A stroke occurs when…
blood flow to part of the brain is interrupted, causing brain tissue death due to lack of oxygen and glucose
Ischaemic stroke
(85%) – caused by blockage (thrombosis or embolism).
Haemorrhagic stroke
(15%) – caused by bleeding; higher mortality rate.
Transient Ischaemic Attack (TIA)
temporary blockage with complete recovery (no tissue death).
Risk factors
- increasing age
- hypertension (most important)
- diabetes mellitus
- high cholesterol
- heart disease
- smoking
Frontal lobe
Voluntary motor control, planning, reasoning, judgment, problem-solving, speech (Broca’s area).
Parietal lobe
Sensory processing (touch, temperature, pain), spatial awareness, coordination.
Temporal lobe
Auditory processing, memory, language comprehension (Wernicke’s area)
Occipital lobe
Visual processing
Cerebellum
Balance, coordination, and fine motor control.
Left hemisphere
Language, analytical and logical thinking, calculation, reading, and writing.
Right hemisphere
Spatial perception, visual awareness, creativity, and recognising faces/objects
characteristics of left sided stroke
- Aphasia (difficulty understanding or producing language).
- Right hemiparesis or hemiplegia (weakness/paralysis of right side).
- Right-sided sensory loss.
- Right visual field defect.
- Difficulty reading, writing, or calculating.
- Dysarthria (slurred speech).
- Poor right conjugate gaze (difficulty moving both eyes to the right).
- Cognitive effects: decreased analytical, sequential, and problem-solving ability
Ot role Functional restoration and adaptation:
- Promote independence in ADLs (dressing, grooming, eating).
- Encourage use of affected right limbs through graded motor retraining and constraint-induced therapy.
- Address cognitive-linguistic deficits by simplifying communication, providing visual cues, and pacing tasks.
Ot role Environmental modification
Reduce distractions and use adaptive equipment to enhance safety.
Ot role Collaborative approach
Work with physiotherapists for mobility and with speech pathologists for language recovery
Ot role education
Teach clients and families strategies for safe communication and task performance.
Aphasia
- A language disorder caused by damage to language areas (usually Broca’s or Wernicke’s).
- Broca’s aphasia: non-fluent speech, good comprehension, difficulty forming sentences.
- Wernicke’s aphasia: fluent but meaningless speech, poor comprehension.
- Global aphasia: severe impairment of both expression and comprehension.
Apraxia
- A motor planning disorder where clients cannot perform purposeful movements despite intact strength, sensation, and comprehension.
- Caused by damage to motor association areas in the frontal and parietal lobes.
- Apraxia of speech (AOS): impaired ability to coordinate speech movements, not due to muscle weakness
Occupational Therapists work with Speech Pathologists to enhance communication with an aphasic client.
- Joint goal setting for communication-focused ADLs (e.g., meal preparation, dressing).
- Use multimodal communication supports: gesture, writing, drawing, visual cards.
- Allow extra response time and use short, simple instructions.
- Practice communication in real-life contexts (e.g., therapy during cooking or grooming).
- Reinforce strategies taught by speech pathologists during OT sessions to maintain consistency.
evidence based intervention strategies for apraxia
- Errorless learning: client practices correct movement sequences to reinforce accurate motor plans.
- Task-specific practice: focus on meaningful, occupation-based tasks (e.g., grooming, feeding).
- Strategy training: verbal cueing, physical guidance, and step-by-step sequencing.
- Graded repetition: repeated practice of targeted actions with increasing complexity.
For speech apraxia: - Melodic Intonation Therapy (MIT) – uses rhythm and melody to improve speech.
- Articulatory kinematic therapy – repeated speech movement practice to retrain coordination.
- Augmentative and alternative communication (AAC) tools if verbal recovery is limited
