HOME-GRASP Home Graded Repetitive Arm Supplementary Program

HOME-GRASP is a home-based exercise programme designed to improve strength, coordination, manual dexterity and functional use of the affected upper limb in people who have experienced a stroke. It involves repetitive, progressive, task-oriented practice aimed at encouraging the use of the affected arm and hand in activities of daily living. The programme is performed at home with guidance and supervision from a rehabilitation professional.

Programme procedure and structure

The programme runs for 8 weeks, with one hour of exercise each day, seven days a week. If preferred, the exercises may be split into two 30-minute sessions.

Exercises are organised into five sections:

• Stretching: activities aimed at maintaining or improving upper-limb mobility.
• Arm strengthening: exercises targeting strength and movement control.
• Hand strengthening: exercises focusing on hand muscles and grip.
• Coordination: activities requiring controlled and precise movements.
• Manual skills: object-manipulation tasks designed to practise functional dexterity.

The programme uses readily available everyday items, such as balls, clothes pegs, coins, blocks, containers and other common objects. A rehabilitation professional adjusts the level of difficulty according to the participant’s abilities, for example by changing object size, materials or the number of repetitions. The manual includes a daily log to help participants track their practice.

Spanish translation and cultural adaptation

The HOME-GRASP manual was translated and culturally adapted into Spanish through a collaboration involving Carlos Soler Pons from Fundación Hospitalarias Valencia and Desirée Valera Gran and Eva María Navarrete Muñoz from the Occupational Therapy Research Group (InTeO) at Miguel Hernández University of Elche (UMH). The Spanish version provides instructions, photographs and recommendations intended to make the exercises easier to understand and carry out at home.

Relevance to rehabilitation

HOME-GRASP supports repetitive practice of movements and functional tasks outside the clinical setting. Its approach is consistent with motor-learning and neuroplasticity principles and encourages active participation in rehabilitation. From an occupational therapy perspective, its emphasis on using the upper limb in everyday activities is particularly relevant. Evidence supporting the original GRASP programme should not automatically be interpreted as evidence of effectiveness for the Spanish adaptation specifically.

AUTHORSHIP:

Original programme
Janice J. Eng and team, University of British Columbia (Canada).

Spanish translation and cultural adaptation:
Carlos Soler Pons (Fundación Hospitalarias Valencia), Desirée Valera Gran and Eva María Navarrete Muñoz (InTeO, UMH).

Document design:
Josué Esteve Esteban

Photography:
Pablo Ferao

LINKS to publications

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