REHAB FOR YOUNGER STROKEES
Children And Babies
Children and newborns can also experience a stroke. The causes of childhood stroke are different from adults. These can include blood vessel problems in the brain and clots travelling from the heart. Reportedly around two out of every 100,000 children are affected worldwide each year. Most cases occur in children under the age of two.
The good news is that their recovery tends to be better because the brain is still at an early stage of development.
Rehabilitation
The full impact of a stroke on a child may not be known for years because of their various developmental stages and maturity. Rehabilitation may have to be ongoing to meet these changes. Therefore, children who have experienced a stroke require long-term monitoring and follow up throughout maturation to ensure optimal achievement of developmental, functional and psychosocial potential. A child’s stroke impacts the whole family and parental guilt or blame is common.
Rehabilitation goals are similar to those for adults (such as walking and communication) and current approaches used with adults are being adapted to assist children as well. Rehab also includes other targets, such as educational and vocational rehabilitation, re-integration into play roles, growth and development as well as developmental psychology. The focus of rehabilitation of children with stroke is more often on ‘new’ learning (habilitation) rather than ‘re-learning’ (rehabilitation) depending on the child’s age at the
time of the stroke.
Newborns and Toddlers
- Focus is on achieving the milestones of a developing child or acquiring the movement skills of a normal child
- Includes lots of play therapy and sensory stimulation to encourage growth of skills and movement
- Parents play an important role because they have to repeat at home what is learned at therapy
Children Above Three
- Continue to ensure skill acquisition as per the developmental milestones
- Play and interaction with appropriate age group.
- Social isolation, teasing, bullying can occur in schools and play groups.
- This can emotionally scar the child and damage the development of social skills and confidence. It is important that the school is alerted and the child and family are counselled on coping skills.
- Integration/re-integration into school and extracurricular activities must be done carefully with supervision by coaches and the school
Young Working Adults
Rehabilitation tends to focus on mobility and gaining function of the weakened side. Due to numerous commitments these adults usually find it much harder to attend rehab regularly. They also tend to have more hang-ups and are prone to depression, anxiety and frustration.
It is important for them to have normal movement because the long-term consequences of compensatory movements are harder to fix and can lead to:
• Increase in tone or extreme muscle tightness
• Poor balance
• Falls
• Musculoskeletal issues resulting in pain as well as wear and tear due to poor muscle balance and control.
Most young adults who have a stroke at this age will probably live long so it is important that the musculoskeletal structure is preserved.
Moreover, fixing abused joints that are in poor condition is painful
Why Focus On Functional Goals
Most working adults have a time limit on how long they can stay off work, so their Occupational
Therapy needs to be more intensive to enable them to achieve their functional goals quicker.
The main focus of the therapy is to help them return to work and also to look after young children (if they have any). Their goals are of a much higher functional level compared to that of the geriatric population. Those returning to work and seeking employment may also face stigmas and difficulties finding employment, as employers may have concerns about employing people with challenges.
