Disability and RT Paper

Disability and RT Paper

Zikeya Hickman
LEI 3703-U01
10/24/2014

Disability and RT Paper

One of the most common accidents that involve the brain is stroke. Stroke involves
ischemia (lack of blood flow to the brain) or blood actually leaking within the brain. A stroke has
been given the name stroke attack because the brain becomes damaged as oxygen is cut off
from the brain (National Stroke Association, 2014). If the lack of blood flow is not restored, then
the more the person is affected. The persons motor skills, thinking, memory, and speech can all
be affected based on how fast or slow the person is treated. Some people have even been
paralyzed due to a stroke. The characteristics of stroke depend on if it is right-brain or left-brain.
Since most people are left-brain dominant, most people are affected by the leftbrain
consequences of stroke which include the right side being paralyzed or weakened, slow behavior,
aphasia (impaired speech), and impaired comprehension (Robertson & Long, 2008). If the
person is right-brain dominant, then they will have similar consequences to their left side.
There are two specific types of strokes, Hemorrhagic and Ischemic. Hemorrhagic stroke
is the least common acquiring for only fifteen percent of strokes, but it is the more dangerous of
the two being that it usually leads to death (National Stroke Association, 2014). This type of
stroke is caused by the leaking of blood that causes swelling to the brain and the damage of
tissue and cells. Hemorrhagic stroke branches off into two other types of strokes, intracerebral
hemorrhage and subarachnoid hemorrhage. The ischemic stroke is the most common type of
stroke that is responsible for eighty-seven percent of strokes (National Stroke Association, 2014).
This type of stroke is caused by the block of blood flow caused by a blood clot. Ischemic stroke
occurs as an embolic stroke or a thrombotic stroke. An embolic stroke occurs when pieces of the
blood clot (usually from the heart) travel to the brain and inside the brain it blocks the blood flow
of a blood vessel. Thrombotic stroke is caused by the lack of blood flow to an artery that helps
blood travel to the brain.

Disability and RT Paper

The last type of stroke is Pediatric stroke. It may seem surprising because stroke is
usually associated with older people with stress and hypertension, but it happens to be common
in children as well. Stroke in children is a high during the first few years of life. It usually stems
from heart defects, sickle-cell, trauma to the head or neck, diseased arteries, and blood clotting
just to name a few. Boys and African American children are more likely to have a stroke than
other groups (National Stroke Association, 2014).
There are multiple causes of strokes, the main one being related to stress which causes
other conditions that lead to stroke. Research done recently concluded that the causes for one
particular ethnicity may be different from another (Biller, 2009). There are multiple causes for all
of the different types of strokes. High blood pressure is related to Ischemic stroke and high
cholesterol and arthrosclerosis can cause thrombotic stroke. Transient Ischemic Attack, TIA, can
also lead to stroke. TIA is basically a warning that a stroke is soon to come because it mimics the
symptoms of a real stroke. TIA does not cause brain damage however. During a TIA blood flow
is blocked, a blood clot breaks off into the body, or a blood vessel to the brain is narrowed
(National Stroke Association, 2014). All of these situations may happen together or separately,
but not at such a severe and serious state as a real-life stroke.
Stroke is the 4th leading cause of death in America. There are over seven million
survivors. The peak rate of stroke in this population occurs in the perinatal period, with 26.4
strokes per 100,000 live births in infants less than 30 days old (Biller, 2009). This statement
contributes to the fact that stroke is very common in children. There is also a difference in race.
African Americans are more prone to stroke than a Caucasian, Hispanic, or Asian. Women are at
a much higher risk of dying from a stroke, especially if they take birth control pills.

Disability and RT Paper

Stroke can stem into other physical conditions, such as hemiplegia (most common),
which involves the loss of sensation or movement on one side of the body (Robertson & Long,
2008). Stroke can affect the persons cognitive domain if aphasia and dysarthria apply. Aphasia
involves the disruption of speech patterns, whereas dysarthria involves impaired speech motor
functions (Robertson & Long, 2008). Emotionally the stroke victim can develop depression or
an anxiety disorder while they are trying to come to terms with the effects that stroke has had on
them. Socially the stroke victim can suffer from isolation due to the emotional state they are in
because they are confused or they just cant communicate how they want due to speech
impairment.
Stroke victims need help physically, emotionally, socially, and cognitively in order to
overcome the effects that the disease had on them. If the person is not supported throughout this
healing process then they may never recover. They need help regaining their strength through
activities that they like to do, but at a slower pace. They to be challenged cognitively with recall
and recognition games and they also need to be encouraged to keep going in order not be
depressed of their current state (Robertson & Long, 2008). If a stroke victim is depressed, then
they wont feel the need to recover physically or be sociable. The stroke victim may have a
limitation of memory or something as simple as knowing which color is which. With the support
and social interaction with family members, doctors, and therapists trying to help them they can
improve emotionally. Their strength is their emotional state. If they have the emotional state of
knowing their self-worth and keeping their confidence, then they can overcome most of the
consequences of stroke with their determination (Auerbach & Benezra, 1998).
Stroke victims become stroke clients when they are admitted to a treatment program
where recreational therapists help them recover. These treatment programs take place in Veteran

Disability and RT Paper

Affairs (VA) hospitals, acute care hospitals with rehabilitation services, outpatient care,
rehabilitation hospital, and nursing homes (Robertson & Long, 2008). In VA hospitals and acute
care hospitals, patients are treated based on the fact that they have injuries or severe illnesses that
need immediate attention. VA hospitals, acute care hospitals, and rehabilitation hospital are
common for recreation therapists to work with stroke clients because it involves collaborating
with physical and occupational therapists to regain the clients strength, motor skills, and speech
as a team. Outpatient care involves working with clients in the comfort of their home.
Recreational therapist may also work in nursing homes where they work with elderly who just
went through a stroke.
Treatment modalities are recreational activities used, in this case, to help stroke clients
with their recovery. A recreational therapist may use sensory stimulation, arts and crafts, reality
orientation, and/or horticulture to help stroke clients regain their physical, emotional, cognitive,
and social strength. Sensory stimulation has to do with the mind and body of the client. Its goal
is to increase arousal and responsiveness to stimuli (Robertson & Long, 2008) by having the
client watch home videos or do an activity that will get a reaction out of them that it pleasurable.
This is important for stroke clients because they may be in a comatose like state or their memory
has been disrupted as a result of the stroke. Arts and crafts can be used to give the client their
own freedom of expression. This deals with their emotional state of confidence. This can also
help the client with the cognitive aspect because a client may have forgotten how to color, color
in the lines, or how to determine which color to use to paint a picture. Reality orientation may be
used for stroke clients to help with their confusion after their stroke by using environmental
cues and verbal reminders (Robertson & Long, 2008). This helps them socially because if they
are confused they may refuse help or speaking to anyone who tries to help them or simply have a

Disability and RT Paper

conversation. Horticulture is used to help the client regain their concentration on tasks,
endurance, planning and decision making (Robertson & Long, 2008). This is an important aspect
for a stroke client because the result of the horticulture activity helps them achieve their
treatment/recovery goals physically and cognitively.

Disability and RT Paper

References
Auerbach, J., & Benezra, A. (1998). Therapeutic Recreation and the Rehabilitation of a Stroke
Patient. Loss, Grief, and Care, 8:1-2, 123-128.
Biller, J. (2009). Stroke in Children and Young Adults. Philadelphia: Saunders, an imprint of
Elsevier Inc.
National Stroke Association. (2014). Retrieved from Stroke: http://www.stroke.org/
Robertson, T., & Long, T. (2008). Foundations of Therapeutic Recreation. Champaign: Human
Kinetics.