Stroke to Strength: How OT Can Assist in Your Recovery

Virtual reality (VR) therapy is a cutting-edge method for stroke recovery that immerses patients in digital worlds to help them get better. By using interactive VR simulations, therapists can design customised exercises that focus on improving the specific motor skills and cognitive functions affected by a stroke. In these virtual environments, patients practice movements and tasks, which can enhance motor coordination, balance, and cognitive skills through repeated practice and instant feedback. Khokale et al (2023) found that VR therapy was effective in improving functional outcomes in adjunct to conventional therapy and highlighted that it improved neuroplasticity. This is an amazing new technique that is effective and engaging.

Constraint-induced movement therapy (CIMT) is an exciting method for stroke recovery that helps improve movement in the affected limb. It works by temporarily restricting the use of the unaffected arm, which pushes the stroke survivor to rely on and strengthen the affected arm through lots of practice. CIMT is recommended under the Stroke Foundation guidelines and  Etoom et al (2017) and Liu et al (2017) completed quality studies that found CIMT to improve arm and hand function. The understanding of how this works is not fully understood, but is likely best described by neuroplasticity, encouraging the brain to adapt and reorganize. The draw backs of CIMT are that it can be quite demanding and requires a strong commitment from client, and some may find the intensity challenging or frustrating.

Functional Electrical Stimulation (FES) is a cutting-edge technique in stroke rehab that uses electrical impulses to help stimulate muscles and nerves, aiming to boost motor function and mobility. It works by placing electrodes on the skin to deliver electrical currents, which activate and strengthen weakened muscles and support movement. Khan et al (2023) completed a meta-analysis which validated the effectiveness of FES in upper limb rehabilitation. Highlighting its ability to improve muscle strength, coordination, and overall motor recovery by encouraging the brain to reorganize and adapt. The great thing about FES is that it can potentially lead to faster recovery, better functional abilities, and increased independence in daily life. However, it’s not without its challenges: some users might find it uncomfortable, and its effectiveness can vary depending on individual factors and the specifics of the stroke.

Mental practice is a fascinating and growing approach in stroke rehabilitation that involves imagining and rehearsing movements in your mind, without physically doing them. The idea is that by vividly visualizing these actions, you can help your brain rewire itself and improve both motor skills and cognitive functions. Mental practice can be effective, especially when combined with physical exercises or other therapies. It works by activating the same neural pathways as real movements, which can lead to better recovery outcomes. The great thing about mental practice there is no limit on how often you can do this and there is no barrier to completing this practice. The down side is that as a stand alone technique it isn't very effective.

Task Specific Training (TST) in stroke rehab focuses on improving motor skills by practicing specific, meaningful movements. This method involves repeatedly performing functional movements like walking, standing from sitting, putting food away, buckling a seatbelt or hitting/kicking a ball. French et al (2016) completed a literature review on repetitive task training in relation to task specific motor activities. Finding that this therapy was effective and the effect was sustain at 6 months post intervention.  By practicing these targeted movements, stroke survivors can boost their motor control and coordination aiding recovery and building and strengthening neural pathways. What I love about TST is that it is a motivating form of therapy as the movements being practices are the activities the client wants to improve in. 

Visual scanning training is an approach in stroke rehab that helps improve how patients use their vision to find and process information around them. This technique focuses on teaching people to systematically scan their visual field to spot objects or read text, which is especially useful for those dealing with visual neglect or attention issues after a stroke. van Kessel et al (2013) found there is evidence to support the effectiveness of visual scanning training, furthermore Batool et al (2022) found that visual scanning and task specific training showed great effectiveness when performed together. This technique focuses on teaching people to systematically scan their visual field to spot objects or read text, which is especially useful for those dealing with visual neglect or attention issues after a stroke.

Mirror therapy is a fascinating and promising method for stroke rehab that uses visual feedback to help improve motor function. In this approach, a mirror is placed between the patient’s two arms, hiding the affected limb and showcasing the unaffected one. As the patient moves their unaffected arm, the mirror creates the illusion that the affected arm is moving too, which can help stimulate the brain’s motor pathways and encourage recovery. Gandhi et al (2020) established that Mirror Therapy is a feasible method for motor, sensory and perceptual deficits in acute, sub-acute and chronic phases of stroke. I love this option as its simple, low-cost, and can be easily included in daily routines. However, consistency is essential and this isn't suitable for all stroke survivors.