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Table 1 Capability, Opportunity, Motivation, Behaviour Model Components of the intervention

From: Virtual Arm Boot Camp (V-ABC): study protocol for a mixed-methods study to increase upper limb recovery after stroke with an intensive program coupled with a grasp count device

What needs to happen so that the affected arm is used? Methods to address components
Capability: Physical
Person needs to have enough arm function to be able to use the limb in a helpful way • GRASP Exercise Program
Capability: Psychological
• Understands the evidence related to experience-driven neuroplasticity
• Understands the importance of “use it or lose it”;
• Understands the importance of challenge and practice
• Has emotional resilience to practice despite frustration
• Has ability to problem solve when encountering problems using the limb
• Has ability to monitor how and how much they are using limb
• Knows how to advance task practice
• Patient has sufficient memory/attention/executive function to develop and adhere to practice schedule
• Education of link between challenging practice and neuroplasticity
• Feedback from TENZR
• Action planning
• Goal setting
• Barrier identification and problem solving
Opportunity: Physical
• Patient has time to use upper limb as tasks will take longer
• Patient has appropriate items in the house or community to enable task practice
• Patient has external reminders to use the limb
• Problem solving
• Feedback from TENZR
Opportunity: Social
• Has a person who will support patient while he/she is less efficient in accomplishing tasks during and after intervention
• Patients not entirely driven to accomplish tasks independently no matter what
• Social pressure to perform activities as before the stroke
• Social support from therapist
• Social support from family
Motivation: Reflective
• Believe that incorporation of their arm into daily activities will improve their function
• Believe that practicing using their arm is important
• Believe that temporary frustration will lead to positive gains
• Be confident that their affected arm can accomplish required task
• People have goals for using their limb (i.e. tasks they wish to change or start doing)
• Have intentions to increase practice or use in daily activities
• Education of link between challenging practice and neuroplasticity
Motivation: Automatic
• Have established routines and habits for using limb
• Experience emotional benefits from using their limb
• Problem solving and planning