OCCUPATIONAL THERAPY FOR STROKE REHABILITATION

Transcription

1 OCCUPATIONAL THERAPY FOR STROKE REHABILITATION

2 FORTHCOMING TITLES Occupational Therapy for the Brain-Injured Adult Jo Clark- Wilson and Gordon Muir Gi/es Multiple Sclerosis Approaches to management Lorraine De Souza Modem Electrotherapy Mary Dyson and Christopher Hayne Autism A multidisciplinary approach Edited by Kathryn Ellis Physiotherapy in Respiratory and Intensive Care Alexandra Hough Community Occupational Therapy with Mentally Handicapped People Debbie Isaac Understanding Dysphasia Lesley Jordan and Rita Twiston Davies Management in Occupational Therapy Zielfa B. Maslin Keyboard, Graphie and Handwriting Skills Helping people with motor disabilities Dorothy E. Penso Dysarthria Theory and therapy Sandra J. Robertson Speech and Language Problems in Children Dilys A. Treharne

3 THERAPY IN PRACTICE SERIES Edited by Jo Campling This series of books is aimed at 'therapists' concerned with rehabilitation in a very broad sense. The intended audience particularly includes occupational therapists, physiotherapists and speech therapists, but many titles will also be of interest to nurses, psychologists, medical staff, social workers, teachers or volunteer workers. Some volumes are interdisciplinary, others are aimed at one particular profession. All titles will be comprehensive but concise, and practical but with due reference to relevant theory and evidence. They are not research monographs but focus on professional practice, and will be of value to both students and qualified personnel. 1. Occupational Therapy for Children with Disabilities Dorothy E. Penso 2. Living Skills for Mentally Handicapped People Christine Peck and Chia Swee Hong 3. Rehabilitation of the Older Patient Edited by Amanda 1. Squires 4. Physiotherapy and the Elderly Patient Paul Wagstaff and Davis Coakley 5. Rehabilitation of the Severely Brain-Injured Adult Edited by /an Fussey and Gordon Muir Gi/es 6. Communication Problems in Elderly People Rosemary Grave/1 7. Occupational Therapy Practice in Psychiatry Linda Finlay 8. Warking with Bilingual Language Disability Edited by Deirdre M. Duncan 9. Counselling Skills for Health Professionals Philip Burnard 10. Teaching Interpersonal Skills A handbook of experientiallearning for health professionals Philip Burnard 11. Occupational Therapy for Strake Rehabilitation Sirnon B.N. Thompson and Maryanne Morgan 12. Assessing Physically Disabled People at Horne Kathy Maczka 13. Acute Head lnjury Practical management in rehabilitation Ruth Garner 14. Practical Physiotherapy with Older People Lucinda Smyth et al.

4 Occupational Therapy for Stroke Rehabilitation SIMON B.N. THOMPSON and MARYANNE MORGAN Springer-Science+Business Media, B.V.

5 1990 Sirnon B.N. Thompson and Maryanne Morgan Originally published by Chapman and Hall in Typeset in 10/12 Times by Leaper & Gard Ltd, Bristol St. Edmundsbury Press, Bury St. Edmunds, Suffolk This paperhack edition is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, resold, hired out, or otherwise circulated without the publisher's prior consent in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed on the subsequent purchaser. All rights reserved. No part of this book may be reprinted or reproduced, or utilized in any form or by any electronic, mechanical or other means, now known or hereafter invented, including photocopying and recording, or in any information storage and retrieval system, without permission in writing from the publisher. British Library Cataloguing in Publication Data Thompson, Simon. Occupational therapy for stroke rehabilitation. 1. Man. Brain. Strokes. Occupational therapy I. Title II. Morgan, Maryanne III. Series 616.8' 1 Library of Congress Cataloging in Publication Data Thompson, Simon. Occupational therapy for stroke rehabilitation I Sirnon Thompson and Maryanne Morgan. p. cm. - (Therapy in practice series : 11) Includes bibliographical references. 1. Cerebrovascular disease-patients-rehabilitation. 2. Occupational therapy. I. Morgan, Maryanne, Il. Title. III. Series. [DNLM: 1. Cerebrovascular Disorders-rehabilitation. 2. Occupational Therapy. WL 355 T476o] RC388.5.T '1-dc20 DNLM/DLC for Library of Congress ISBN ISBN (ebook) DOI / CIP

6 Contents Acknowledgements viii Preface 1x Introduction x 1 Epidemiology 1 2 Assessment 28 3 Treatment Approaches 75 4 Occupational Therapy 87 5 Biofeedback in Rehabilitation Database Techniques and Expert Systems Expert Systems for Strake in Occupational Therapy 167 Glossary 186 References 198 Index 212

7 Acknowledgements The authors would like to thank the following: Kevin Cook for all his hard work; Mike Coleman and Annie Turner for their encouragement and advice; Avril Drummond, Judy Edmans and Carole Roberts for advice on the occupational therapy application; Sue Croshaw for typing; Fiona Sidgwick for proof reading; and of course, to our parents for their continuing support. viii

8 Preface This book is both an introductory text to the rehabilitation of stroke for student therapists and a reference text for qualified therapists. The layout of the book reflects these needs with Chapters 1-4 assuming a minimal level of understanding of the material. These chapters provide an introduction to the condition of stroke itself, the problern therapists face in assessing and treating stroke patients and therapeutic approaches in occupational therapy. Prognosis of stroke is also discussed which is an issue taken up in later chapters concemed with expert systems. The use of microcomputers in occupational therapy is discussed throughout the book with particular reference to their direct role during therapy. Chapters 5-7 assume a higher level of understanding from the reader although students will find the material useful as an insight into the work of the modern-day therapist. Chapter 5 addresses the work carried out in the area of biofeedback; Chapter 6 introduces the concept and uses of databases, and Chapter 7 discusses the versatility of microcomputers, especially in the provision of expert systems for the prognosis of stroke. A comprehensive Glossary, Reference section and Index provide information for all levels of use which complements other books in the Therapy in Practice series. lt is hoped that this book will be informative for those who require more than just a basic knowledge of stroke rehabilitation. As information technology is becoming increasingly important in all areas of therapy, this information is essential to ensure the continuing growth of the profession. ix

9 Introduction Occupational therapy involves the diagnosis, assessment, treatment and prognosis of patients suffering from conditions such as stroke. In the 1980s therapists concerned with the rehabilitation of stroke victims recognized the benefits of information technology, in particular microcomputers, applied to each of these areas. The importance of this recognition has been reflected by the use and development of both hardware and software ( e.g. 'concept keyboards' and programs to improve motor and cognitive function). Therapists were initially encouraged to introduce information technology into their departments under the DHSS/DTI Scheme in This involved the issue of BBC B Microcomputers to several rehabilitation units for research and experimentation. The benefits of using information technology in rehabilitation departments are numerous. For example, microcomputers not only save time and space storing medical data in databases, but they can also provide accurate and fast records of direct physiological measurements. Similarly, long and complicated data manipulations ( e.g. retrieving data according to a particular category or making a mathematical calculation) can be made very quickly and often far more efficiently than by therapists. However, inherent with these benefits are some disadvantages. Microcomputers can be relatively costly and are prone to human error. To avoid information being lost, backup procedures such as printouts and disc copies are required. There is also the need for therapists to be familiar with the new technology. It is not necessary for therapists to be computer programmers, but there is a need to have a basic knowledge of computing to meet the requirements of their patients and environment. Most therapists and clinicians using information technology agree that the problems of using microcomputers are far outweighed by the advantages; they offer a new and exciting contribution to many areas of patient care, especially to the rehabilitation of stroke. X