Rehabilitation in stroke

Treatment of the neglect syndrome in stroke patients using a contingency electrical stimulator

Two patients with major infarcts in the right middle cerebral artery territory associated with severe perceptual problems including tactile neglect were treated with a contingency electrical stimulator. This delivered electrical stimuli to the forearm skin on the neglected side whenever the patient moved the contralateral normal arm, with the intention of drawing the patient's attention to the neglected side. The effect of this treatment was assessed in a single case design using the Rivermead Perceptual Assessment Battery.

Both patients had a statistically significant improvement in tests of perceptual function during the period of the study. In addition, there was a significant difference between the treatment and the baseline periods: the differences between the slopes of the regression lines fitted to the scores were statistically significant, favouring the treatment periods. This supported the inference that the changes were at least in part due to the treatment rather than merely the natural history of the disease.

These results suggest that this approach to treating an otherwise intractable condition should be further investigated.

The personal experience of carers of stroke survivors: an interpretative phenomenological analysis

PURPOSE

The occurrence of a stroke can result in significant traumatic consequences for the stroke survivor and their family. Efforts have tended to concentrate on the stroke survivor, and relatives and friends have been neglected. There have been limited studies concerning the impact upon the family. The present study explores the experiences of members of families who are involved as carers of stroke survivors. In order to facilitate a detailed analysis, this study is concerned with the early caring period-before patients return home.

METHOD

Four relatives were interviewed about their experiences. Interpretative Phenomenological Analysis (IPA) was employed using the data provided by the verbatim transcripts of the interviews.

RESULTS

Three common themes were identified: uncertainty, personal impact, and strength of relationships. This research has discovered a number of valuable findings for this group of carers. An important aspect that has been uncovered is that families experience emotional strain while relatives are still in hospital. Relatives require time to adjust and share with the stroke survivor in their difficulties. This exploration has demonstrated that the same processes of uncertainty can occur for families as well as patients themselves.

CONCLUSION

This study provides a rich account of the importance that strengths of relationships have for families at this difficult time. It helps expand the current literature on the experiences of relatives of stroke survivors.