Stroke Symposium - Post Stroke Rehabilitation PDF

STROKE SYMPOSIUM Post Stroke Rehabilitation Jessica Fryer Team Lead Occupational Therapist Bexhill Rehabilitation Unit East Sussex Healthcare Trust October 2023 SESSION OBJECTIVES • Brief overview of • Our guidelines and evidence base • Current climate • The general principles, theories and tools...

STROKE SYMPOSIUM Post Stroke Rehabilitation Jessica Fryer Team Lead Occupational Therapist Bexhill Rehabilitation Unit East Sussex Healthcare Trust October 2023 SESSION OBJECTIVES • Brief overview of • Our guidelines and evidence base • Current climate • The general principles, theories and tools to aid stroke rehabilitation OUR STANDARDS •“People with motor recovery goals following stroke should receive at least 3 hours a day of therapy (therapist-delivered) and should be supported to remain active for up to 6 hours a day” NATIONAL - LOCAL NHS – Long term Plan 2018 National Stroke Service Model Integrated Stroke Delivery Networks  Structure of services should include the whole pathway PHYSIOTHERAPY AND OT KEY STANDARDS FOR PROVISION OF REHABILITATION SERVICES:-  Specialist Early Supported Discharge service  Specialist Rehabilitation Services with a Co-Ordinated MDT approach  Close links and Referral Procedures NEEDS BASED AND RESPONSIVE REHABILITATION 18 – 20 stroke specific rehabilitation beds Increased to 27 – 30 post COVID PREVIO US ‘VS’ NEW CLIMATE Demand now greatly outweighing capacity Increased complexity in patient presentations across units The importance of data has never been more prevalent to support the case for increased staffing Transformational Thinking WHAT IS POST STROKE REHABILITATI ON? •At Bexhill we strive to provide patients with an opportunity to regain as much pre-Stroke ability as possible and to support them with living with their post stroke difficulties. • • • • • Accessible and needs based Individualised Focused and Specific A 24 Hour Approach Fluid within the pathway •We are only a stepping stone in their journey KEY COMPONENTS OF REHABILITATION Neuroplastici ty Independenc e/Function Patient Managing complication s Rehabilitati on cycle NEUROPLASTICITY 10 principles Respons e to stimuli Enduring cortical change Post Stroke problems that impact on therapy  Cardiovascular instability  Altered consciousness/ arousal  Cognitive problems  Comprehension/ understanding  Attention difficulties  Hearing and vision  Receptive/ Expressive Dysphasia  Dysphagia  Contractures  Tissue Breakdown/Pressure Sores  Arthritic Joints  Unstable Shoulder  Respiratory Complications  Urinary Problems  Constipation  Pain  Circulatory Problems  Depression and Anxiety  Osteoporosis  CV Deconditioning  Oedema  Motor weakness  Bladder/Bowel  Sensory Loss  Co-ordination  Muscle Tone Changes  Personality Changes  Behavioural Changes  Memory Problems • Subjective Assessment - HPC, PMH, SH, DH, Input to date • Objective Assessment • - Vision, ROM, MRC, Tone, JPS, Sensation • Functional Assessments - Bed Mobility, Lie to sit, Sitting balance, Sit to stand, Standing Balance, Transfers, Mobility • THERAPY ASSESSMEN TS : GOAL SETTING OT ASSESSMENTS Capacity Cognition Memory Perception Attention Apraxia Driving Advice Functional Tasks Vision Equipment Activities of Daily Living Role Sensation Meet Guidelines Increase engagement WHY OFFER GROUPS? Social aspect Self efficacy Enjoyment Incorporating new skills into functional tasks GROUPS THERAPY OPTIONS Therapy Adjuncts SUMMARY We aim to adhere to the NICE guidelines to ensure evidence based rehabilitation Neuroplasticity has a key role in stroke rehabilitation All Professionals must work together keeping the patient at the centre of all decisions You as the medical representations have a key role in supporting AHP’s to facilitate patients to achieve their potential Please email emma.quigley@nhs. net