Stroke Rehabilitation

Occupational Therapy       •       Speech Therapy       •       Physical Therapy

Occupational Therapy

 

The Role Of Occupational Therapy In Stroke Rehabilitation

Stroke is a leading cause of adult disability in the United States, with an estimated 7 million stroke survivors. Each year, approximately 795,000 people have either a new or recurrent stroke (Go et al., 2013). Stroke survivors face multiple challenges, such as weakness on one side of the body, decline in cognitive and emotional functioning, social disability, inability to walk and care for themselves, and a decrease in community participation. Occupational therapy can be instrumental in addressing these challenges at all stages in the continuum of care (i.e., acute, sub-acute, chronic, and post-rehab at home and in the community) and is an important component of the interdisciplinary care provided to stroke survivors in a variety of settings (e.g., neuro intensive care units, inpatient and outpatient rehabilitation facilities, home care).

The focus of occupational therapy is to help individuals achieve health, well-being, and participation in life through engagement in occupations (i.e., activities) (American Occupational Therapy Association [AOTA], 2014). Occupational therapy practitioners collaborate with clients and their families or caregivers to determine what activities are necessary, meaningful, and/or relevant to them. Based on their education and clinical expertise, and the philosophical basis of the profession, occupational therapy practitioners are uniquely able to analyze the interactions among the person, the environments in which they need to function, and the occupations they need or want to perform.

 

 

We Can Help Increase Your Independence

Occupational therapy during rehabilitation focuses on ensuring that the client will function as well as possible after discharge, which often includes caregiver education and training, if needed, during post-rehab intervention. Other occupational therapy interventions include home modifications, assistive technology training, and wheelchair prescriptions (manual or powered) for improving quality of life and increasing independence.

 

 

The Technology Makes A Difference

Home modifications may include accessible designs for all rooms in one’s house, ramps, wheelchair lifts or elevators, and stair lifts.

Assistive technology may include environmental control units, augmentative communication, and computer access technology. The occupational therapist considers the client’s available range of motion, strength, coordination, cognitive status, etc., and works with the vendor as needed to select the most appropriate assistive technology equipment, set it up, and provide training to ensure that it is functional for that individual.

 

 

Mobility Changes Everything

Community mobility is often a primary goal for people recovering from a stroke, and many people want to return to driving. Occupational therapists can perform pre-driving screens and driving assessments, which include a comprehensive physical, cognitive, and visual-perceptual evaluation prior to a road assessment. A road assessment entails all aspects of driving, such as parking, switching lanes, turning one’s head to look for cars, reaction time, and the ability to follow driving rules. Equipment recommendations may include a spinner knob for people with limited voluntary movement of one hand or arm, or a left foot accelerator for people who have weakness in the right leg. Occupational therapy practitioners also work with individuals and their families in planning alternative transportation and community mobility methods, such as access-a-ride, family or friend assistance, and senior center transportation systems.

 

 

Our Therapists Are Here To Help You

Occupational therapy practitioners understand the importance of emotional well-being, social connections, and healthy life habits for individuals post-stroke. In addition to ongoing physical rehabilitation as needed, they engage stroke survivors and family members to take charge of their lives, create human connections, and lead healthy lifestyles. This may include developing coping strategies to deal with loss, individualized ways to promote psychosocial health, education to minimize potential for a second stroke, promotion of increased exercise and healthy eating, and strategies to overcome barriers to sexual intimacy.

Stroke can cause serious long-term disability, and many stroke survivors face barriers to engaging in productive activity. Occupational therapy practitioners use their expertise in activity analysis and adaptive methods to facilitate the client’s performance of needed or meaningful occupations within realistic contexts to promote independence.

 

Speech Therapy

 

Aphasia After Stroke

After a stroke it is very common to have communication problems. This condition known as aphasia can affect your ability to find the right words, to understand what others are saying and/or reading and writing.

 

What Is Aphasia?

If you have aphasia you may have difficulty in expressing yourself when speaking, trouble understanding speech, and difficulty with reading and writing. Aphasia is not a disease, but a symptom of brain damage. It is most commonly seen in adults who have suffered a stroke.

No two people experience aphasia the same way. The exact type will depend on what part of the brain is injured by the stroke. Generally, aphasia can be divided into four broad categories:

  • Expressive aphasia. You know what you want to say, but cannot find the words you need.
  • Receptive aphasia. You hear someone talking or see the printed page but cannot make sense of the words
  • People with anomic or amnesia aphasia, the least severe form of aphasia, have difficulty in using the right names for objects, people, places, or events.
  • Global aphasia is the most severe, caused by widespread damage to the language areas of the brain. Stroke survivors with global aphasia cannot speak or understand speech, nor can they read or write.

 

 

Can Aphasia Be Treated?

A full recovery from aphasia is possible. Speech therapy is the most common treatment for aphasia. There are a variety of specific speech therapy exercises and techniques. Other types of therapy have also proven effective for some stroke survivors, including

  • Melodic intonation therapy which allows stroke survivors to sing words they cannot speak
  • Art therapy
  • Visual speech perception therapy focuses on associating pictures with words.
  • Constraint-induced language therapy involves creating a scenario in which spoken verbal communication is the only available option, and other types of communication, such as visual cues from body language, are not possible.
  • Group therapy and support groups
  • Some prescription medication can aid in the recovery of aphasia

Practice at home will support professional speech therapy. Some activities to support aphasia recovery include:

  • Play word-based games, such as board games, cards and crossword puzzles.
  • Cook a new recipe and read the ingredients.
  • Practice writing a shopping list or greeting cards to loved ones.
  • Read aloud or sing.
  • Go out to eat, order off a menu and calculate the tip.

 

 

Tips For Communicating With Aphasia

If you have aphasia, here are some tips for communicating with others:

  • Use props to make conversation easier (photos, maps).
  • Draw or write things down on paper.
  • Stay calm. Take one idea at a time.
  • Show people what works best for you.
  • Take your time. Make phone calls or try talking only when you have plenty of time.
  • Create a communication book that includes words, pictures and symbols that are helpful.
  • Use the Internet to connect to people via email or to create a personal Web page.
  • Carry and show others a card or paper explaining what aphasia is and that you have it. Keep it in your purse or wallet.

 

Tips For Communicating With Survivors of Aphasia

  • Use props to make conversation easier (photos, maps).
  • Draw or write things down on paper.
  • Be patient. Take one idea at a time.
  • Speak simply, clearly and slowly.
  • Be sure the person with aphasia understood you.
  • Treat the person with aphasia as an intelligent adult; aphasia does not typically affect thinking skills.
  • Try different ways to get your message across.

Physical Therapy

 

Information coming soon.