Dawn Nilsen, Glen Gillen, Marian Arbesman, Deborah Lieberman; Occupational Therapy Interventions for Adults With Stroke. Am J Occup Ther 2015;69(5):6905395010p1-6905395010p3. doi: 10.5014/ajot.2015.695002.
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© 2017 American Occupational Therapy Association
Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice project. The clinical condition discussed in this inaugural Evidence Connection article is adults with stroke. Findings from the systematic reviews on this topic were published in the January/February 2015 issue of the American Journal of Occupational Therapy and in AOTA’s Occupational Therapy Practice Guidelines for Adults With Stroke (Wolf & Nilsen, 2015). Each article in this series will summarize the evidence from the published reviews on a given topic and presents an application of the evidence to a related clinical case. Evidence Connection articles illustrate how the research evidence from the reviews can be used to inform and guide clinical decision making.
The Fugl-Meyer Assessment (Fugl-Meyer, Jääskö, Leyman, Olsson, & Steglind, 1975) and the Action Research Arm Test (Lyle, 1981), to further assess arm and hand neuromuscular–skeletal functions, sensory functions, and motor skills
The Catherine Bergego Scale (Azouvi et al., 2003), to further evaluate the impact of unilateral spatial neglect on daily function as well as Jorge’s awareness of the impairment
The Beck Depression Inventory–II (Beck, Steer, & Brown, 1996), to assess Jorge’s psychological status.
Moderate evidence from several studies supports the use of occupation-based interventions to improve performance of activities of daily living (ADLs) in the inpatient setting.
Moderate to strong evidence also supports the use of activity- or occupation-based interventions to increase participation in leisure activities.
Strong evidence supports visual scanning training (VST) for people with stroke.
In the area of motor impairment, strong evidence supports using repetitive task training (RTP) to improve UE function, balance, and mobility and activity and participation for clients with motor impairments.
Moderate evidence supports combining a task-oriented training intervention such as RTP with a cognitive strategy such as action observation (AO) to improve UE function.
Occupation-based interventions to improve ADLs.
RTP to enhance arm and hand function to support engagement.
VST to improve performance and compensate for unilateral neglect.
AO combined with task practice to promote self-directed independent practice.1
Manipulation of a computer mouse; specifically, organizing icons on the screen of Jorge’s work laptop, entering data onto a spreadsheet, and so forth.
Manipulation of bathing and grooming items; specifically, organizing items in a basin, opening and closing containers, and so forth.
Playing cards; specifically, dealing cards, flipping cards, stacking cards, and so forth.
Watching AO videos on his computer, followed by actual task practice of manipulating cooking utensils and grooming items, and
Providing an occupation box of items related to Jorge’s identified goal areas, such as a deck of cards, dog brush, can opener, pen and paper, coins, and utensils and encouraging him to engage in RTP using these items during down time.
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