Post stroke occupational therapy in North Palm Beach is the part of recovery that deals with your actual day. The morning you try to button a shirt with one hand that will not cooperate. The afternoon you stand at a stove and lose track of what you were doing. A stroke or a brain injury damages the wiring that carries messages around, and the arm, the hand and the attention span all pay for it downstream.
By The First Rehabilitation Team · Reviewed by Dr. Dave Kashuba, Ph.D.
This came up on our podcast in an unexpected way. Susan Mann of Bright Minds Processing joined Dave and Mike to talk about children with auditory and visual processing disorders, a condition we do not treat. But her husband had a traumatic brain injury, and in researching her children she found the same processing therapy being used with brain injury and stroke patients. The framing she brought back is worth borrowing.
The eyes and the ears are only messengers
The audiologist who treated Susan Mann’s children, Dr. Leah Light, taught her that even though we call these vision and hearing problems, the organ involved is the brain. “They’re only the messengers,” Susan Mann said of the eyes and ears.
That is the right way to think about the arm after a stroke too. The muscle is usually intact. The instruction is not arriving, or it arrives scrambled, so the hand closes when you wanted it to open. Which is why post stroke therapy is built around repeated, task specific practice rather than around strengthening alone. The route is the thing being rebuilt.
What post stroke occupational therapy actually covers
Our occupational therapy program breaks into six areas, and a stroke usually pulls in several at once.
- Activities of daily living: dressing, bathing, cooking, and the ordinary skills independence rests on
- Post stroke recovery: task specific work on upper extremity function, coordination and daily routines
- Cognitive rehabilitation: memory, attention and problem solving strategies
- Hand and upper extremity function: fine motor and functional use training
- Ergonomics and adaptive equipment: workstation assessment, plus the tools that make a task safe again
- Return to work programs: graded conditioning and task simulation
An evaluation sorts out which of those matter for you, in what order. Somebody who cooks every day and somebody who needs to get back behind a desk get different plans out of the same diagnosis.
Cognitive rehabilitation after injury, and what it covers
This is the piece families are least prepared for. The arm is visible. The attention span is not, so a patient can look recovered and still be unable to follow a three step instruction, track a conversation, or keep hold of a task through an interruption.
Cognitive rehabilitation works on memory, attention and problem solving, and it is practical rather than abstract. The target is the medication schedule, the grocery list, the route home, the sequence of getting out of the house in the morning. Susan Mann’s description of what her children experienced maps onto it closely. She asks kids what they hear when the teacher talks, and they tell her nothing, they just stare at a blank space on the wall. Adults after a stroke describe that same fade, and they are usually embarrassed by it.
Getting the hand and arm back to work
Upper extremity recovery is where our occupational therapy and our certified hand therapy program overlap. Laura Drumm, CHT, leads the hand therapy side, and the two run in coordination when a stroke has left the hand weak, clumsy or partly closed. Fine motor work, functional use training, and splinting when the hand needs a position held. The two plans run as one.
That coordination also matters when the stroke is not the only thing in the chart. Plenty of patients arrive with a shoulder or wrist problem alongside the neurological one, and the plan has to account for both. Our hand and wrist and post surgical pages cover how that side of the work runs.
A return to work program after injury, for people driving in from Palm Beach Gardens
A return to work program is graded. A date on a calendar is not a plan. Task simulation and conditioning that build toward the real demands of the job, rather than a blanket clearance handed out at a fixed number of weeks. For desk work that usually means a workstation assessment and adaptive equipment. For anything physical it means loading the actual movements.
We see people from across the county for this. The clinic is at 733 US Highway 1, Suite 2A in North Palm Beach, which is a short drive from Palm Beach Gardens, Juno Beach and Jupiter. Hours are Monday through Friday 8:00 AM to 5:30 PM, with Saturday mornings 8:00 AM to 12:30 PM, which is the slot working family members tend to want when they are the ones bringing someone in.
The homework is the treatment
Mike McGann made the point on air that every therapy has the same catch. You have to do the exercises. “You’re not gonna get a result if you don’t,” he said, and Susan Mann agreed without hesitation: “It is exactly true.” Her own program runs sixteen weeks, once a week in the chair with exercises to practice five evenings at home.
Post stroke occupational therapy works the same way. The hour in the clinic sets the task and corrects it. The repetitions between visits are what move the needle, and that is the honest reason two people with similar strokes end up in very different places a year later. It is also the part a family can help with, once somebody has shown them what the practice actually looks like.
Starting, and what it costs
An evaluation is one on one, and treatment usually begins the same day. Medicare requires a physician to certify your plan of care, and we take Medicare and Medicare Advantage along with BCBS, Aetna, Humana, Tricare, workers’ compensation and self pay. The front desk will tell you exactly what your plan needs before you come in. More of those answers sit in our insurance and cost FAQ and the occupational therapy FAQ.
You can read more about the program on our occupational therapy page, and hear the conversation that prompted this article on the Pain 2 Power podcast page. If someone in your family has had a stroke or a brain injury and the hard part has become the daily routine rather than the diagnosis, call us at 561-624-4263 or request an evaluation.
This article is general information, not medical advice. Every situation is different, so please consult a qualified professional about yours.