Private Occupational Therapy and Sensory Integration | The OT Centre

Occupational Therapy for Stroke

A stroke, also known as a cerebrovascular accident (CVA), occurs when there is a sudden disruption of blood flow to a part of the brain. This interruption can lead to damage of brain cells due to the lack of oxygen and nutrients carried by the blood. Strokes require prompt attention because the extent of damage and the potential for recovery depend on how quickly treatment is administered.

Facts

Common Difficulties associated with Stroke

How can Occupational Therapy help?

Classification

There are two primary types of strokes:

Ischemic Stroke: This is the most common type of stroke, accounting for approximately 87% of all cases. It occurs when a blood clot or plaque buildup blocks or narrows an artery supplying blood to the brain. The lack of blood flow results in damage to brain tissue.
Hemorrhagic Stroke: This type of stroke is less common but more severe. It occurs when a blood vessel in the brain ruptures, causing bleeding in or around the brain. The increased pressure can damage surrounding brain tissue.

Cause

Strokes can have various causes, including:

Ischemic Stroke Causes:

Thrombotic Stroke: Caused by a blood clot that forms in an artery supplying blood to the brain.
Embolic Stroke: Caused by an embolus (a clot or other particle) that forms elsewhere in the body and travels to the brain.

Hemorrhagic Stroke Causes:

Intracerebral Hemorrhage: Bleeding directly into the brain tissue.
Subarachnoid Hemorrhage: Bleeding in the space between the brain and the surrounding membranes.

Risk Factors

The risk factors for strokes include high blood pressure, smoking, diabetes, high cholesterol, atrial fibrillation, age, family history, and a history of previous strokes or transient ischemic attacks (TIAs).

Symptoms

Common symptoms of a stroke include:

Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
Sudden confusion, trouble speaking, or difficulty understanding speech.
Sudden trouble seeing in one or both eyes.
Sudden severe headache with no known cause.

Occupational Therapy Specialism

Occupational Therapists who specialise in assessing and treating people who have had a stroke are are based in a branch of Occupational Therapy called Neurorehabilitation.

Common Difficulties associated with Stroke

Motor Impairments

Hemiparesis/Hemiplegia: Weakness or paralysis on one side of the body.
Impaired Coordination: Difficulty in coordinating movements, leading to challenges in activities such as walking or grasping objects.

Sensory Disturbances

Numbness or Tingling: Loss of sensation or abnormal sensations in the affected areas.
Pain: Some individuals may experience pain, often in the affected limbs.

Speech and Language Challenges

Aphasia: Difficulty understanding, speaking, reading, or writing.
Dysarthria: Impaired ability to control the muscles used in speech, leading to slurred or difficult-to-understand speech.

Cognitive Impairments

Memory Loss: Difficulty remembering information or forming new memories.
Attention and Concentration Issues: Challenges in staying focused on tasks.
Executive Function Deficits: Difficulty with tasks that involve planning, organising, initiating, and completing actions.

Visual Disturbances

Visual Field Defects: Loss of part of the visual field, leading to difficulties in seeing objects in specific areas.
Eye Movement Abnormalities: Difficulty controlling eye movements.

Emotional and Psychological Impact

Depression and Anxiety: Common emotional responses to the life changes brought about by a stroke.
Emotional Lability: Sudden and unpredictable mood swings.

Fatigue

Physical and Mental Fatigue: Many stroke survivors experience fatigue, which can affect both physical and mental activities.

Swallowing Difficulties

Dysphagia: Trouble swallowing, which can lead to complications such as aspiration pneumonia.

Balance and Coordination Issues

Ataxia: Lack of coordination and balance.

Changes in Personality and Social Functioning

Social Isolation: Difficulty participating in social activities due to physical or cognitive limitations.
Changes in Personality: Some individuals may experience changes in behaviour or personality.

How can Occupational Therapy help?

Occupational therapists help individuals regain skills and independence affected by a stroke, such as motor control, balance, and activities of daily living;

Assessment and Goal Setting

- Conduct comprehensive assessments to understand the individual's physical, cognitive, and emotional abilities.
- Collaborate with the individual and their family to set realistic and meaningful rehabilitation goals.

Activities of Daily Living (ADL) Training

- Focus on improving independence in activities such as bathing, dressing, grooming, and feeding.
- Implement adaptive strategies and recommend assistive devices to make daily tasks more manageable.

Motor Skills Rehabilitation

- Design exercises and activities to improve fine and gross motor skills.
- Work on coordination, strength, and balance to enhance mobility and prevent falls.

Cognitive Rehabilitation

- Address cognitive deficits such as memory, attention, and problem-solving skills.
- Develop strategies to improve cognitive function and promote safety in daily activities.

Environmental Modifications

- Assess and recommend modifications to the home or work environment to enhance safety and accessibility.
- Provide guidance on the use of adaptive equipment to facilitate independence.

Psychosocial Support

- Address emotional and psychological aspects of recovery, such as anxiety or depression.
- Offer coping strategies and support to help individuals and their families adjust to life after a stroke.

Community Reintegration

- Assist in transitioning individuals back into their communities and returning to work or other meaningful activities.
- Facilitate participation in social and recreational activities to improve overall quality of life.

Patient and Caregiver Education

- Educate patients and their families about stroke, rehabilitation, and strategies for continued progress.
- Provide training on proper techniques for caregivers to support the individual's recovery at home.

Adaptive Technology Integration

- Introduce and train individuals on the use of assistive technology to improve independence in daily activities.
- Explore technology solutions that can aid in communication, mobility, or other specific needs.

Collaboration with Multidisciplinary Team

- Work closely with other healthcare professionals, such as physical therapists, speech therapists, and physicians, to ensure a holistic approach to rehabilitation.