Additional Information
Book Details
Abstract
Learn to confidently manage the growing number of stroke rehabilitation clients with Gillen’s Stroke Rehabilitation: A Function-Based Approach, 4th Edition. Using a holistic and multidisciplinary approach, this text remains the only comprehensive, evidence-based stroke rehabilitation resource for occupational therapists. The new edition has been extensively updated with the latest information, along with more evidence-based research added to every chapter. As with previous editions, this comprehensive reference uses an application-based method that integrates background medical information, samples of functionally based evaluations, and current treatment techniques and intervention strategies.
- Evidence-based clinical trials and outcome studies clearly outline the basis for stroke interventions.
- UNIQUE! Survivor's Perspectives help readers understand the stroke rehabilitation process from the client'' point-of-view.
- UNIQUE! Case studies challenge readers to apply rehabilitation concepts to realistic scenarios.
- UNIQUE! A multidisciplinary approach highlights discipline-specific distinctions in stroke rehabilitation among occupation and physical therapists, physicians, and speech-language pathologists.
- Review questions in each chapter help readers assess their understanding of rehabilitation concepts.
- Key terms and chapter objectives at the beginning of each chapter help readers study more efficiently.
- Three new chapters broaden your understanding of stroke intervention in the areas of Using Technology to Improve Limb Function, Managing Speech and Language Deficits after Stroke, and Parenting after Stroke.
- Learning activities and interactive references on a companion Evolve Resources website help you review textbook content and locate additional information.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Evolve page | IFC3 | ||
| Stroke Rehabilitation | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Preface | ix | ||
| Acknowledgments | x | ||
| Table Of Contents | xi | ||
| 1 Foundations of Stroke Rehabilitation | 1 | ||
| 1 Pathophysiology, Medical Management, and Acute Rehabilitation of Stroke Survivors | 2 | ||
| Chapter Objectives | 2 | ||
| Key Terms | 2 | ||
| Prevalence and Impact of Stroke | 2 | ||
| Epidemiology of Stroke | 2 | ||
| Pathogenesis and Pathology of Stroke | 2 | ||
| Definition and Description of Stroke Syndromes | 2 | ||
| Stroke. | 2 | ||
| Transient Ischemic Attack. | 3 | ||
| Ischemic Stroke | 3 | ||
| Embolic Stroke. | 3 | ||
| Sources of Emboli | 3 | ||
| Cardiac Sources. | 3 | ||
| Vascular Sources. | 4 | ||
| Paradoxical Sources. | 4 | ||
| Unknown Sources. | 4 | ||
| Thrombotic Stroke | 4 | ||
| Pathophysiology. | 4 | ||
| Atherothrombotic Disease. | 4 | ||
| Lacunar Syndrome. | 6 | ||
| Hemorrhagic Conversion. | 7 | ||
| Hemorrhagic Stroke | 7 | ||
| Hypertensive Bleed. | 7 | ||
| Lobar Intracerebral Bleed. | 8 | ||
| Saccular Aneurysm and Subarachnoid Bleed. | 8 | ||
| Arteriovenous Malformation. | 9 | ||
| Posttraumatic Hemorrhagic Stroke. | 9 | ||
| Other Causes of Stroke and Strokelike Syndromes | 9 | ||
| Arterial and Medical Disease. | 9 | ||
| Strokelike Syndromes. | 9 | ||
| Cerebral Neoplasm. | 9 | ||
| Stroke Diagnosis | 9 | ||
| Cerebrovascular Imaging | 11 | ||
| Computed Axial Tomography | 11 | ||
| Magnetic Resonance Imaging | 11 | ||
| Positron Emission Tomography and Single-Photon Emission Computed Tomography Scanning | 13 | ||
| Workup for Cause of Stroke | 13 | ||
| Transcranial and Carotid Doppler | 13 | ||
| Magnetic Resonance Angiography | 13 | ||
| Electrocardiography | 13 | ||
| Echocardiography | 13 | ||
| Blood Work | 13 | ||
| Medical Stroke Management | 14 | ||
| Principal Goals | 14 | ||
| Acute Stroke Management | 14 | ||
| General Principles | 14 | ||
| Ischemic Stroke | 14 | ||
| Pharmacologic Therapies | 15 | ||
| Antithrombotic Therapy (Antiplatelet and Anticoagulation). | 15 | ||
| Thrombolytic Therapy. | 15 | ||
| Other Treatments for Altering Cerebral Perfusion. | 15 | ||
| Neuroprotective Agents. | 15 | ||
| Agents for Cerebral Edema. | 16 | ||
| Cooling Therapy. | 16 | ||
| Surgical Therapies | 16 | ||
| Endarterectomy. | 16 | ||
| Extracranial–Intracranial Bypass. | 16 | ||
| Balloon Angioplasty. | 16 | ||
| Hemorrhagic Stroke | 16 | ||
| Prevention of Rebleeding. | 16 | ||
| Control of Vasospasm. | 17 | ||
| Prevention of Stroke Recurrence | 17 | ||
| Ischemic Stroke | 17 | ||
| Hypertension. | 17 | ||
| Antiplatelet Medications. | 17 | ||
| Anticoagulation. | 17 | ||
| Treatment of Dysrhythmias or Underlying Disease. | 17 | ||
| Carotid Endarterectomy. | 17 | ||
| Hemorrhagic Stroke | 17 | ||
| Prevention of Complications and Long-Term Sequelae | 18 | ||
| General Principles | 18 | ||
| Musculoskeletal Complications | 18 | ||
| Contractures. | 18 | ||
| Osteoporosis. | 18 | ||
| Heterotopic Ossification. | 18 | ||
| Falls. | 18 | ||
| Neurologic Complications | 19 | ||
| Seizures. | 19 | ||
| Hydrocephalus. | 19 | ||
| Spasticity. | 20 | ||
| Other Complications | 20 | ||
| Deconditioning. | 20 | ||
| Psychological Complications. | 20 | ||
| Urinary Tract Dysfunction. | 21 | ||
| Skin Breakdown and Decubitus Ulcers. | 21 | ||
| Dysphagia. | 21 | ||
| Aspiration. | 21 | ||
| Deep Venous Thrombosis. | 21 | ||
| Future Trends in Medical Stroke Management | 23 | ||
| Improved Primary Stroke Prevention | 23 | ||
| Hypertension | 23 | ||
| Cigarette Smoking | 23 | ||
| Cardiac Dysrhythmia and Myocardial Infarction | 23 | ||
| Blood Lipids | 23 | ||
| Diabetes | 23 | ||
| Oral Contraceptives | 24 | ||
| Alcohol | 24 | ||
| Activity | 24 | ||
| Public Education | 24 | ||
| Introduction to Acute Stroke Rehabilitation | 24 | ||
| The Importance of Early Intervention | 24 | ||
| Team Approach | 24 | ||
| Monitoring the Intensive Care Unit and Acute Stroke Survivor | 25 | ||
| Basic ICU Monitor | 25 | ||
| Telemetry | 25 | ||
| Common Lines and Drains | 27 | ||
| Foley Catheter. | 27 | ||
| External Ventricular Drain. | 27 | ||
| Intracranial Pressure Monitoring Catheter. | 27 | ||
| Spinal Drain. | 27 | ||
| Intravenous Line. | 27 | ||
| Feeding Tubes | 27 | ||
| Nasogastric Tube. | 27 | ||
| Percutaneous Endoscopic Gastrostomy. | 27 | ||
| Ventilator | 28 | ||
| Assessments Used in Acute Stroke Rehabilitation | 28 | ||
| Interventions for Acute Stroke Rehabilitation | 28 | ||
| Splinting | 30 | ||
| Positioning | 30 | ||
| Functional Activity Suggestions during the Acute Phase | 31 | ||
| Bed Mobility | 31 | ||
| Rolling to the Affected Side. | 31 | ||
| Rolling to the Unaffected Side. | 31 | ||
| Maintaining Side Lying. | 31 | ||
| Bridging. | 31 | ||
| Side Lying to Sitting toward the Affected Side. | 31 | ||
| Side Lying to Sitting toward the Unaffected Side. | 31 | ||
| Weight Bearing for Function | 31 | ||
| Graded Sitting and Standing Activities | 32 | ||
| Supported Sitting in Bed. | 32 | ||
| Supported Sitting in a Chair. | 32 | ||
| Unsupported Sitting. | 32 | ||
| Unsupported Sitting at the Edge of the Bed with Feet Dangling. | 32 | ||
| Sit to Stand: Pretransfer Phase. | 32 | ||
| Supported Standing in Front of a Raised Bed. | 32 | ||
| Edema Management | 33 | ||
| Shoulder Management | 33 | ||
| Supine | 33 | ||
| Edge of Bed | 33 | ||
| Out of Bed in a Chair | 33 | ||
| Increasing Spatial Awareness by Arranging the Environment | 33 | ||
| Early Cognitive Management | 34 | ||
| Skin Protection and Prevention of Breakdown | 34 | ||
| Communication | 34 | ||
| Dysphagia Screening | 34 | ||
| Self-Care Training | 36 | ||
| Family Training | 36 | ||
| Goal Setting in Acute Care | 39 | ||
| Discharge Planning | 39 | ||
| Summary | 40 | ||
| Case Study 1 | 40 | ||
| Ischemic Stroke: Management of Acute Case and Complications with Workup | 40 | ||
| Case Study 2 | 41 | ||
| Hemorrhagic Stroke: Management of Acute Case with Workup | 41 | ||
| Review Questions | 41 | ||
| References | 41 | ||
| 2 Improving Participation and Quality of Life through Occupation | 46 | ||
| Chapter Objectives | 46 | ||
| Key Terms | 46 | ||
| Concepts Central to Enabling Participation | 46 | ||
| Occupation | 46 | ||
| Work | 47 | ||
| Play/Leisure | 47 | ||
| Self-Care | 47 | ||
| Client-Centered Care | 48 | ||
| Quality of Life | 49 | ||
| Assessment of Participation | 49 | ||
| Assessment of Quality of Life | 50 | ||
| Barriers to Participation and Quality of Life | 51 | ||
| How to Foster Participation Throughout the Continuum of Care | 53 | ||
| Acute Care | 53 | ||
| Inpatient Rehabilitation | 53 | ||
| Home Health | 54 | ||
| Outpatient Therapy | 54 | ||
| Community Reintegration | 55 | ||
| Case Study | 55 | ||
| Improving Participation through Occupation | 55 | ||
| Review Questions | 57 | ||
| References | 57 | ||
| 3 Task-Oriented Approach to Stroke Rehabilitation | 59 | ||
| Chapter Objectives | 59 | ||
| Key Terms | 59 | ||
| Theoretical Assumptions and Model Underlying the Occupational Therapy Task-Oriented Approach | 59 | ||
| Systems Model of Motor Control | 59 | ||
| Ecological Approach to Perception and Action | 60 | ||
| Dynamical Systems Theory | 60 | ||
| Systems View of Motor Development | 61 | ||
| Contemporary View of Motor Learning | 61 | ||
| Systems Model of Motor Behavior | 62 | ||
| Evaluation Framework Using the Occupational Therapy Task-Oriented Approach | 63 | ||
| Treatment Principles Using the Occupational Therapy Task-Oriented Approach | 69 | ||
| Help Patients Adjust to Role and Task Performance Limitations | 69 | ||
| Create an Environment That Uses the Common Challenges of Everyday Life | 69 | ||
| Practice Functional Tasks or Close Simulations to Find Effective and Efficient Strategies for Performance | 69 | ||
| Provide Opportunities for Practice Outside of Therapy Time | 70 | ||
| Use Contemporary Motor Learning Principles in Training or Retraining Skills | 70 | ||
| Minimize Ineffective and Inefficient Movement Patterns | 71 | ||
| Remediate a Client Factor (Impairment) if It Is the Critical Control Parameter. | 71 | ||
| Adapt the Environment, Modify the Task, Use Assistive Technology, or Reduce the Effects of Gravity. | 71 | ||
| For Persons with Poor Control of Movement, Constrain the Degrees of Freedom. | 72 | ||
| For Persons Who Do Not Use Returned Function in Their Involved Extremities, Use Constraint-Induced Therapy. | 72 | ||
| Evidence Supporting the OT Task-Oriented Approach | 73 | ||
| Summary | 73 | ||
| Case Study | 74 | ||
| Occupational Therapy Task-Oriented Approach for a Stroke Survivor | 74 | ||
| Initial Evaluation | 74 | ||
| Home Environment | 75 | ||
| Community Environment | 75 | ||
| Week 1 Treatment Plan | 75 | ||
| Week 2 Treatment Plan | 75 | ||
| Review Questions | 76 | ||
| References | 76 | ||
| 4 Activity-Based Intervention in Stroke Rehabilitation | 79 | ||
| Chapter Objectives | 79 | ||
| Key Terms | 79 | ||
| Activity-Based Intervention | 79 | ||
| Support for Using Activity-Based Intervention in Occupational Therapy Stroke Rehabilitation | 80 | ||
| Neuroscience Studies of Brain Plasticity | 80 | ||
| Constraint-Induced Movement Therapy | 80 | ||
| Outcomes Studies of Task-Related Training | 81 | ||
| Occupational Therapy Practice Framework | 81 | ||
| Practice and Learning | 83 | ||
| Goals of Training and Learning | 83 | ||
| Promoting Generalization of Learning | 83 | ||
| Strategy Development | 83 | ||
| Motor Strategies | 84 | ||
| Cognitive Strategies | 84 | ||
| Strategies for Community Participation | 84 | ||
| Feedback and Instructions | 84 | ||
| Type of Feedback | 84 | ||
| Knowledge of Performance. | 85 | ||
| Knowledge of Results. | 85 | ||
| Instructions to Help Clients Develop Implicit and Explicit Learning Processes | 85 | ||
| Object Affordances | 85 | ||
| Amount of Practice | 85 | ||
| Practice Conditions | 86 | ||
| Contextual Interference. | 86 | ||
| Practice Schedules. | 86 | ||
| Whole versus Part Practice. | 86 | ||
| Practice in Natural Settings. | 86 | ||
| Using Activity-Based Intervention in Occupational Therapy with Stroke Clients | 86 | ||
| Client Prerequisites to Engaging in Activity-Based Practice | 86 | ||
| Freedom from Mechanical Constraints to Movement | 87 | ||
| Self-Monitoring Skills | 87 | ||
| Task Analysis and Problem-Solving Skills | 88 | ||
| Expectation for Goal Achievement | 88 | ||
| Structuring Activity Demands to Provide Effective Practice Opportunities | 88 | ||
| Task Analysis by the Therapist | 88 | ||
| Analyzing an Activity’s Requirements for Postural Set | 88 | ||
| Analyzing Activity Requirements Related to Preparatory Strategies | 89 | ||
| Analyzing Activity Requirements for Weight Shift and Balance | 89 | ||
| Analyzing Activity Requirements for Dissociation Between Body Segments | 89 | ||
| Other Aspects of Task Analysis | 89 | ||
| Using Activity to Assess a Client’s Skills | 89 | ||
| Helping Clients Develop Their Own Skills in Activity Analysis | 90 | ||
| Activity Selection and Synthesis | 90 | ||
| Case Study | 90 | ||
| Using Activity-Based Intervention to Improve Motor Function and Quality of Life in a Stroke Survivor | 90 | ||
| Initial Evaluation | 90 | ||
| Review Questions | 93 | ||
| References | 94 | ||
| 5 Client Centeredness: | 96 | ||
| Chapter Objectives | 96 | ||
| Key Terms | 96 | ||
| Introduction | 96 | ||
| The Event* | 97 | ||
| Therapy | 98 | ||
| Going Home | 99 | ||
| Concluding Remarks | 99 | ||
| P.S. | 100 | ||
| Epilogue | 100 | ||
| References | 101 | ||
| 2 Maximizing Participation in Everyday Activities | 103 | ||
| 6 Enhancing Performance of Activities of Daily Living Tasks | 104 | ||
| Chapter Objectives | 104 | ||
| Key Terms | 104 | ||
| Occupational Therapy Intervention Process Model | 106 | ||
| Assessment of Motor and Process Skills | 107 | ||
| ADL Taxonomy | 109 | ||
| Case Study | 112 | ||
| Geriatric Day Rehabilitation Unit: Client Living in Comfort (Assisted) Living | 112 | ||
| Background before Entering the Geriatric Day Rehabilitation Unit | 112 | ||
| Establish Client-Centered Performance Context | 112 | ||
| Environmental Dimension | 113 | ||
| Role Dimension | 113 | ||
| Motivational Dimension | 113 | ||
| Task Dimension | 113 | ||
| Social Dimension | 113 | ||
| Societal Dimension | 114 | ||
| Body Function Dimension | 114 | ||
| Temporal Dimension | 114 | ||
| Adaptation Dimension | 114 | ||
| Develop Therapeutic Rapport and Work Collaboratively with Client | 114 | ||
| Identify Resources and Limitations Within Client-Centered Performance Context | 115 | ||
| Documentation of the Initial Occupational Therapy Evaluation (Part 1) | 115 | ||
| Background Information. | 115 | ||
| Reason for Referral. | 115 | ||
| Identify Client’s Reported and Prioritized Strengths and Problems of Occupational Performance | 115 | ||
| Documentation of the Initial Occupational Therapy Evaluation (Part 2) | 115 | ||
| Self-Reported Level of Occupational Performance | 115 | ||
| Priorities for Intervention | 116 | ||
| Observe Client’s Performance of Prioritized Tasks and Implement Performance Analyses | 116 | ||
| Observation of Prioritized Task 1: AMPS Task C-2—Hot Cooked Cereal and Beverage for One Person | 117 | ||
| Observation of Prioritized Task 2: AMPS Task F-7—Open-Faced Meat or Cheese Sandwich with Sliced Vegetable for One Person | 118 | ||
| Document the Client’s Global Baseline Quality of Occupational Performance | 119 | ||
| Documentation of the Initial Occupational Therapy Evaluation (Part 3) | 119 | ||
| Global Baseline: Overall Quality of Activity of Daily Living Task Performance | 119 | ||
| Define and Describe Task Actions the Client Does and Does Not Perform Effectively | 119 | ||
| Step 1: Score the AMPS Items for Each Observed Activity of Daily Living Task Performance | 120 | ||
| Step 2: Select the AMPS Items That Best Reflect the Client’s Observed Quality of Activity of Daily Living Task Performance | 120 | ||
| Step 3: Group Related AMPS Items into Clusters and Write Summary Statements | 120 | ||
| Documentation of the Initial Occupational Therapy Evaluation (Part 4) | 120 | ||
| Specific Baseline: Specific Task-Related Actions That Most Reflect Skilled Activity of Daily Living Task Performance | 120 | ||
| Specific Task-Related Actions That Most Reflect Diminished Quality of Activity of Daily Living Task Performance | 120 | ||
| Step 4: Enter the Client’s Data into the OTAP Software, Generate an AMPS Results Report, and Interpret the Results | 121 | ||
| Criterion-Referenced Interpretation. | 121 | ||
| Norm-Referenced Interpretation. | 121 | ||
| Predicting the Need for Assistance to Live in the Community. | 121 | ||
| Establish, Finalize, or Redefine Client-Centered and Occupation-Focused Goals | 124 | ||
| Documentation of the Initial Occupational Therapy Evaluation (Part 5) | 124 | ||
| Global Goal | 124 | ||
| Specific Subgoals | 124 | ||
| Other Preliminary Goals to Target for Future Baseline Evaluation | 124 | ||
| Clarify or Interpret the Reason(s) for Client’s Problems of Occupational Performance | 124 | ||
| Documentation of the Initial Occupational Therapy Evaluation (Part 6) | 126 | ||
| Interpretation of Reasons for Diminished Quality of Activity of Daily Living Task Performance. | 126 | ||
| Select an Intervention Model and Plan and Implement Occupation-Based and/or Occupation-Focused Interventions | 126 | ||
| Preliminary Ideas for an Intervention Plan (Not Part of Maria’s Documentation) | 128 | ||
| Adaptive Occupation | 128 | ||
| Acquisitional Occupation | 128 | ||
| Education Program | 128 | ||
| Documentation of the Initial Occupational Therapy Evaluation (Part 7) | 128 | ||
| Intervention Plan | 128 | ||
| Subgoal 1: When Performing Kitchen Tasks, Astrid Will Move Her Wheelchair and Transport Task Objects with Only Minimal Increased Physical Effort and Mild Inefficiency. | 128 | ||
| Subgoal 2: Astrid Will Reach for Task Objects Without Evidence of Increased Physical Effort. | 130 | ||
| Subgoal 3: Astrid Will Safely and Independently Hold and Stabilize Task Objects When Preparing Simple Meals. | 130 | ||
| Putting It Together: Engaging in Acquisitional and Compensatory Occupation | 131 | ||
| Reevaluate for Enhanced and Satisfying Occupational Performance | 131 | ||
| Progress Report: Preparing Simple Meals (e.g., Hot Cereal, Open-Faced Sandwich) | 131 | ||
| Initial Baseline (5/27/2014) | 131 | ||
| Goal | 131 | ||
| Current Status (6/30/2014) | 131 | ||
| Result | 131 | ||
| Continued Occupational Therapy Services | 133 | ||
| Final Progress Report | 133 | ||
| Goal 1 | 133 | ||
| Current Status (7/24/2014) | 133 | ||
| Result | 133 | ||
| Goal 2: | 134 | ||
| Current Status (7/24/2014) | 134 | ||
| Result | 134 | ||
| Review Questions | 134 | ||
| References | 134 | ||
| Suggested Readings | 135 | ||
| 7 Activities of Daily Living Adaptations: | 136 | ||
| Chapter Objectives | 136 | ||
| Key Terms | 136 | ||
| Basic Environmental Considerations | 136 | ||
| Safety | 136 | ||
| Ease of Mobility and Performance of Activities of Daily Living | 137 | ||
| Functional Assessment | 137 | ||
| Basic Activities of Daily Living | 138 | ||
| Grooming and Hygiene | 138 | ||
| Toileting. | 138 | ||
| Showering and Bathing. | 139 | ||
| Shampooing. | 140 | ||
| Drying. | 140 | ||
| Washing at the Sink. | 140 | ||
| Performing Oral Hygiene. | 141 | ||
| Applying Deodorant. | 141 | ||
| Caring for Fingernails. | 141 | ||
| Caring for Toenails. | 141 | ||
| Hairstyling. | 142 | ||
| Shaving. | 142 | ||
| Applying Makeup. | 142 | ||
| Dressing | 142 | ||
| Fasteners | 143 | ||
| Buttons. | 143 | ||
| Zippers. | 143 | ||
| Adaptive Dressing Techniques. | 143 | ||
| Upper Extremity Dressing | 143 | ||
| Donning Garments with Front Fasteners. | 143 | ||
| Donning Ties. | 143 | ||
| Donning Pullover Shirts | 143 | ||
| Donning Brassieres. | 143 | ||
| Lower Extremity Dressing | 144 | ||
| Donning Pants and Underwear While Lying in Bed | 144 | ||
| Donning Pants and Underwear While Sitting Up | 145 | ||
| Donning Skirts | 145 | ||
| Donning Socks | 145 | ||
| Donning Shoes | 145 | ||
| Donning Lower Extremity Orthotics. | 145 | ||
| Adaptive Devices | 145 | ||
| Feeding Techniques | 148 | ||
| Positioning at the Table. | 148 | ||
| Use of Adaptive Devices. | 148 | ||
| Instrumental Activities of Daily Living | 148 | ||
| Kitchen Activities | 148 | ||
| Energy Conservation and Work Simplification. | 148 | ||
| Storage | 148 | ||
| Transport. | 148 | ||
| Stabilization. | 148 | ||
| Food Storage. | 150 | ||
| Dish Washing. | 150 | ||
| Home Maintenance | 150 | ||
| Caring for the Floor. | 150 | ||
| Cleaning the Bathroom. | 150 | ||
| Bed Making. | 150 | ||
| Changing Sheets. | 151 | ||
| Laundry | 151 | ||
| Machine Washing Clothes. | 151 | ||
| Hand Washing Clothes. | 151 | ||
| Wringing Clothes. | 151 | ||
| Ironing | 151 | ||
| Sewing | 151 | ||
| Threading Needles. | 151 | ||
| Cutting. | 151 | ||
| Hand Sewing. | 151 | ||
| Machine Sewing. | 151 | ||
| Communication | 151 | ||
| Writing. | 151 | ||
| Typing. | 151 | ||
| Using the Telephone. | 151 | ||
| Community-Based Activities | 151 | ||
| Grocery Shopping | 151 | ||
| Banking | 152 | ||
| Case Study | 152 | ||
| One-Handed Training after Stroke | 152 | ||
| Long-Term Goals | 152 | ||
| Short-Term Goals | 152 | ||
| Adaptations | 152 | ||
| Bathing | 152 | ||
| Oral Hygiene | 152 | ||
| Nail Management | 152 | ||
| Dressing | 153 | ||
| Feeding and Simple Meal Preparation | 153 | ||
| Dominance Retraining and Financial Management | 153 | ||
| Marketing and Grocery Shopping | 153 | ||
| Summary | 153 | ||
| Review Questions | 153 | ||
| References | 154 | ||
| Suggested Readings | 154 | ||
| 8 Functional Mobility | 155 | ||
| Chapter Objectives | 155 | ||
| Key Terms | 155 | ||
| Terminology | 155 | ||
| Overview of the Literature | 155 | ||
| Functional Mobility: Relationship to Activities and Participation | 155 | ||
| Influence of Contextual Factors on Functional Mobility | 156 | ||
| Functional Mobility: the Outcome of Multiple Processes | 157 | ||
| Impairment of Body Functions and Structures and Skills | 157 | ||
| Functional Mobility Tasks | 157 | ||
| Activities in the Supine Position | 157 | ||
| Bridging | 158 | ||
| Analysis of Movement | 158 | ||
| Selected Problems | 158 | ||
| Treatment Strategies | 159 | ||
| Rolling | 160 | ||
| Analysis of Movement | 160 | ||
| Rolling to the Hemiplegic Side: Selected Problems and Treatment Strategies | 160 | ||
| Rolling to the Unaffected Side: Selected Problems and Treatment Strategies | 161 | ||
| Supine to Sit | 162 | ||
| Analysis of Movement | 162 | ||
| Selected Problems | 162 | ||
| Treatment Strategies | 164 | ||
| Side Lying to Sit Toward the Affected Side | 164 | ||
| Side Lying to Sit Toward the Unaffected Side | 164 | ||
| Activities in Sitting | 166 | ||
| Analysis of Movement | 166 | ||
| Selected Problems | 166 | ||
| Functional Activities in Sitting | 166 | ||
| Scooting | 167 | ||
| Analysis of Movement | 167 | ||
| Selected Problems | 167 | ||
| Treatment Strategies | 168 | ||
| Transfers | 168 | ||
| Analysis of Movement | 168 | ||
| Selected Problems | 168 | ||
| Treatment Strategies | 169 | ||
| Sit to Stand | 170 | ||
| Analysis of Movement | 170 | ||
| Selected Problems | 171 | ||
| Treatment Strategies | 177 | ||
| Activities in Standing | 180 | ||
| Analysis of Movement | 180 | ||
| Selected Problems | 180 | ||
| Treatment Strategies | 181 | ||
| Falls Prevention | 182 | ||
| Consideration of Mobility and Valued Positions | 184 | ||
| Adjunct Techniques to Enhance Skill Acquisition | 184 | ||
| Feedback | 184 | ||
| Mental Practice | 186 | ||
| Manual Guidance | 186 | ||
| Evaluation Tools | 187 | ||
| Anticipating Changing Environments | 187 | ||
| Strategy Development | 188 | ||
| Practice Conditions | 189 | ||
| Blocked and Random Practice | 189 | ||
| Varying the Practice Conditions for Specific Tasks | 189 | ||
| Closed Tasks | 189 | ||
| Variable Motionless Tasks | 190 | ||
| Consistent Motion Tasks | 190 | ||
| Open Tasks | 191 | ||
| Summary | 191 | ||
| Rolling | 191 | ||
| Side Lying to Sit | 191 | ||
| Sit to Stand | 191 | ||
| Review Questions | 191 | ||
| References | 192 | ||
| 9 Gait Awareness | 194 | ||
| Chapter Objectives | 194 | ||
| Key Terms | 194 | ||
| Terminology | 195 | ||
| Reliable Gait Parameters | 196 | ||
| Hemiplegic Gaits | 199 | ||
| Causes of Gait Deviations | 201 | ||
| Osteoporosis | 201 | ||
| Treatment Interventions | 202 | ||
| Other Abnormal Gait Patterns | 206 | ||
| Cerebellar Strokes | 206 | ||
| Contraversive Pushing or Pusher Syndrome | 207 | ||
| Proprioceptive Deficits | 209 | ||
| Visual Deficits | 209 | ||
| Perceptual Deficits | 210 | ||
| Orthotic Interventions | 210 | ||
| Assistive Devices | 214 | ||
| Gait Patterns | 216 | ||
| Two-Point Contralateral Gait Pattern Using One Device | 216 | ||
| Four-Point Contralateral Gait Pattern Using Two Devices | 216 | ||
| Two-Point Contralateral Gait Pattern Using Two Devices | 217 | ||
| Five-Point Gait Pattern Using One Device | 217 | ||
| Three-Point Gait Pattern Using Two Devices | 217 | ||
| Guarding Techniques | 217 | ||
| Case Study | 218 | ||
| Gait Training after Stroke | 218 | ||
| Summary | 220 | ||
| Review Questions | 220 | ||
| References | 221 | ||
| 10 Work after Stroke | 224 | ||
| Chapter Objectives | 224 | ||
| Key Terms | 224 | ||
| Is Return to Work an Option? | 224 | ||
| Understanding the Job and Workplace | 225 | ||
| Assessing the Client’s Work Abilities and Limitations | 226 | ||
| After the Assessment | 229 | ||
| Designing Treatment to Address Return to Work after Stroke | 230 | ||
| Where Can Occupational Therapy Address Return to Work after Stroke? | 232 | ||
| Case Study | 233 | ||
| Joan | 233 | ||
| Case Study | 234 | ||
| Eric | 234 | ||
| Appendix A | 235 | ||
| Job Performance Measure | 235 | ||
| Review Questions | 235 | ||
| References | 235 | ||
| 11 Driving and Community Mobility as an Instrumental Activity of Daily Living | 237 | ||
| Chapter Objectives | 237 | ||
| Key Terms | 237 | ||
| Introduction | 237 | ||
| The Impact of the Baby Boomers | 238 | ||
| Occupational Therapy Roles in Stroke Rehabilitation | 238 | ||
| Stakeholders Considered with Driving | 241 | ||
| The Profession of Driver Rehabilitation | 242 | ||
| The Driver Rehabilitation Specialist and Occupational Therapist | 243 | ||
| Levels of Service for Driving | 243 | ||
| Screening and Evaluation Process for Driving and Community Mobility | 247 | ||
| Evidence and Clinical Judgment in Determining Risk for Driving | 247 | ||
| Evidenced-Based Assessment Tools for Driving Fitness | 249 | ||
| Interventions to Facilitate Returning to Driving | 254 | ||
| Evidence of Interventions for Improving Fitness to Drive | 255 | ||
| Interactive Driving Simulators | 256 | ||
| Adaptive Equipment and Vehicle Modification for Driving | 257 | ||
| Alternative Transportation Options | 258 | ||
| Summary | 258 | ||
| Suggested Resources for Driving and Community Mobility | 261 | ||
| Review Questions | 261 | ||
| Further Resources | 262 | ||
| References | 262 | ||
| 12 Parenting after Stroke | 265 | ||
| Chapter Objectives | 265 | ||
| Key Terms | 265 | ||
| Research on Parent/ Child Collaboration | 265 | ||
| Research on Baby Care Adaptive Equipment | 266 | ||
| Visual History | 266 | ||
| Occupational Therapy Assessment to Guide Baby Care Adaptations | 266 | ||
| Intervention Model | 266 | ||
| Working with Pregnant Women Post Stroke | 267 | ||
| Facilitating Relationships Between Babies and Parents Post Stroke | 267 | ||
| Facilitating Physical Care by the Parent | 267 | ||
| Holding | 268 | ||
| Case Study 1 | 268 | ||
| Carrying and Moving | 268 | ||
| Positional Changes | 269 | ||
| Transfers | 269 | ||
| Case Study 2 | 270 | ||
| Providing Adaptive Baby Care Equipment | 270 | ||
| Bedtime | 270 | ||
| Childproofing | 270 | ||
| Diapering Equipment | 271 | ||
| Examples of Equipment on the Market | 271 | ||
| Durable Medical Equipment | 271 | ||
| Adaptive Techniques and Strategies | 271 | ||
| Feeding: Combining Adaptive Baby Care Equipment and Techniques | 271 | ||
| Breastfeeding. | 271 | ||
| Bottle Feeding. | 272 | ||
| Burping | 272 | ||
| Diapering | 273 | ||
| Fastening the Diaper. | 273 | ||
| Nighttime. | 273 | ||
| Position. | 273 | ||
| Undressing and Dressing | 273 | ||
| Birth to 3 Years Old. | 273 | ||
| Dressing a Younger Baby. | 273 | ||
| Undressing a Younger Baby. | 273 | ||
| Dressing an Older Baby. | 273 | ||
| Undressing an Older Baby. | 274 | ||
| Socks. | 274 | ||
| Dressing and Undressing a Toddler. | 274 | ||
| Car Seats | 274 | ||
| Placing Children in Car Seats | 274 | ||
| Infants | 274 | ||
| Crawling Babies. | 274 | ||
| Toddlers. | 274 | ||
| Cognitive Issues | 274 | ||
| Case Study 3 | 275 | ||
| Emotional Issues | 275 | ||
| Case Study 4 | 275 | ||
| Care by Others | 275 | ||
| Discipline from Crawling Through Toddling | 276 | ||
| Case Study 5 | 276 | ||
| Temper Tantrums | 276 | ||
| Transition Navigating Social Obstacles Integral to Parenting | 276 | ||
| Getting Out in the Community | 276 | ||
| Transportation | 276 | ||
| Recreation | 277 | ||
| Parenting Older Children | 277 | ||
| Case Study 6 | 277 | ||
| The Impact of Growing Up with a Parent with a Disability | 278 | ||
| Review Questions | 278 | ||
| References | 278 | ||
| 13 Sexual Function and Intimacy | 280 | ||
| Chapter Objectives | 280 | ||
| Key Terms | 280 | ||
| Normal Human Sexual Response | 280 | ||
| Aging and the Human Sexual Response Cycle | 281 | ||
| Women | 281 | ||
| Men | 281 | ||
| Sexuality and Neurologic Function | 281 | ||
| Effects of Stroke on Sexual Function | 281 | ||
| Societal Attitudes | 284 | ||
| Role of Occupational Therapy | 284 | ||
| Team Approach | 285 | ||
| Permission, Limited Information, Specific Suggestions, and Intensive Therapy | 285 | ||
| Permission | 285 | ||
| Limited Information | 286 | ||
| Specific Suggestions | 286 | ||
| Intensive Therapy | 287 | ||
| Developing Competency | 288 | ||
| Specific Suggestions for Treatment | 288 | ||
| Hemiparesis or Sensory Loss | 288 | ||
| Cognitive, Perceptual, and Neurobehavioral Impairments | 289 | ||
| Decreased Endurance | 290 | ||
| Inadequate Vaginal Lubrication | 290 | ||
| Erectile Dysfunction | 290 | ||
| Incontinence | 290 | ||
| Contraception and Safer Sex | 290 | ||
| Case Study 1 | 291 | ||
| “When Will My Husband’s Sex Drive Return?” | 291 | ||
| Permission | 291 | ||
| Limited Information | 291 | ||
| Specific Suggestions | 292 | ||
| Case Study 2 | 292 | ||
| “I Want to Get out of the Wheelchair So I Can Chase a Man” | 292 | ||
| Case Study 3 | 292 | ||
| “Will I Ever Have Sex Again?” | 292 | ||
| Program Development | 293 | ||
| Documentation and Billing | 293 | ||
| Summary | 293 | ||
| Review Questions | 293 | ||
| References | 294 | ||
| Suggested Readings | 295 | ||
| Sexuality Resources | 295 | ||
| Specific Websites | 295 | ||
| 14 Leisure Participation after Stroke | 296 | ||
| Chapter Objectives | 296 | ||
| Key Terms | 296 | ||
| Definition of Leisure | 296 | ||
| Leisure, Stroke, and Occupational Therapy | 297 | ||
| Factors Affecting Leisure Performance | 297 | ||
| Leisure Activities during Occupational Therapy | 298 | ||
| Evaluation of Leisure Skills | 299 | ||
| Interventions to Improve Leisure Skills | 301 | ||
| Leisure Interventions for Stroke Survivors: Evidence-Based Practice | 303 | ||
| Adapting the Leisure Task | 306 | ||
| Summary | 306 | ||
| Case Study | 306 | ||
| Leisure Skills after Stroke | 306 | ||
| Review Questions | 307 | ||
| References | 307 | ||
| 15 Caregiving after Stroke | 309 | ||
| Chapter Objectives | 309 | ||
| Key Terms | 309 | ||
| Overview of Caregiving in the United States | 309 | ||
| Characteristics of Caregivers of Adults in the United States | 309 | ||
| Tasks That Caregivers of Adults Perform | 310 | ||
| Effects of Caregiving on the Caregiver | 312 | ||
| Caregiver Burden | 313 | ||
| Occupational Therapy Role with Caregivers of Persons with Stroke | 314 | ||
| Evaluating the Caregiver | 314 | ||
| Intervention with the Caregiver | 320 | ||
| Intervention Timing and Outcomes for the Caregiver | 321 | ||
| Summary | 322 | ||
| Online Caregiver Resources | 324 | ||
| Review Questions | 324 | ||
| References | 324 | ||
| 3 Maximizing Outcomes for Specific Problem Areas Following Stroke | 329 | ||
| 16 Psychological Aspects of Stroke Rehabilitation | 330 | ||
| Chapter Objectives | 330 | ||
| Key Terms | 330 | ||
| Psychological Factors as Predictors of Stroke | 331 | ||
| Emotional Reaction to Stroke | 332 | ||
| Personality Change after Stroke | 333 | ||
| Psychiatric and Emotional Disorders | 333 | ||
| Depression | 333 | ||
| Anxiety Disorders | 334 | ||
| Psychosis | 335 | ||
| Dementia | 335 | ||
| Screening for Psychological Conditions | 335 | ||
| Biologic Intervention | 335 | ||
| Coping with Illness, Recovery, and Rehabilitation | 336 | ||
| Children with Stroke | 337 | ||
| Impact of Stroke on the Family | 338 | ||
| Well-Being of the Family Member as Caregiver | 338 | ||
| Considerations for the Recovery Process | 339 | ||
| Occupational Therapy Intervention | 340 | ||
| The Therapeutic Relationship | 340 | ||
| Evaluation | 341 | ||
| Patient-Centered Care | 342 | ||
| Family-Centered Care | 343 | ||
| Intervention to Include the Caregiver | 343 | ||
| Summary | 343 | ||
| Review Questions | 344 | ||
| References | 344 | ||
| 17 Approaches to Motor Control Dysfunction: | 348 | ||
| Chapter Objectives | 348 | ||
| Key Terms | 348 | ||
| Understanding Evidence- Based Practice | 348 | ||
| Criteria for Evaluating Research Articles | 349 | ||
| Traditional Paradigm | 349 | ||
| Implications for Practice | 350 | ||
| Current Approaches: Task-Related Training | 350 | ||
| Systematic Reviews | 351 | ||
| French et al (2008) | 351 | ||
| Glossary | 732 | ||
| Index | 740 | ||
| A | 740 | ||
| B | 741 | ||
| C | 742 | ||
| D | 743 | ||
| E | 744 | ||
| F | 745 | ||
| G | 746 | ||
| H | 746 | ||
| I | 747 | ||
| J | 747 | ||
| K | 748 | ||
| L | 748 | ||
| M | 748 | ||
| N | 749 | ||
| O | 750 | ||
| P | 750 | ||
| Q | 752 | ||
| R | 752 | ||
| S | 752 | ||
| T | 754 | ||
| U | 755 | ||
| V | 756 | ||
| W | 756 | ||
| Z | 756 | ||
| Inside Back Cover | ibc1 |