Occupational Therapy (OT) after stroke aims to enable stroke survivors to lead an independent life by improving their skills, helping them find different ways to complete tasks and using certain handy equipment. Helping stroke victims perform Activities of Daily Living (ADLs), Occupational Therapy instills a sense of confidence among stroke survivors and hence saves them from slipping into severe depression and anxiety.
Just like Physical Therapy and Speech Therapy, OT needs to be customized to serve the stroke survivor’s rehabilitation program. While one stroke victim may need to learn various strategies to indulge in one-hand cooking, another may need to learn coordination exercises for functional use of both hands. Generally, a top-down rehabilitation approach (addressing functional challenges) is adopted during OT assessment and intervention. A typical OT program includes arm and hand therapy, use of handwriting aids, work equipment modifications, leisure skill development, manual or electric wheelchair use, and dressing and grooming aids till a stroke patient achieves a fully functional life.
Stroke survivors experience weakened functional performance due to impaired motor function, medication side-effects, fatigue, depression and lack of motivation or cognitive impairment after stroke. This results in limitations in fine motor coordination and hence stroke survivors face a hard time while manipulating items such as buttons, shoe laces and other small items around the house.
OT works on improving the patient’s motor abilities, helping him re-learn the skills needed for performing self-directed activities (also known as occupations) such as personal grooming, preparing meals and performing other daily jobs. By breaking a complex activity into small subtasks, the stroke patient improves coordination and learns how to carry out planned actions.
OT also aims at changing stroke survivors’ environment elements that limit their ADL. In order to retrain the patient’s brain into self-care and post-rehab tasks, the appropriate use of adaptive equipment may be prescribed to maximize an individual’s ability to perform ADLs such as bathing, dressing safely.
Targeted towards the restoration of impaired skills, OT program for stroke should employ attentional strategies, cognitive and sensory cueing techniques, and conductive education methods. While conductive education methods employ group-based exercises to improve handwriting, gait, and other forms of movement control, cueing techniques aid performance of personal and domestic tasks among stroke survivors.
During an OT program, a patient is given opportunities to practise daily activities such as going to a special kitchen area to practise making a cup of tea. As time progresses, each daily activity is made harder to challenge the patient and to improve his stamina.
Though the occupational therapist mainly uses ADL exercise to treat difficulties, they might sometimes have to target a specific problem. For instance, if the stroke victim has movement problems, he will be asked to practise stretching his arm and hand. In case of memory loss, the occupational therapist will indulge him in memory exercises.
Developing coping strategies to support psychosocial health, developing strategies to overcome barriers to sexual intimacy, equipment recommendations for safe return to driving and education on alternate means of transportation are other essentials of OT program.