Strawson, Amanda;
Francis, Jill J;
Brander, Fran;
Kelly, Kate;
Haddad, Mark;
Ward, Nick S;
(2025)
Investigating changes in quality-of-life after high-dose high-intensity upper limb rehabilitation in chronic stroke survivors: A mixed-methods analysis of the Queen Square Programme.
Clinical Rehabilitation
, 39
(10)
10.1177/02692155251363439.
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Abstract
Objective: To evaluate changes in quality-of-life and explore psychosocial influences on social participation and recovery in chronic stroke survivors following intensive upper limb neurorehabilitation. Design: Mixed-methods design with quantitative (pre-post design with follow-up) and qualitative (semi-structured interview) phases. Setting: Three-week Queen Square upper limb neurorehabilitation programme. Participants: 65 stroke survivors who participated in the programme from July 2016 to March 2018. Main measures: Stroke Impact Scale (3.0) (SIS) and Action Research Arm Test, collected on admission, discharge, 6-week and 6-month follow-up (n = 65). Beliefs and psychosocial factors influencing quality-of-life were investigated through thematic analysis of semi-structured interviews in two subgroups, based whether the SIS-participation domain change from admission to follow-up was high (> 20, n = 5) or low (<-24, n = 5). Results: Seven out of eight SIS domains, overall self-rated recovery (p < 0.001) and Action Research Arm Test (p < 0.001) improved from admission to discharge. The emotion domain improved from admission to discharge (p < 0.001) and reduced from discharge to 6-month follow-up (p < 0.001). Interviews highlighted four key psychosocial themes with contrasting positive and negative perspectives between higher change and lower change groups; themes ‘hidden negative effects’ and ‘loneliness’ were evident in the lower change group and ‘getting on with my life’ in the higher change group. Conclusion: The Queen Square upper limb neurorehabilitation programme led to measurable therapeutic benefits on physical and non-physical quality-of-life outcomes. However, the lack of sustained improvement in self-reported emotion contrasts with the clear benefits in other domains. This indicates a need for ongoing psychosocial support for some stroke survivors, supported by the qualitative findings.
| Type: | Article |
|---|---|
| Title: | Investigating changes in quality-of-life after high-dose high-intensity upper limb rehabilitation in chronic stroke survivors: A mixed-methods analysis of the Queen Square Programme |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/02692155251363439 |
| Publisher version: | https://doi.org/10.1177/02692155251363439 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | ANXIETY, IMPACT, Life Sciences & Biomedicine, QUESTIONNAIRE, RECOVERY, Rehabilitation, SCALE, Science & Technology |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214004 |
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