OCCUPATIONAL THERAPY INTERVENTIONS AND THE FUNCTIONAL OUTCOMES OF STROKE PATIENTS IN AN IRISH IN-PATIENT REHABILIATION UNIT

Background: Stroke is the leading cause of acquired disability in Ireland... [ view full abstract ]

Background: Stroke is the leading cause of acquired disability in Ireland (Irish Heart Foundation, 2010). Occupational Therapists (OTs) aim to improve the functional independence of their patients.There is currently a paucity of Irish research investigating the duration and range of occupational therapy (OT) interventions in stroke rehabilitation, and possible correlation with functional outcomes.

Method: A prospective, non-experimental study design was utilised. All patients had a Functional Independence Measure (FIM) completed within 5 days of admission and on discharge. Data from consecutive patients admitted to the unit, who meet the inclusion and exclusion criteria was recorded using a proforma designed by the researchers. Therapy times were extrapolated from Electronic Patient Records.

Results: Data collection commenced in June 2015. Data correlates with international findings, moderately affected patients (Initial FIM score 40-80) were most likely to make clinically significant gains, return home and were less likely to require extensive supports. OTs utilise a wide range of interventions; in this setting posture and pressure care, personal care retraining and discharge planning appear to be prioritised. Those requiring specialised seating or home visits received the most direct hours of OT.

Conclusion: Findings have highlighted that the FIM score upon admission to rehabilitation is highly predictive of functional outcomes and discharge destination for our clinical population. Patients with moderate levels of dependency on admission have been shown to benefit greatest from rehabilitation.

Application to Practice: This research demonstrates that in our setting the FIM is a predictive tool for rehabilitation outcomes and OT resources required.