Journal Club Discussion #6: Effectiveness of Commonly Used Stroke Interventions

Hey readers! Today I read an article for my research class that I thought was interesting, so I thought it would be a great article to discuss for this week’s journal club! It is called “What is the Evidence for the Effectiveness of Interventions to Improve Occupational Performance After Stroke?” by Glen Gillen, EdD, OTR, FAOTA. AOTA members can access the article here.

Background Info

Greater than half of all occupational therapists treat clients who have had a stroke (Gillen, 2015). Most of the available research on the effectiveness of interventions for stroke is regarding motor and cognitive impairments, and more attention is needed on social participation and emotional impairments (Gillen, 2015).

The Results

According to Gillen (2015), neurodevelopmental treatment (NDT) and Brunnstrom’s movement therapy are the most widely used intervention strategies for individuals who have experienced a stroke. However, research does not prove their effectiveness. In fact, “NDT was inferior when compared with meaningful task-related training, an approach clearly in line with occupational therapy philosophy” (Gillen, 2015, p. 2). Furthermore, it seems as if there is a widening gap between evidence and practice.

What I Think

I do not have any experience in treating patients who have had a stroke myself, but this information is alarming to me as a student. I hope that in the future, more clinicians and students engage in evidence-based practice in the way of journal clubs (props to anyone reading this and checking out the article for themselves!) and other methods of sharing new research. It is important that licensed practitioners only provide the best possible care to their patients.

While the gap between evidence and practice was alarming, I thought that this piece of research was really interesting! I think that it is so cool that meaningful task-related activities worked BETTER than other methods of intervention. Isn’t that what occupational therapy is all about?!

Question of the Week: Do you use NDT or Brunnstrom’s approach in practice? If so, tell me how it has worked for your patients! And what do you think about this research?

Citation: Gillen, G. (2015). “What is the evidence for the effectiveness of interventions to improve occupational performance after stroke?” American Journal of Occupational Therapy, 69, 6901170010. http://dx.doi.org/10.5014/ajot.2015.013409

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