Table of Contents
List of Contributors ix
Foreword xi
Preface xiii
Acknowledgements xv
1 Introduction Judi Edmans Fiona Coupar Adam Gordon 1
Definition of stroke 1
Impact of stroke 1
Symptoms of stroke 2
Causes of stroke 3
Classification of stroke 4
International Classification of Functioning, Disability and Health 4
Medical investigations following stroke and TIA 6
The prevention of recurrence of stroke (secondary prevention) 7
Neuroanatomy 9
Damage that can occur in different areas of the brain 13
Policy documents relating to stroke 13
Self-evaluation questions 23
2 Theoretical Basis Janet Ivey Melissa Mew 24
Introduction 24
Theoretical constructs 24
Conceptual models of practice 25
Frames of reference 27
Neuroplasticity 29
Intervention approaches 36
Self-evaluation questions 47
3 The Occupational Therapy Process Melissa Mew Janet Ivey 49
Introduction 49
The occupational therapy process 49
Procedural reasoning in different stroke care settings 53
Professional duties 60
Self-evaluation questions 63
4 Early Management Sue Winnall Janet Ivey 64
Introduction 64
Prior to assessment 64
Initial interview 66
Initial assessment 67
Intervention 75
Equipment 75
Other impairments impacting on functional ability 77
Swallowing 80
Mood 81
Fatigue 83
Self-evaluation questions 84
5 Management of Motor Impairments Stephanie Wolff Thérèse Jackson Louisa Reid 86
Introduction 86
Assessment 86
Management principles and intervention 90
Therapeutic aims of intervention 91
Positioning the early stroke patient 91
Clinical challenges 109
Upper limb re-education 111
Avoiding secondary complications 112
Self-evaluation questions 116
6 Management of Visual and Sensory Impairments Melissa Mew Sue Winnall 117
Introduction 117
Visual processing 119
Somatosensory processing 127
Auditory processing 137
Vestibular processing 139
Olfactory and gustatory processing 141
Self-evaluation questions 142
7 Management of Cognitive Impairments Thérèse Jackson Stephanie Wolff 144
Definition of cognition 144
Cognitive functions 144
Assessment of cognitive functions 144
Cognitive rehabilitation 146
Attention 147
Memory 149
Language 151
Motor planning and apraxia 151
Executive dysfunction 155
Self-evaluation questions 157
8 Management of Perceptual Impairments Louisa Reid Judi Edmans 158
Introduction 158
Definition of perception 158
Normal perception 158
Perceptual impairments 160
Perceptual assessment 162
Intervention 165
Self-evaluation questions 172
9 Resettlement Pip Logan Fiona Skelly 173
Home visits 173
Community rehabilitation 174
Support available after a stroke and self-management 177
Carers 178
Younger people 180
Lifestyle and long-term management 180
Leisure rehabilitation 181
Getting out of the house and transport 183
Driving after stroke 185
Vocational rehabilitation 186
Resuming sexual activity 188
Stroke education 189
Self-evaluation questions 190
10 Evaluation Fiona Coupar Judi Edmans 191
Record keeping 191
Standardised assessments 195
Evidence-based practice (EBP) 199
Outcome measures 203
Standards 206
Self-evaluation questions 207
Appendix: One-Handed Techniques 208
References 212
Definitions 229
Useful Books 231
Useful Organisations 233
Index 241
