Stroke Week: MDT

Question 1

What is occupational therapy?

Answer 1

Primary goal is to enable people to participate in activities of every day life and enable them to do things that matter most to them

Question 2

State some specific roles of occupational therapist in stroke patients

Answer 2

• Assess pt within 72 hours of referral
• Pts should have 45 mins of occupational therapy everyday
• Assess pt safety & independence
• Pt should be mobilised in 24-48 hours
• Ask about work and leisure

.. and more

Question 3

State 3 components that affect occupational performance

Question 4

State some roles of physiotherapists

Answer 4

• Restore movement & function disability
• Management of pain, preventing disease and disability
• Help to relearn lost abilities, regain independence and reduce risk of further strokes

Question 5

What is the minimum treatment reccomendation for physiotherapy treatment in stroke patients?

Answer 5

• Assess pt within 72 hours
• Minimum 45 mins, 5 days a week
• Rehab
• Access to community rehab

Question 6

Suggest some functions which are assessed in the stroke physiotherapy assessment

Answer 6

Question 7

What may rehabilition physiotherapy involve for a stroke patient?

Answer 7

Question 8

State and describe the 5 types of communication disorder which can occur following a stroke

Answer 8

• Dysphasia/aphasia: dys=partial, a=complete. Difficult with anything to do with language; this can be speaking, understanding, reading, writing, numbers, gesture
• Dysarthria: speech disorder due to weakness or abnormal muscle tone of the muscles that are articulators. May see facial paralysis, drooling, poor respiration etc…
• Dyspraxia/apraxia of speech: difficulty coordinating muscles to say what they want to say
• Dysphonia: typically caused by disorder of vocal cords
• Dysfluency: disruption of fluent speech

Question 9

State some impacts of communication difficulties

Answer 9

• Increased length of stay
• Low mood
• Independence and need for assistance
• Barriers to rehabilitation and effective care
• Psychosocial (relationships, isolation etc)

Question 10

Communication disorders can act as a barrier to decision making in clinical care; who would you contact in this case and what can they do?

Answer 10

Speech and language therapists can provide accessible information that’s aphasia frienldy using e.g. graphics, written info etc… NOTE: this is only case if pt has capacity

Question 11

Suggest some ways in which we can help patients to express themselves

Answer 11

Question 12

Suggest some ways in which we can help patients understand

Answer 12

Question 13

What investigation can we do to determine if pt has abnormal swallow?

Answer 13

Videofluroscopy

Question 14

What do we mean by silent aspiration?

Answer 14

Aspiration without coughing

Question 15

In addition to the primary motor areas and brainstem, other areas have been associated with swallowing problems- state some of these areas

Answer 15

• Thalamus
• Cerebellum
• Basal ganglia
• Pyramidal tracts

Question 16

What is aspiration?

Answer 16

Inhalation of foreign material into the airway beyond the vocal cords

Question 17

State some signs of aspiration

Answer 17

Question 18

State some symptoms of aspiration/dysphagia

Answer 18

Question 19

State some impacts of dysphagia

Answer 19

• Poorer outcomes
• Increased length of stay in hospital
• Quality of life
• Mood/psychosocial
• Discharge complications

Question 20

State some conditions which can predispose to aspiration

Answer 20

Question 21

Dicuss how swallow is assessed in terms of the tiers of assessment

Answer 21

1. Nurse screens for dysphagia
2. SLT bedside assessment and management (will provide nurses with instructions on consistency, quanitity, strategies, positioning, therapy etc…)
3. Instrumental assessment (e..g videofluoroscopy, fibreoptic endoscopic evaluation)
4. SLT may offer medication

Question 22

State some treatments/interventions for dysphagia

*Include non-oral an oral interventions

Answer 22

Question 23

What is risk feeding?

Answer 23

• When pt continues to eat and drink orally despite risk
• Decision is reached between pt and medical team ensuring to mange pt and families expectations. It is a balance of best interests and patient wishes

Question 24

What is a multidisciplinary team?

Answer 24

MDT involves professionals from different disciplines working together and using each others knowledge to provide the best possible care to patients- particularly when the patient’s needs are complex.

Question 25

When are MDT meetings needed?

Answer 25

Idea is they are needed often/at many different stages in treatment