Literature Review
Introduction
In 2015, the Centers for Disease Control and Prevention found that stroke is the leading cause of long-term disability and the fifth leading cause of death for Americans (“Stroke Facts,” 2015). Despite this degree of prevalence, stroke mortality rates in the United States (U.S.) are among the lowest in the world. Between 1960 and 1990 there has been a 60% decline in stroke mortality (Sacco et al., 1997). In 2008 alone, The Centers for Disease Control and Prevention cited a 3.6% rate of decline in stroke mortality (“Prevalence of Stroke,” 2012). This means that a greater number of people are living with stroke-related hemiparesis; a number that is expected to increase in the next 30 years as the percentage …show more content…
Factors contributing to motor recovery include neuroplasticity, response to focal injury, and strategies for adaptive responses. Neuroplasticity is a concept that suggests a given function in the brain can transfer to another area of the brain if damage has occurred. The brain reorganizes itself by forming new synaptic connections, or neural pathways, through the process of repetitive learning. After a focal brain injury, the degree of damage to the corticospinal tract correlates to the ability to recover motor function. If the pathway from the primary motor cortex to the motor neurons in the spinal cord is disrupted, secondary motor areas of the brain will be recruited. Secondary motor areas are less numerous and less excitatory; therefore, they will contribute to motor recovery, but will not provide exact substitutions for projections from the primary motor cortex. Finally, strategies to promote adaptive responses can influence recovery of motor function after a stroke. These strategies include changing the environmental and behavioral contexts to influence cerebral reorganization and promote recovery of function (Ward & Cohen, …show more content…
The Model of Human Occupation (MOHO) provides a theoretical approach that examines occupational participation through an individual’s motivation for occupation, the routine patterning of occupations, the nature of skilled performance, and the effect of the environment on occupation. When a group experiencing customary occupational therapy intervention with more physically focused interventions such as transferring between surfaces, muscle strengthening, stretching in a sitting position, and walking with a frame was compared to MOHO-based intervention involving volition, role performance, and environmental changes, the MOHO-based intervention group had improved ADL scores and quality of life (QOL) outcomes (Sinohara, Yamada, Kobayashi, & Forsyth, 2012). Therefore, the principles of MOHO will be applied to FES intervention to motivate patients to engage in occupational
Introduction
In 2015, the Centers for Disease Control and Prevention found that stroke is the leading cause of long-term disability and the fifth leading cause of death for Americans (“Stroke Facts,” 2015). Despite this degree of prevalence, stroke mortality rates in the United States (U.S.) are among the lowest in the world. Between 1960 and 1990 there has been a 60% decline in stroke mortality (Sacco et al., 1997). In 2008 alone, The Centers for Disease Control and Prevention cited a 3.6% rate of decline in stroke mortality (“Prevalence of Stroke,” 2012). This means that a greater number of people are living with stroke-related hemiparesis; a number that is expected to increase in the next 30 years as the percentage …show more content…
Factors contributing to motor recovery include neuroplasticity, response to focal injury, and strategies for adaptive responses. Neuroplasticity is a concept that suggests a given function in the brain can transfer to another area of the brain if damage has occurred. The brain reorganizes itself by forming new synaptic connections, or neural pathways, through the process of repetitive learning. After a focal brain injury, the degree of damage to the corticospinal tract correlates to the ability to recover motor function. If the pathway from the primary motor cortex to the motor neurons in the spinal cord is disrupted, secondary motor areas of the brain will be recruited. Secondary motor areas are less numerous and less excitatory; therefore, they will contribute to motor recovery, but will not provide exact substitutions for projections from the primary motor cortex. Finally, strategies to promote adaptive responses can influence recovery of motor function after a stroke. These strategies include changing the environmental and behavioral contexts to influence cerebral reorganization and promote recovery of function (Ward & Cohen, …show more content…
The Model of Human Occupation (MOHO) provides a theoretical approach that examines occupational participation through an individual’s motivation for occupation, the routine patterning of occupations, the nature of skilled performance, and the effect of the environment on occupation. When a group experiencing customary occupational therapy intervention with more physically focused interventions such as transferring between surfaces, muscle strengthening, stretching in a sitting position, and walking with a frame was compared to MOHO-based intervention involving volition, role performance, and environmental changes, the MOHO-based intervention group had improved ADL scores and quality of life (QOL) outcomes (Sinohara, Yamada, Kobayashi, & Forsyth, 2012). Therefore, the principles of MOHO will be applied to FES intervention to motivate patients to engage in occupational