Post-Stroke Paralysis: A Quick Guide From Observation to Functional Activities
February 11, 2016
2 min. read

Stroke is the most common diagnosis treated by occupational therapists1 and hemiplegia paralysis of one side of the body is one of the most common symptoms of stroke.2Therefore, knowing how to evaluate hemiplegia and improve function are primary concerns for occupational therapists. Jan Davis addresses these topicsin Part A: Functional Treatment Ideas and Strategies in Adult Hemiplegia.4Here are my main takeaways after watching her course.
Evaluation
What yousee, hear, andfeel isimportant for a thorough evaluation of a clientwith hemiplegia.
See.Observe your client's body alignment and symmetry, first stationary and then in motion. Pay attention toany changes inmuscle tone, posture, and alignment. Look at all sides of your clientand note the proximal and distal movement patterns.
Hear.Listen to what your clienthas to say. Ask what they are most concerned aboutandwhatfunctional activities do they want to be able to perform.Listen for their main complaints andnote to yourself theirpriorities.
Feel.Use your tactile sensation to see how the muscles and movement feel. How does it feel at the end of the range of movement? Does it hurt when they move or when you gently move their limb? What kind of pain do they feel? Feel for muscle tightness and resistance or loose joints and muscle atrophy.
Clinical Reasoning
Now that youve used your senses, its time for you to use your clinical reasoning. Hemiplegia often leads to long-term impairments in a client's functional abilities.3
You should identify key underlying limitations and determine those most likely to impact your clients ability to perform functional activities. You may also need to evaluate aclient's environment, equipment, and other factors (sensation, vision and cognition) to determine if they contribute to functional limitations.
Functional Activities
Functional activities play two major roles in rehabilitation. Not only are they the goal of interventions, but they can also be the means of addressing identified deficits (e.g. reduced strength and range of motion). When participating in functional activities, your client is likely to have the motivation to move with more range of motion, push harder, and stay engaged for longer periods of time.5
Below, Jan Davis demonstrates observation of asymmetry as part of hemiplegia evaluation in a short video from her course, Part A: Functional Treatment Ideas and Strategies in Adult Hemiplegia.
