Effects of forced use combined with scheduled home exercise program on upper extremity functioning in individuals with hemiparesis

Objectives: The aims of this study were to 1) investigate the effects of forced use combined with scheduled home exercise program compared to forced use only on increasing upper extremity functioning, 2) examine whether increased upper extremity functioning generalized to activities of daily living (ADL) functioning, and 3) explore participants' psychosocial functioning. Methods: A single-subject A-B-A'-C research design was employed in this study. The intervention consisted of two conditions: forced use only (intervention period B), and forced use in addtion to scheduled home exercise program (intervention period C). Results: The results were as follows: 1) Forced use combined with scheduled home exercise program compared to forced use only allowed individuals with stroke to take part in exercise programs on their own within their home setting, ultimately improving their upper extremity functioning. 2) The program's promotion of performance in ADL tasks have the advantage of keeping participants focused so that a number of exercises can be maintained throughout the intervention. 3) Finally, forced use combined with scheduled home exercise program showed partial effects on improving the participants' psychosocial functioning. Conclusion: The results of the present study suggest that forced use combined with scheduled home exercise program compared to forced use only has the potential to be a cost- and resource-efficient method for intensifying rehabilitation.