advice so they can be active partners with therapists to manage their upper-limb recovery.

Conclusion
Therapy services should recognize stroke survivors’ changing priorities and work with them as active partners in upper-limb recovery. Intermittent access to review and advice should be included in service design.

Implications for rehabilitation
Strokesurvivors’ priorities may change over timefromrecovery ofwalking toward upper-limb recovery.
Post-strokeservicescan be perceived as insufficient to meet the needs ofstrokesurvivors who want to participate
actively in rehabilitation oftheir upper limb.
Strokesurvivors may prefer services thatare moreflexibleto provideregular reviewoftheir progress,access to
guidanceand support to self-managetheir recovery.