After a stroke, individuals may struggle to perform the activities of daily living such as eating, bathing, or getting dressed. Fortunately, different stroke interventions used in occupational therapy can help survivors learn recovery exercises and compensation strategies to accomplish these activities. Occupational therapy can also help individuals maximize their functional independence and navigate changes in life after stroke.
This article will discuss various stroke interventions used in occupational therapy and how they help promote recovery.
Understanding the Goals of Occupational Therapy During Stroke Rehabilitation
Occupational therapy focuses on providing individuals with the proper tools necessary to achieve their recovery goals. This can include a combination of rehabilitation exercises and compensatory tactics.
Compensation involves accomplishing a task in a different way than before, whereas recovery involves accomplishing a task in the same way as before the stroke. For example, after a stroke individuals may struggle with foot drop, or the inability to lift the front portion of the foot. As a result, the toes may drag on the floor which can increase the risk of tripping or falling.
To help compensate for the muscle weakness associated with foot drop, a therapist may recommend wearing ankle foot orthotics. An AFO brace is a compensatory tactic that can help provide support to the foot and ankle and lower the risk of further injury. However, an AFO brace does not treat the root cause of foot drop, which is the miscommunication between the brain and muscles. To treat the root cause and improve foot drop, survivors must practice foot drop recovery exercises.
Occupational therapists can provide exercises that target specific muscle groups such as the arms, legs, and trunk, along with the areas a survivor wants to improve and their level of ability. They can also provide specific tasks to help survivors improve their independence and achieve their recovery goals.
Tasks usually fall into three categories, including:
- Self-care: exercises usually focus on daily activities like eating, bathing, and getting dressed.
- Productivity: tasks can consist of returning to work, school, or other prior responsibilities and finding new ways to adjust.
- Leisure: activities usually include fun things a person enjoyed doing prior to the injury such as golfing, painting, dancing, and other social skills.
Self-care, productivity, and leisure activities are an important part of everyday life. The more these skills are practiced, the higher the chances of regaining function and seeing promising results.
10 Occupational Therapy Interventions for Stroke Survivors
There are various exercises occupational therapists can try with their patients, including exercises to improve fine motor skills or fun activities to help them ease back into life after a stroke.
Some occupational therapy activities for stroke recovery can include:
1. Home Modifications
After discharge, it can be challenging to transition smoothly back home. An occupational therapist can help make the appropriate adjustments to ensure an individual’s safety. This can include making home modifications such as adding doorknob extenders and/or using non-slip bathmats.
A therapist may also suggest removing excess clutter from the bedroom and living room to lower the risk of falling or further injury to the head. A smoother transition can help survivors feel more at ease and redirect their energy towards healing.
2. Rehabilitation Exercise Programs
An occupational therapist can provide various exercises for individuals to practice safely at home. Establishing a proper rehabilitation program at home and practicing therapeutic exercises consistently is important to stimulate neuroplasticity, the brain’s ability to rewire itself. It works by strengthening neural connections in the brain and creating new ones, which is an essential part of stroke recovery.
3. Interactive Neurorehab Devices
An occupational therapist can provide sheets of exercises for their patients to practice at home in between therapy sessions. They may also recommend using interactive at-home therapy programs like FitMi and MusicGlove. Both were designed to improve mobility and can help survivors increase their chances of regaining function after a stroke. There are also clinic versions of these neurorehab devices available for occupational therapists to use with their patients in a clinical setting.
4. Task-Specific Training
Task-specific training is a stroke intervention that focuses on improving a skill by practicing it directly. The goal is to improve function in the affected muscle through repeated activity. For example, occupational therapists can provide individuals with specific hand exercises that directly apply to daily activities to help strengthen fine motor skills after a stroke. For example, individuals may practice turning door knobs or flipping light switches on and off. Practicing these exercises can spark neuroplasticity in the brain and help improve functional independence.
5. Visual Scanning
Spatial neglect is a condition that can make it difficult to orient, report, or respond to stimuli in the environment on the affected side. For instance, when an individual sustains a stroke on the right hemisphere of the brain, they can experience spatial neglect on the left side.
Fortunately, visual scanning can help treat spatial neglect by encouraging individuals to pay careful attention to their affected side. For example, one visual scanning activity an occupational therapist may suggest is using a highlighter to draw a bright line down the left side of a book. The individual must then practice moving their eyes all the way to the left until they find the highlighter mark.
6. Constraint Induced Movement Therapy
Constraint induced movement therapy (CIMT) is a stroke intervention that involves forced use of the affected limbs and constrained use of the non-affected limbs. The goal is to increase the use of the affected limbs to stimulate the brain and activate neuroplasticity. To practice CIMT at home, an occupational therapist may suggest wearing an oven mitt or a sock over the non-affected limb to help encourage the survivor to use their affected limb.
While this treatment approach may be challenging, it can help lower the risk of learned-nonuse after a stroke, which occurs when an individual suppresses the use of their affected limb. If learned-nonuse persists, it can lead to further complications such as muscle weakness and muscle atrophy. Occupational therapists can provide more tips on how to prevent learned-nonuse from worsening.
7. Electrical Stimulation
When the areas of the brain that control movement are affected by a stroke, the brain may be unable to communicate with certain muscles. Without the appropriate stimuli from the brain, the muscles don’t know when to contract or relax, which can result in motor difficulties like paralysis or spasticity (stiff, rigid muscles). This can make it difficult to move or perform daily activities.
Fortunately, studies show that electrical stimulation can help improve mobility and reduce spasticity in stroke survivors. It works by placing non-invasive electrodes on the skin and sending gentle electrical impulses to the affected muscles. Reactivating the muscles can help stimulate the brain and encourage neuroplasticity.
8. Mirror Therapy
Mirror therapy is another type of stroke intervention that is particularly helpful for survivors with hand paralysis or severe hand impairments. It works by placing a tabletop mirror in the middle of the body to face the non-affected side and hide the affected side.
Studies have shown that mirror therapy may help improve movement, sensation, and post-stroke pain. Another benefit from mirror therapy is that it can be performed with an occupational therapist in a clinical setting or at home independently.
9. Mental Practice
When a movement is mentally rehearsed, it can spark changes in the brain the same way that physically practicing it does. Because of this, mental practice is a great occupational therapy intervention for stroke survivors. For example, a survivor with limited mobility or paralysis in their right arm can picture themselves moving their arm through daily activities such as grasping a cup of coffee.
This mental exercise can help spark neuroplasticity in the brain and strengthen the neural connections for that movement, eventually making it easier to execute and move the affected arm. Thus, motor imagery can be a powerful tool during rehabilitation when combined with other stroke interventions like task-specific training. An occupational therapist can also recommend tips on how to incorporate motor imagery throughout rehabilitation.
10. Work Accommodations
Lastly, occupational therapy can help survivors relearn the skills they need to return to their occupation. Therapists may provide individuals with unique tasks to practice depending on the type of workload and environment.
To transition smoothly back to work after a stroke, OTs may also recommend:
- Working shorter hours
- Taking breaks to help prevent overstimulation
- Installing grab bars in the office restrooms to help with balance
- Having ergonomic equipment and flexible scheduling to help with increased fatigue after a stroke
- Using wall calendars and alternative lighting to help with concentration and spatial neglect
Therapists may also encourage their patients to talk to their employer about what they can do to help facilitate their return to work. It’s important to note that the American Disabilities Act requires employers to make reasonable accommodations for their employees to help them get back to work.
Occupational Therapy Interventions for Stroke Recovery
A stroke can interfere with the ability to perform the activities of daily living and maintain a proper rehabilitation regimen. Fortunately, there are various stroke interventions used in occupational therapy that can help survivors reach their recovery goals and maximize functional independence.
We hope this article helped you understand the benefits of various stroke interventions used in occupational therapy.
The post Stroke Interventions: 10 Occupational Therapy Techniques to Promote Recovery appeared first on Flint Rehab.
