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By Nick Losseff
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Further, a cognitive profile that reflects an individual’s strengths and weak Page 33 nesses can be used to provide information to family and carers that may help to explain current problems and prognosis for the future. Nutrition intervention at all stages of stroke care can reduce complications, length of stay, morbidity and mortality and improve a patient’s quality of life (Finestone et al, 1995). Screening is important to identify those patients who would benefit from practical interventions at a ward level and to ensure that those patients at high nutritional risk are referred for dietetic intervention.
Their role after discharge includes providing the patient and carer with information on support groups and making referrals to outside agencies as required. This allows the therapist to identify barriers to movement. Repeated practice is thought to drive neuroplastic changes (Dobkin, 1998; Turton, 1998; Nundo and Friel, 1999), improve strength and endurance, and aid return to independent living. There is little written about the treatment of ‘pushing’ patients, but therapy may focus on reorientating the patient to midline, encouraging them to lie on their nonhemiplegic side while in bed, and reducing overactivity.
American Psychologist 2 :737–45. Wiley, New York. Journal of Neurophysiology 75:1765–78. Stroke 25: 1999–2004. Scandanavian Journal of Rehabilitation Medicine 27:199–204. Current Opinion in Neurobiology 12:217–22. Stroke 26:90–5. Ivanco TL, Greenough WT (2000) Physiological consequences of morphologically detectable synaptic plasticity: potential uses for examining recovery following damage. Neuropharmacology 39:765–76. Journal of Pharmacology and Experimental Therapeutics 283:1445–52. Science 251:944–7.