Changing Face of Stroke: Implications for Occupational Therapy Practice

Abstract

Stroke is one of the most life-altering syndromes affecting the world population. Rehabilitation for people experiencing stroke is focused almost exclusively on self-care activities and being able to return home and has little to no focus on work rehabilitation or community reintegration. The Cognitive Rehabilitation Research Group (CRRG) at the Washington University School of Medicine in St. Louis was formed with the vision of improving everyday life for people after stroke by translating knowledge from neuroscience into treatment programs for productive living. Descriptive analysis of the intake assessment from the CRRG Clinical Core (N = 7,740) revealed three important findings: The age at stroke is decreasing, most strokes are neurologically mild to moderate in nature, and discharge placement decisions are being made largely on the basis of measures of impairment. The changes in the stroke population require occupational therapy to expand rehabilitation beyond the acute management of stroke to address full participation in work, family, and community life.

The effects of hemodynamic lag on functional connectivity and behavior after stroke

“…The demographic and medical characteristics of the patients in our sample were compared to those of a large control group (n ¼ 1209) that was selected from the Cognitive Rehabilitation Research Group database 13 of all patients seen at Barnes Jewish Hospital between 2008 and 2013 (n ¼ 6260) using the same inclusion/exclusion criteria. All included stroke and control subjects provided informed consent according to procedures approved by the Institutional Review Board at Washington University.…”

Effects of Somatosensory Impairment on Participation After Stroke

“…The sample comprised a subset of participants from an existing large stroke cohort (Wolf, Baum, & Connor, 2009). Inclusion criteria were first clinical stroke; no history of schizophrenia or dementia; and availability of required data, which included the acute NIHSS individual item scores, obtained on hospital admission, and the ACS construct scores, collected after the participant had returned home and completed rehabilitation.…”

Factors which are predictive of return work after stroke

“…The increasing number of working age stroke survivors was also reported in Wolf et al (2009)'s study. They reported that a significant number of people who have had a stroke are less than 55 years old.…”