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.
http://cjo.sagepub.com/content/81/4/215.abstract?

1. Susan D. Doyle⇑
2. Sally Bennett
3. Brian J. Dudgeon

1. 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.