Occupational Therapy (OT) in

Stroke Rehabilitation

Phinoj K Abraham, MOTh.,Clinical Neuro Occupational Therapist

NewRo, Bangalore - 27

Overview

• What is Occupational Therapy (OT) ?

• How OT can help a person with stroke?

• When are OT services indicated ?

• Why are OT services important?

– Illustrative Case Study

OT in Rehabilitation Team

• Rehabilitation is like a ‘Building construction process’

• It involves multiple experts working in different aspects for the same building construction

OT in Rehabilitation Team Contd…

Building Construction

Rehabilitation Professionals Involved

Raw Materials- The essential part of a construction

To make the patient ‘Medically Stable’

Consulting Physician, Neuro surgeon, Neurologist etc…

Building Blocks & Units

Muscle power, ROM, Co-ordination, Balance, Walking

Physical Therapist

‘Making’a Building•Taking care of one’s self•Making them ‘Functionally Independent’

Occupational Therapist (OT)

•Teaching them where to walk and how? Neuropsychologist •Communication Skills Speech & Language

Pathologist

What is Occupational Therapy?

• Occupational therapy is skilled treatment that helps people become successful in their everyday ‘occupations’.

Work

Leisure

ADL

How OT can help a person with stroke

• Often Functional independence is the goal and can be achieved through:

• Skilled treatment in rehabilitating lost physical function– Remediating or Compensatory method

• Adaptive equipment • Home modifications• Client and caregiver guidance

When OT services are is indicated ?

OT is indicated if there is a decline in• upper extremity strength, sensation, endurance, hand function• activities of daily living (ADL)

(feeding, grooming, dressing, bathing, toileting)

• functional transfers(tub transfers, toilet transfer)

• home management abilities(cooking, laundry, house hold activities)

• or if there is need for work simplification /modification / energy conservation

Why OT services are important?

“Action speaks louder than words.” ― English Proverb

Story 1• A 35 year old school teacher, with right side hemiplegia

(Paralysis)

• OT Evaluation– Physical assessment

• Muscle power & control Nil• Abnormal Muscle tone Present

– Activities of Daily Living (ADL) / Work / Leisure • ADL: Depedent in Eating, Brushing, bathing, toileting etc…• Work: Teaching: Unable to write with right hand• Leisure: Unable to engage in his time pass activity – Table

tennis

– Persons Background• He is the primary earning member of the family

Story 1 Contd…

• OT ‘Therapy’ Planning process– Based on the medical status & health

• Young, no other complications, shows early signs of recovery, duration of illness

– Based on individual specific need• He is the primary earning member of the family

– Selection of best, maximum possible outcome.• Remediating Therapy

Story 2• A 65 year old Retired Engineer, with 2 year old right side hemiplegia

• OT Evaluation– Physical assessment

• Muscle power & control Nil• Abnormal Muscle tone Present• Right Shoulder subluxation & painful hand Present

– Activities of Daily Living (ADL) / Work / Leisure • ADL: Dependent in Eating, Brushing, bathing, toileting etc…• Work: Retired Engineer.• Leisure: Unable to engage in his time pass activity – Gardening

– Persons Background• He is leading retirement life. He is staying with his younger son. Both

his son and his daughter in law are IT professionals.

Story 2 Contd…

• OT ‘Therapy’ Planning process– Based on the medical status & health

• Elder age, with associated complications, delay in “early signs of recovery”, long duration of illness

– Based on individual specific need• He is leading retirement life. His caregivers are in

earning job

– Selection of best, maximum possible outcome.• Compensatory Therapy

Benefits of OT services

• OT services can help a person with stroke to– adapt to his / her living environment – restoration of maximum possible function– participate more fully in day – to – day activities– Enhance recovery & outcomes– Improved quality of life– Prevention

• Secondary Complications

Questions ..?