Stroke Rehabilitation: A Functional Activity Based Approach (Hardbound - 2014)

Amongst the many treatment options available from medicine and surgery to acupuncture, ayurveda and other alternate forms of treatment, physiotherapy and occupational therapy play a crucial role in a stroke patient’s road to recovery. They in fact are the only treatments that directly access the nervous system and exploit the plastic potential of the human brain.

The science of stroke rehabilitation has moved beyond facilitation approaches and the reflex theories to motor control and motor learning based treatment around the end of the 20th century. There have been rapid developments in the field of motor control and learning over the past few years. The changes in understanding of motor control and biology as a unitary concept to biopsychosocial model have provided a holistic understanding to the human functioning. Although stroke patients have difficulty in moving their body which results in dire consequences to their whole quality of life, the movements themselves emanate from an interaction between the body, the immediate physical potentials, the psychology of behavior, the ecological opportunities and the larger social life through which the person requires to connect with the world. A treatment that reduces the movement to a set of joint and muscle coordination is therefore a simplistic reduction of the complexity involved in performing movement.

There have been many function oriented treatments in the recent times. However, the paradigm the book takes is that, every movement emanates from a purpose, and derives a unique and variable set of solutions to the functional goal it serves to achieve directed by the psyche, eco, physical facilitators and barriers.

The book is divided into two sections. The first section provides the scientific rationale for the unique problems faced by stroke patients. It talks about normal control of the activity as performed in natural environments typical of task performance, viz. how are they affected when stroke patients perform the activities and why are they affected. The second section provides specific methods of addressing the various functional activities that utilizes movements of the body inclusive of sit to stand, gait and upper limb. It explains the assessment and treatment methods built upon the treatment principles derived in the initial chapters.

The suggested treatment has been derived from the authors’ clinical practice and in-depth analysis of the progress in various basic science fields and evidences available at the present point of time and more importantly the direction to which the evidence points. The book is directed to assist the clinical therapists to plan and execute the treatment. As the treatment methods provide more weightage to the contextual factors, the intervention methods need to be adapted for various other contexts.

K. Hariohm is a physiotherapist with a Master’s degree in neuro-physiotherapy. He is a clinician and a teacher for the past 18 years in the field of neuro-rehabilitation. He is currently working as a Professor in MSAJ College of PT, Chennai. K. Hariohm is a well-known author with research interest in stroke rehabilitation and evidence based medicine. He is involved in management of patients with stroke.

R. Vasanthan, is Professor, Oxford College of Physiotherapy, Bangalore. Together with K. Hariohm, he has conducted numerous training programs in evidence based stroke rehabilitation and evidence based medicine in various universities.

The authors can be contacted at [email protected]