Occupational therapy treatment protocols for cerebrovascular accidents: a rapid review of evidence

Abstract

Introduction: The rising prevalence of stroke in sub-Saharan Africa necessitates  the exploration of the role of occupational therapy in rehabilitation of stroke. In the southern African country of South Africa, occupational therapy aligns with healthcare policies and laws, and this article presents a review of synthesized evidence of occupational therapy intervention in stroke care and rehabilitation.

Method: Rapid review methodology was used to develop a research question about cerebrovascular accident - intervention by  occupational therapists., The Cochrane Library and MEDLINE databases were searched for relevant articles published between 2018 and 2023. Twenty four articles met the inclusion criteria and were analysed according to quantitative and qualitative parameters.

Results: Evidence of occupational therapy intervention with post-stroke upper limb impairment was found in 37,5% of articles. Occupational therapy for global improvement in function, cognitive rehabilitation, balance, social participation, work, and leisure comprised   45,8% of articles, and one article each reported evidence for occupational therapy addressing ADL and caregiver interventions.

Conclusion: Evidence from the past five years reflect diverse occupational therapy interventions with clients with stroke. Gaps in recent evidence remain in relation to context-specific interventions, especially from low- and middle-income countries.

Implications for practice

Occupational therapists should adopt a holistic approach to stroke rehabilitation, tailoring interventions to address the multifaceted needs and goals of individual stroke survivors. The effectiveness of individualised, occupation-based approaches across various domains are highlighted.

• Therapists should stay informed about emerging technologies and evidence-based practice to enhance their effectiveness in stroke rehabilitation.


• Given the prevalence of upper limb impairments post-stroke, therapists should be well-versed in diverse intervention approaches for upper limb rehabilitation, including technologies like Brain Computer Interface, Mental Practice, Mirror Therapy, and Action Observation Therapy.


• Occupational therapy is vital in addressing cognitive impairments in stroke survivors, and practitioners should explore interventions such as Virtual Reality and computer-assisted cognitive rehabilitation that have shown promise in improving cognition and ADL.