Optimising rehabilitation potential after stroke: a 24-hour interdisciplinary approach

Abstract

Approximately 150 000 people in the UK experience a stroke each year, often resulting in complex disability. Restoration of sensorimotor function after stroke involves processes of relearning and neuroplasticity. Different mechanisms by which neuroplasticity can occur post stroke include dendritic sprouting, unmasking of previously inactive synapses, synaptogenesis, long-term potentiation and cortical reorganisation. To optimise recovery potential, rehabilitation strategies which promote neuroplasticity and recovery post stroke through sensorimotor retraining should involve: an enriched environment, social interaction, opportunities for repetition and practice of movement and functional activities involving paretic limbs, sensory stimulation to paretic limbs, and early activity out of bed. A rehabilitation culture of 24-hour care should be fostered within an interdisciplinary team; nursing staff are ideally placed to coordinate this approach and motivate stroke survivors, to enhance recovery, in collaboration with specialist therapists in the team. This could be facilitated by flexibility of professional roles and traditional working patterns.

Combining scoping review and concept analysis methodologies to clarify the meaning of rehabilitation potential after acquired brain injury

“…Two types of publications were found; eight articles were opinion papers [20,[33][34][35][36][37][38][39] and ten reported original research studies [7,12,13,19,[40][41][42][43][44][45]. Only three opinion papers focused specifically on the concept of rehabilitation potential [20,34,39].…”

“…The second use of rehabilitation potential in documents published in the last two decades relates to patients' actual performance (or outcome) following rehabilitation interventions. Here authors suggest ways to optimize rehabilitation potential during rehabilitation [33] or discuss patient recovery with rehabilitation [37]. Other authors refer to rehabilitation potential as an indication of the effectiveness of therapy where rehabilitation potential is the measured improvement from admission to discharge.…”

Daily functioning support – a qualitative exploration of rehabilitative approach in acute hospitalised care

“…In the teams, staff members can use their interdisciplinary competences in the best way to support the fast recovery of the patient. Effective interdisciplinary teamwork is a way to minimise patient’s complications, shorten the time in hospitalised care and optimise patient’s recovery (16,46,47). In the future, tighter interdisciplinary teamwork in which the responsibilities are shared could clarify the area of rehabilitative approach in patient care.…”

Nursing – a core element of rehabilitation

“…One concept for rehabilitation of patients with neurological conditions stresses that rehabilitation care must be done 24 h per day and underlines that this has to be accomplished in collaboration between health professionals, the person requiring care and their family (Aries 2014).…”