After a stroke, many people benefit from therapy to increase their ability to walk, talk and complete their daily routine. According to T.J. Rowland and colleagues in a 2008 article in the "Annals of Indian Academy of Neurology," there is a growing emphasis on the multidisciplinary approach to stroke rehabilitation. In other words, stroke patients benefit from receiving several different types of therapy care in order to address all of their needs. Steultjens and colleagues in a 2003 article in "Stroke" add that even in limited trial studies, occupational therapy is significantly beneficial for stroke patients.
Activities of Daily Living
Occupational therapists (OTs) focus extensively on practicing ADLs , or activities of daily living. During ADLs OTs help patients dress and bathe themselves, though this process is more complex than it sounds. Often a patient has difficulty moving one side of their body, so therapists teach them hemiplegic, or one-sided, dressing skills to increase their independence. OTs can also use this ADL practice to work on other skills at the same time, such as coordination, reaching, planning and problem solving.
Muscle Retraining Tools
When a person has weakness on one side of the body after a stroke, their muscles can be retrained to move and function. This is when OTs use their skills with muscle reeducation, usually in the muscles of the hands, arms and shoulders. OTs may use positioning and movement as a tool to reduce muscle spasms, encourage bearing weight on that arm or simply to practice isolated movements for muscle control. For instance, a person with poor shoulder strength after a stroke may need to lie sideways on a mat and practice moving their arm forward and back, to "relearn" this movement. After this, they can try to use the arm during a functional task.
Electrical Stimulation
Another method of muscle retraining is called neuromuscular electrical stimulation, or NMES. NMES involves sending a current into the nerve through electrodes placed on the skin, to trigger a muscle contraction. Placed strategically, an OT can use NMES to help a stroke patient perform such movements as making a fist or bending their elbow. NMES can also be used to retrain a dislocated shoulder to remain in its socket, a common problem in stroke patients. Other forms of NMES use specially fitted devices for the arm that can be timed, so the arm or hand can function with assistance during tasks and routines.
Therapeutic Activities
Sometimes, a stroke patient needs to do something familiar or repetitive for their brain to react to their movement needs. OTs often use therapeutic activities to drill skills needed for daily routine tasks, such as gripping, pinching and lifting. OTs may set up "stations" for stroke patients, such as reaching cans on a shelf or placing clothespins on a thin bar.
Visual Training Tools
Visual problems are fairly common after a stroke, and OTs often teach their stroke patients how to compensate for them. Visual training can involve training stroke patients to turn their head if their visual field is cut, or to cover one eye to reduce double vision. They may use specialized devices such as eyeglass prisms or lined bookmarks to help a person read again. OTs can also make recommendations about lighting and setup of an environment to compensate for visual problems. Some OTs are specially trained in eye exercises, and can help stroke patients practice eye movements like scanning and tracking in order to improve their function.
