FEATURE STROKE SERVICES
Sarah D ’ Anastasi , Maria-Elena Gutiérrez-López and Katherine Parkins ( l to r )
Future projects and professional profile The screening tool we developed has allowed us to identify visual deficits and dysfunctions within our patient caseload . This year , we wanted to be part of a small project that could validate our screening tool findings , as currently the screen is not utilised any standardised equipment and it is at risk of subjective variation .
We were hoping that by using the QoL questionnaire , a visual function questionnaire and an eyes tracker device with special software , we could capture changes in quality of life , participation and visual function .
However COVID-19 has delayed our intention , and now that Fiona Rowe has released a brand new tool called ‘ VISA screening tool app ’, which has been validated , it may be too late for us to do it ( https :// apps . apple . com / gb / app / visa-screen / id1515930083 ).
We are working on a model to allow other occupational therapists to clinically reason the visual findings and feel confident on how to best manage them , but before it is shared or released , in order to be understood , we would encourage occupational therapists to learn about the neuroanatomy of the visual processing , as it is crucial to understanding the model .
We currently have a special interest on making a case study evaluation of the use of neuroplasticity and motor control principles to trigger automatic and voluntary oculomotor activity following a stroke through : meaningful visualisation , activities and environments ; visual memory recalls ; sensory stimulation ; best use of postural settings ; passive movements ; active practice of residual movements ; and controlled occlusion , as equivalent of constrained induced therapy .
However , this cannot be done in isolation ; we need to involve other disciplines to start backing up interventions that are not evidence based , due to the lack of research , but would require a clear clinical reasoning and interdisciplinary approach to be proved effective .
Vision will soon be included as a part of the Sentinel Stroke National Audit Programme ( SSNAP ). The NICE stroke guidelines will also be reviewed soon and we are hoping that others share our views about the occupational therapy role in relation to vision and a much more interdisciplinary approach can be reflected going forward .
References
RCP ( 2016 ) National Clinical Guidelines for Stroke . Intercollegiate Stroke Working Party
Rowe F ( 2013 ) Care provision and unmet need for post stroke visual impairment report . University of Liverpool , Stroke Association and Thomas Pocklington Trust Warren M ( 1993 ) A hierarchical model for evaluation and treatment of visual perceptual dysfunction in adult acquired brain injury , part 1 and 2 . American Journal of Occupational Therapist . DOI : Jan ; 47 ( 1 ): 55-66 . DOI :
10.5014 / ajot . 47.1.55
Maria-Elena Gutiérrez-López , Sarah D ’ Anastasi and Katherine Parkins , band six specialist occupational therapist , CBNRT East Berkshire ESD team . With acknowledgment to Beverley Baily , band six occupational therapist , who joined the team almost three years ago and has taken part in this journey .
40 OTnews February 2021