Improving Stroke Recovery Through Occupational Therapy

What is Occupational Therapy?

Occupational Therapy (OT) is focused on all of the activities that occupy your time. It is all about helping the patient return to the activities that make their lives fulfilling and enjoyable.

Following a stroke, occupational therapy focuses on activities such as bathing, dressing, eating, using the bathroom, preparing meals, planting a garden or accessing the Internet.

When a stroke occurs, people generally lose the ability to use one side of their body because it becomes paralyzed. There is a large spectrum of paralysis, from having a little weakness to being completely without movement. Improvements can always be made anywhere along that spectrum by undergoing rehab.

When beginning occupational therapy, the therapist first completes an evaluation and sets appropriate goals with the patient. This step is important as it provides the therapist and patient their focus.

Focusing on functional, everyday life activities:

Everyday activities would include items such as dressing. The OT works with the patient to teach them techniques such as hemi dressing, which requires the patient to dress the weaker side of the body first, or the therapist may do hand over hand guiding with the weaker arm. They type of teaching usually occurs in the morning when the patient would normally get dressed.

Next the patient would work either in their room or in the gym to work on developing the physical components necessary to perform functional activities.

Research shows that encouraging a person who has suffered a stroke to use their weakened side will "awaken" the brain to re-route that lost function, thereby restoring function to their paralyzed extremity, often referred to as "Restraint Therapy." Through a series of steps, each building on the other, rehab helps the stroke patient recover to their maximum level.

Ways to retrain the weakened side of the body:

One method used to retrain the weakened side of the body is through weight bearing. The patient's sitting balance may be poor, so the therapist may have them sit on the edge of the mat, unsupported with their weakened arm down beside them, resting their hand on the edge of the mat. This task may seem simple, but when the muscles in half of your body do not work correctly, it becomes a very difficult task. When the hand is in contact with a firm surface, the patient is in weight bearing.

In the beginning, activities revolve around weight bearing with the body on the arm, meaning the arm is stable on a firm surface and the weight of the patient's body and movement revolves around the stable arm. Once some muscle control/movement is established in the shoulder, arm on body movements may begin. The last step is arm on body movements with no weight bearing. The patient now uses the arm and hand to develop further control and coordination of movements.

Unfortunately, not every patient responds to treatment the way the therapist would like, so they look for ways to help the patient adapt to the environment. A patient may desire to return to cooking, so a cooking activity may be incorporated where one-handed utensils and techniques are taught and practiced so the task can be made possible for the patient.

Additional consideration and importance is given to the inclusion of hobbies/leisure activities. Patients may be introduced to adaptive golf, bowling, gardening or whatever their particular interest may be. When necessary, the therapist will look for ways of adapting activities so the patient may enjoy them again.