Know Stroke & Occupational Therapy Intervention With Rosalin Child Development

 

Stroke is one of the most common causes of death & residual disability. Stroke is the second leading cause of death worldwide. It can occur at any stage of life. A stroke occurs mainly due to a lack of blood supply to the brain tissues due to ischemia or haemorrhage. Few people are more prone to stroke or cerebrovascular accidents. People with a history of stress, hypertension (High BP), diabetes, heart issues, a sedentary lifestyle, hyperlipidemia, and a family history of stroke are more prone to stroke.

Diagnosis of stroke starts with clinical findings and a CT scan. In the initial phase medical professionals need to assess, whether the stroke is due to ischemia or haemorrhage. The initial three to four and half hours are the golden period for stroke survivors. In the initial phase, neurologists mainly suggest for tPA which can resolve brain clots. In such, condition patients can recover fully without any residual paralysis. If patients miss this window period, then they may suffer from residual paralysis. Residual paralysis affects the patient’s ability to sit, stand, walk, and perform daily activities. Stroke can also affect the ability to communicate, comprehend, vision, and postural reflexes.

Here Occupational therapists play an important role in recovering patients from disabling conditions. An occupational therapist works on the Occupational performance of the patients. Occupational performance is related to a person’s life role. i.e. in what manners does a person utilize/occupy their 24-hour. time. Occupational performance can be divided into three areas Occupational area, Occupational Component and Occupational context. An occupational therapist works on the Occupational component & Occupational context in the initial phase and assesses the effect of the same on the occupational area. In the later phase if patients’ recovery becomes a statement and if we feed the need for a rehabilitative approach then we can focus on the occupational area directly. In which we can use the assistive and adaptive device and can do the environmental modification.

The role of occupational therapists starts with the acute phase of stroke rehabilitation. In the acute phase, the Occupational Therapist works on proper positioning, education of patients about their condition, and coma stimulation in comatose patients. In the sub-acute phage, the occupational therapist starts bed mobility activity, functional training, and facilitation of hand function. In the chronic phase Occupational therapists work on ADL training, Vocational Training & Return to work programs.

Occupational therapist starts his intervention with rapport building with the patients. Rapport building is an ongoing process. One’s rapport builds with the patients and caregiver. OT focuses on the assessment of the patient's condition. Assessment includes demographic data, the chief complaint of patients, clinical observation, clinical findings, functional status of the patient, any sensory-motor losses, hand function assessment, ADL, and work and leisure assessment. After the initial assessment Occupational therapist designs the treatment strategy based on short-term & long-term goals. Short-term & long-term goals are made by the therapist with informed consent of the patient. In some cases, informed consent is taken with the caregiver if the patient is not in the condition to make a decision for himself. Treatment strategy changes with time and the response of the patient.

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