Deans' stroke musings: Sensory impairment after stroke: Exploring therapists’ clinical decision making

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, November 13, 2014

Sensory impairment after stroke: Exploring therapists’ clinical decision making

This is the major problem with stroke rehab. There are NO stroke rehab protocols that can be tested/critiqued. All because of the stupid belief, 'All strokes are different, all stroke recoveries are different'. Maybe if they just read what Margaret Yekutiel wrote in the book, Sensory Re-Education of the Hand After Stroke in 2001 they might be able to cobble together a stroke protocol. It is only 13 years old so if they had any analysts keeping track of stroke rehab advancements they might know something.

Sensory impairment after stroke: Exploring therapists’ clinical decision making

Susan Doyle, School of Occupational Therapy, University of Puget Sound, 1500 N. Warner St., Tacoma, Washington, 98416, USA. Telephone: 253-879-3506. E-mail: sdoyle@pugetsound.edu

Abstract

Background. Stroke survivors experience sensory impairments that significantly limit upper-limb functional use. Lack of clear research-based guidelines about their management exacerbates the uncertainty in occupational therapists’ decision making to support these clients.

Purpose. This study explores occupational therapists’ clinical decision making regarding upper-limb, post-stroke sensory impairments that can ultimately inform approaches to support therapists working with such clients.

Method. Twelve therapists participated in a qualitative descriptive study. Transcripts of semi-structured interviews were analyzed using content analysis.

Findings. Three overarching categories were identified: deciding on the focus of interventions (describing intervention choices), it all depends (outlining factors considered when choosing interventions), and managing uncertainty in decision making (describing uncertainty and actions taken to resolve it).

Implications. Providing training about post-stroke sensory impairment and decision making may improve therapists’ decision making and ultimately improve client outcomes. Further research is needed to understand the impact of uncertainty on occupational therapy decision making and resulting care practices.