From the Guidelines
Approximately 70% of patients with major stroke require occupational therapy follow-up in the chronic phase of stroke. The chronic phase typically begins around 3-6 months post-stroke and can continue for years afterward 1. Occupational therapy during this phase focuses on maximizing independence in activities of daily living, improving quality of life, and addressing ongoing functional limitations. The need for continued therapy varies based on stroke severity, location, and individual recovery patterns. Patients with more severe strokes affecting dominant hemispheres or those with significant motor, cognitive, or perceptual deficits are more likely to require long-term occupational therapy services 1.
Key Considerations
- The provision of comprehensive rehabilitation programs with adequate resources, dose, and duration is an essential aspect of stroke care 1
- More than two thirds of stroke survivors receive rehabilitation services after hospitalization, indicating a high demand for occupational therapy follow-up 1
- Despite the development of stroke center designation and improved systems to recognize stroke symptoms and deliver care promptly, many patients remain with residual functional deficits, necessitating ongoing occupational therapy 1
- Unmet needs persist in many domains, including social reintegration, health-related quality of life, maintenance of activity, and self-efficacy, which occupational therapy can help address 1
Recommendations
- Early comprehensive rehabilitation starting in the acute phase and continuing through the subacute phase improves outcomes and may reduce the percentage of patients requiring extensive chronic phase therapy 1
- Regular reassessment of functional status is essential to determine the appropriate duration and intensity of occupational therapy services throughout the chronic recovery period 1
- Occupational therapy should be tailored to the individual's specific needs and goals, taking into account their stroke severity, location, and recovery patterns 1
From the Research
Occupational Therapy Follow-up for Stroke Patients
- The provided studies do not directly address the percentage of patients with major stroke who require occupational therapy follow-up in the chronic phase of stroke 2, 3, 4, 5, 6.
- However, the studies suggest that occupational therapy is an important aspect of stroke rehabilitation, aiming to restore independence in activities of daily living and improve functional performance 2, 3, 4, 5.
- The studies also highlight the effectiveness of occupational therapy in improving performance in activities of daily living and reducing the risk of deterioration in these abilities 3, 5.
- A scoping review of implementation strategies and outcomes for occupational therapy in adult stroke rehabilitation found that various implementation strategies, such as distributing educational materials and conducting educational outreach visits, were used to promote the use of evidence-based occupational therapy practices 6.
- While the studies provide evidence for the importance and effectiveness of occupational therapy in stroke rehabilitation, they do not provide a specific percentage of patients who require occupational therapy follow-up in the chronic phase of stroke.