Rehabilitation in Hospital Discharge Care Plans for Stroke Patients

November 16, 2012

Medicine

Rehabilitation in Hospital

Rehabilitation in Hospital

Rehabilitation forms part of hospital discharge care plans in cases involving cerebrovascular accident (CVA). CVA, more commonly known as stroke, is a result of lack of oxygen in the brain causing tissue injury and death of brain cells. It is one of the most common neurological disorders in adults, and the leading cause of disability. There are approximately 750,000 cases of CVA in USA each year, making it the third most common cause of death in the country. Risk factors for CVA include age, gender, race, heredity, cigarette smoking, physical inactivity, and other medical conditions including high blood pressure, high blood cholesterol level, and diabetes. The destruction of motor neurons leads to: motor function impairment, deficits in vision and speech, paralysis, and impaired comprehension. The effects of stroke can be overcome in some cases, but in others, depending on the type of stroke the patient had, and which part of the brain has been affected, the disability is intense and permanent.

When the patient with CVA is medically stable, they may require rehabilitation activity such as physical therapy, occupational therapy and speech therapy. Rehabilitation aims to help patients to return to normal activities and to regain the skills of daily living. Support from the family is very important during rehabilitation.

Physiotherapy

Physiotherapy provides programmes of muscle stretching and strengthening, and range of motion exercises to prevent contractures in affected and unaffected areas. A chartered physiotherapist works with the patient, training them in: mobility, sitting balance, transfers, standing balance, and weight bearing when standing, sitting and walking. Physiotherapists also train patients to walk or climb stairs using assistive devices like a walking frame, quad cane or single point cane. Patients, especially those with quadriceps weakening, also learn how to use a leg brace, or other orthosis, to facilitate walking. Patients, who are unable to ambulate in any way, learn how to use a wheelchair. About 75 to 80 percent of stroke patients can return to walking independently.

Occupational Therapy

Nearly half of stroke survivors have trouble with daily activities. Occupational therapists promote patients’ functional independence; they plan the most effective training for the patient, family and health care provider to give continuity of care with community services. They train the patient to perform daily activities like dressing, eating, bathing and bathroom transfers. They also teach higher levels of daily activities: preparing meals, money management, use of public transport, shopping and recreational activities. They promote use of the arms and hand function through techniques including: the use of neuromuscular electrical stimulation (NMES), using hemi slings as support to the arms, stretching of the upper extremities and other muscle strengthening exercises.

Speech Therapy

Speech therapists help to improve speech and facilitate eating. They provide the patient with exercises to restore strength and balance in the movement of tongue and facial muscles that are used for speaking and swallowing. They use standardised tests to identify the patient’s strengths and weaknesses in communication. Tools used include worksheets, computer learning programmes and family education. Through these activities, the patient will able to speak more clearly.

Aereen Lim works for an occupational travel therapy company catering to patients in various states. She holds a master’s degree in occupational therapy and enjoys using her educational advancement in travelling while rendering occupational therapy services through Advanced Medical, Travel Therapy Company.

 

Rehabilitation in Hospital Discharge Care Plans for Stroke Patients


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Hospital, Rehabilitation

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