Tuesday, November 8th, 2016
As an occupational therapist, you play a vital role in helping stroke patients regain the ability to live as independently and confidently as possible. Recovering patients may suffer from a myriad of symptoms that can interfere with their daily lives.
From learning to use cooking and dining utensils again to bathing and dressing themselves, self-directed exercises and specialized tools help these patients take back control of their lives. To best assist your patients in these efforts, it is helpful to stock a rehabilitation workstation with as many pieces of specialized equipment, useful tools, and everyday items as possible.
The use of adaptive equipment may help patients become more self-sufficient in everything from daily-living activities to dining unassisted to getting around the house without help. Not only are these items helpful for dexterity and neurological stimulation, but they also go a long way in boosting confidence and facilitating the psychological and emotional recovery of rehabilitating patients.
Neurological damage is often concentrated on one side of the body in stroke patients. For this reason, it is wise to stock your workstation with one-handed utensils so as to teach patients how to reprogram unaffected parts of the brain, as well as stimulate and strengthen weakened muscles. One-handed writing aids, key turners, and knob turners are immeasurably useful items for post-stroke physical therapy.
Using zipper pulls and sock aids, along with one-handed button aids and dressing sticks, empowers patients to dress and prepare for the day without assistance. Tools such as reachers help retrieve items in high or awkward places, and long-handled sponges are effective for use in bathing oneself.
Learning to feed themselves again is another vital skill stroke patients must practice. Some may benefit from the use of easy-grip cutlery, while others may want or require the option of hand-grip cutlery. Adaptive cups and non-skid plates and bowls are also important to have on hand.
Many household items come in handy for performing physical therapy exercises at home. Items such as towels and chairs can be used to practice stretching and balancing exercises, while pens and cups can assist in improving grasp-and-release movements. Using canes may help improve posture and further assist a patient in doing balance exercises. Even fruits can help patients work on dexterity and small motor movements.
Physical therapy and rehabilitation options are limited for neurological patients lacking the effective grasp-and-release functions of their hands. Stroke rehabilitation gloves, such as the SaeboGlove, are must-have items in your workstation because they use an integrated tension system that helps patients extend their fingers and thumbs in response to a grasping motion. This assisted extension stimulates neuroplastic changes within the brain needed to successfully reprogram those areas that remain unaffected by stroke.
Other orthoses, such as the SaeboFlex, assist in improving the hand’s vitally important motion of grasping and releasing. This device is equipped with an extension spring, which mimics the releasing motion of the hand after the patient stops trying to grasp an object.
It is common practice to provide stroke recovery patients with static hand splints in order to maintain neutral wrist and hand position and avoid muscle contracture. However, studies have shown not only that static splinting is ineffective against muscle contracture but that it may in fact be a cause of soft-tissue shortening, loss of range of motion, and joint damage. The SaeboStretch is an ideal option for a dynamic splint, which stretches tendons, muscles, and ligaments while reducing pain and minimizing damage to joints.
Constraint-induced movement therapy (CIMT) is the practice of placing a mitt over the unaffected hand of a stroke survivor and asking them to perform repetitive movement with the neurologically impaired arm for several hours a day. Between 2001 and 2003, the EXCITE clinical trial, involving seven academic institutions, showed that CIMT led to increased use of the affected arm in stroke patients with mild to moderate upper-extremity impairment. The improvements seen with CIMT have been shown to last for as long as two years.
Sensory Electrical Stimulation (SES) can be utilized to stimulate areas of the brain required for stroke recovery by improving neuroplasticity, motor movement, and function. Tools such as the SaeboStim Micro, a conductive glove and elbow sleeve that delivers electrical stimulation to the affected extremity, can be extremely effective for this form of rehabilitation. A total body solution like the Saebo MyoTrac Infiniti is another rehabilitation option. For patients in stage 1 of stroke recovery, SES can reduce the effects of flaccid plasticity, weakness, and spasticity of the hand and wrist.
For patients suffering from neurological impairment, rehabilitation equipment that reduces the effects of gravity can facilitate the redevelopment of affected limbs. By unloading the arm, motor recovery through normal movement patterns and independent living are made possible. Devices such as the SaeboMAS are designed to support the weight of a patient’s arm, alleviating reliance on hand and shoulder muscles to perform simple motor movements and tasks.
There are many uncomfortable complications that can occur after a stroke such as spasticity, edema, and shoulder subluxation, to name a few. Edema gloves can help reduce the volume of swelling by pushing fluids out of the arm and hand. Shoulder subluxation is also common after stroke, and occurs when the upper arm bone comes out of the shoulder socket. Occupational therapists should know how to gently handle someone with shoulder subluxation, and be prepared with a shoulder subluxation sling. The sling can reduce the pain in the shoulder, and help reduce edema as well.
Mirror and virtual reality therapies involve helping along the recovery of motor function through combining repetitive skills practice and action observation. Mirror therapy has been shown to improve activities of daily living, have a significant effect on motor function, and have positive effect on pain. Through this simulated visual feedback, it becomes more possible for the patient to move the affected limb and unclench it from potentially painful positions. Virtual reality (VR) therapy accomplishes a similar goal using technology. By providing a computer generated environment in which the patients movements can be closely monitored, VR can help stroke survivors regain use of their affected limbs.
As an occupational therapist, it is important to have the most effective and proven tools at your disposal. To best help your patients recovering from stroke, it is wise to stock your workstation with everything you may need during a therapy session.
Everyday household items such as towels and cups can be useful in rehabilitation, as can adaptive equipment like one-handed writing aids, non-skid plates, and reachers. Rehabilitation gloves and splints can be utilized to promote proper hand movement and reduce pain, and constraint-induced movement therapy, electrical stimulation, and gravity compensation devices can provide the right neurological stimulation for motor recovery. If you keep these useful items close, your patients will have what they need as they relearn necessary life skills.
All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.