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| RebeccaDutton Home After a Stroke |
A study found that impaired attention and visual-spatial deficits 3 months after a stroke was significantly associated with a poor quality of life 12 months after a stroke (1). Studying what seems like an obvious connection may seem wasteful if you do not know some therapists ignore cognition. They focus on concrete issues like passive range of motion and strength and assume clients will know what to do with their physical gains when they go home.
Without cognitive skills I would not have the luxury of getting up in the morning whenever I feel like it, fixing what I want for breakfast, and sitting at the table after breakfast reading the newspaper. I used to drive 100 miles round trip to work so lounging after breakfast while other people are doing battle in rush hour traffic never gets old.
My recent post begging someone to teach us to turn is a perfect example of what I am talking about. Making multiple turns while concentrating on the steps of preparing breakfast requires constant attention and visual-spatial awareness. I had to learn to pay attention to what objects are doing instead of concentrating on what my hands and feet are doing. Squeezing Theraputty and walking in the PT gym did not make this possible. Therapists who have a simplistic view of recovery need to incorporate cognition into their clinical practice. Therapists and stroke survivors need to remember that mobility = physical recovery + problem solving.
- Cummings TB, Brodtmann A, Darby D, Berhardt J. The importance of cognition to quality of life after stroke. J Psychosom Res, 2014;15: ??
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