Resumen de Dressing after a Stroke: a Survey of Current Occupational Therapy Practice
Marion F. Walker, Alan Sunderland, Christina M. Walker
The objective of this study was to determine occupational therapists' beliefs about the influence of cognitive impairment on dressing difficulties and to ascertain current practice when treating dressing problems. The study design was a questionnaire survey of occupational therapists experienced in stroke care who treated patients with dressing difficulties. Out of 137 questionnaires sent, 76 (55.5%) were returned. The frequency of dressing practice provided by the occupational therapists ranged from two to four times a week. Only 43% of the therapists used standardised assessments and the most common one used was the Rivermead Perceptual Assessment Battery. Apraxia was reported by 76% of the therapists as influencing a patient's ability to dress, neglect by 71% and memory problems by 63%. Seventy-six per cent of the therapists reported that orientating clothing and relating it to body parts was a major dressing difficulty. Other dressing difficulties reported were sequencing by 56% and failing to dress the affected side by 34%. Ninety-eight per cent of the therapists spent time providing the practice of specific functional skills on a repetitive basis; however, 60% continued to use table-top tasks aimed at targeting a particular cognitive impairment. The majority of the therapists felt that cognitive impairment was a major reason for dressing difficulties in stroke patients. With the exception of one, all the therapists provided repetitive practice on dressing tasks and over half continued to use table-top tasks. The evidence to support the types of treatment used by occupational therapists remains controversial. Further research into this area is required.
