Occupational therapy in stroke
In this turn of the century marked by speed and daily stress, stroke becomes the cause of death of 10% of the planet’s population. According to statistics, there are 35% more strokes in Moldova than in the rest of Europe.
What is a stroke?
Stroke can be ischemic, caused by a blockage of blood in a cerebral artery as a result of thrombosis or embolism, or can be hemorrhagic by rupturing a cerebral vessel with the onset of hemorrhage.
What are the main risk factors for stroke?
- Hypertension;
- Hypercholesterolemia;
- Diabetes;
- Obesity;
- Diet and unhealthy lifestyle;
- Excessive alcohol consumption;
- Heart disease;
- Stress.
What is occupational therapy?
Following the stroke, the patient has a contralateral hemiplegia of the affected cerebral hemisphere, which is initially flaccid and then spastic.
Current recovery programs integrate occupational therapy as a stand-alone procedure. Occupational therapy is the science that deals with the study and measurable scientific use of activities to reduce patient dysfunction (Boston School of Occupational Therapy, 1924).
The International Federation of Occupational Therapists comes to complete this definition, stating that occupational therapy is the profession that deals with the promotion of health and well-being through employment. The primary goal is to allow individuals to participate in daily activities.
Occupational therapy is a functional therapy and an active method of physical and psychological recovery, which aims to adapt / rehabilitate the person with disabilities and increase the degree of independence.
Occupational therapy after a stroke
After a stroke, occupational therapy will begin with a careful evaluation of the patient, the grips, the gait, the development of the ADLs.
– ADL – the basic gestures / skills of an individual used to carry out daily life independently; the ability to meet all personal needs and those related to community life.
– ADLs are divided into Basic ADL (basic) and IADL (activities based on complex motor skills)
Basic ADLs are grouped into 4 categories:
- Self-care: dressing, toileting, food;
- Mobility: walking, bed movement, transfer;
- Communication: speaking, writing, gesturing;
- Handling: handle, drawer, taps, keys, etc.
IADLs are divided into 5 categories, depending on the field in which they take place:
- Household: shopping, childcare, house cleaning;
- Community life: use of money, cards;
- Health: medicines, knowledge of risk factors ;
- The field of home and personal security;
- Handling of modern objects: telephone, computer, equipment, etc.
Correction / learning of these ADLs and IADLs are part of the goals of occupational therapy in patients with hemiplegia after stroke, representing the restoration and restoration of patient independence.
The next goals are to re-educate gestures and expression. These involve asking the patient to compensate for the mobility deficit and restore human expression: speech, attitude, behavior, activity.
- Global movements are used for gestures, with a stimulating effect for the affected muscles but also for the psyche. In re-educating the patient’s expression, it is important to encourage him to carry out the activities that please him and to help and readjust him to them.
- The use of ADL walking aids (wheelchairs, crutches, sticks, orthoses, prostheses, or various adapted utensils) and the arrangement of the external environment is an important point of occupational therapy. Therefore, the therapist will communicate and teach both the patient and their relatives regarding the prevention of risk factors, the arrangement of the home (according to the patient’s needs) and will readjust the entourage to the patient’s requirements.
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