The research question for this paper is “What are the benefits of motor skill exercises for stroke patients at rest homes to regain their motor functions?”. McIntosh (2020) has explained that a drop in the blood supply to the brain results in a stroke. It is a medical emergency and a person who experiences stroke should immediately be given treatment. Webmd (n.d.) has enumerated the 5 different types of stroke, namely, Ischemic Stroke, Haemorrhagic Stroke, Transient Ischemic Attack (TIA or mini-stroke), Brain Stem Stroke and Cryptogenic Stroke. A stroke can be fatal as brain cells start dying quickly and it can also lead to paralysis. The Internet Stroke Center (n.d.) has mentioned that most of the strokes occur among people above the age of 65 years. However, strokes can happen to anybody at any age. Strokes can be life-threatening and they daily result in a large number of deaths worldwide. Blocked arteries and leaking or bursting of blood vessels are the two main causes of stroke (Webmd, n.d.). Some habits leading to stroke are too much common salt in diet, high-cholesterol diet, lack of movement or exercise, smoking, unmanaged and uncontrolled diabetes, obesity, alcoholism and stressing out (Gonzalez, 2016). Cowman, et al. (2010) have identified the need for stroke patients to be admitted to nursing homes. In addition, they can also be admitted to rest homes and hospitals where essential treatment can be given to them. In these rest homes, stroke patients are encouraged for motor skills exercises to regain their motor functions.
Merriam-Webster (n.d.) defines rest homes as establishments which provide accommodation and general care to old and/or convalescent persons. Rest homes and nursing homes are different. In nursing homes, people require constant care of professionals, whereas in rest homes, people require minimal care. Rest homes do not admit patients, they rather adopt them. People find a new home and an extended family in rest homes and the staff is mostly loving and caring (Massachusetts Association of Residential Care Homes, n.d.). Most rest homes are also old age homes. Mayo Clinic (n.d.) has explained that when blood supply to a portion of a person’s brain is interrupted or reduced, stroke occurs. An interrupted blood supply prevents the tissues in the brain from getting oxygen and nutrients leading to high rate of death of a large number of brain cells. The type of stroke a person experiences affects their line of treatment and recovery (Centers for Disease Control and Prevention, n.d.). The Iowa Clinic (2018) has identified five sure warning signs that a person is experiencing or is about to experience a stroke. Knowing these signs and what can be done in the situation of a person experiencing a stroke can save their life. Strokes are sudden, yet preventable. Weakness or numbness in the face, arm or leg, difficulty in speaking or understanding, decrease in or blurring of vision in the eyes, sudden loss of balance and severe headache are the five signs which point towards stroke. Staff at rest homes are aware of these signs. They encourage stroke inpatients to perform motor skills exercises to regain their motor functions.
Stroke patients find difficulty in performing the simplest of tasks like sitting, standing, walking, bathing, dressing and eating. After they face a stroke, they usually join a rehab or a rest home to recover their previous bodily functions. These rest homes have occupational therapists who give therapy to stroke patients, most of whom are old people. Goldenberg (2017) has identified some fine motor skills exercises for stroke patients which can help them to regain their motor functions. Stringing beads with slightly big holes, squeezing stress balls, building coin towers, painting with fingers which requires hand-eye coordination, folding clothes and solving jigsaw puzzles are some good activities to regain motor functions. Flint Rehab (2020) has mentioned some more exercises to improve hand and finger movements of patients after a stroke. They are therapy putty exercises, MusicGlove hand therapy, various tabletop exercises, moving beans and rubber band resistance exercises. The recovery of hand and finger movement is more gradual than the arm or leg movement because their extremities are farther from the midline of the body and such recovery takes a lot of effort. All of these exercises need to be repeated consistently every day. This is the key to recovery as it helps in activating neuroplasticity post stroke, which is the process the brain makes use of to rewire itself and recover. Passive exercises are best in the case of severe plasticity. These include assisting the affected body part with the non-affected body parts, for example, the affected hand can be made to move by the non-affected hand. Neuroplasticity is stimulated in such a way and recovery is encouraged. Kim, et al. (2015) have identified that ankle strengthening exercises with motor imagery training can help recover foot movements and balance among stroke patients at rest homes. With the help of these exercises, affected-side weight bearing ratio and affected-side front/rear weight bearing ratio would be improved. The balance errors are also checked and balance is improved with the help of these exercises. Najafabadi, et al. (2019) have identified that volleyball exercises can improve the upper limb motor control among chronic stroke survivors. These exercises decrease feedback dependency of motor control. Their research design was based on randomised clinical trial and they compared the effects of competitive and non-competitive volleyball exercises among serious stroke patients and found that competitive exercises had increased positive effects in both functional and motor control levels. Lee, et al. (2018) have mentioned that high-dosage motor skills exercises and putting in efforts to carry out Activities of Daily Living (ADL) have significant contributions in the achievement of recovery among stroke patients. They have pointed out that the stroke-affected upper limb should be used by the patients at rest homes or community centres. Giving timely feedbacks on limb usage and assessment of the quality of motor performance at rest homes can encourage stroke patients to indulge in high-dosage motor practices which help them in recovery. Hatem, et al. (2016) in their research have discussed techniques to trigger upper extremity convalescence. They have pointed out that rehabilitation training is the most successful paths to choose to lessen motor impairments among stroke patients.
The present research will be done based on the phenomenological approach and qualitative data. This is because of the fact that qualitative data is essential for finding out the specific frequencies of features and attributes of stroke patients at rest homes who regularly perform motor skills exercises to regain their motor functions. The data will be collected from the online journals and articles as well as by trying to visit the identified rest homes where stroke patients live, by trying to interact with them, finding out about their routines and also about their frequencies of performing motor skills exercises. Moreover, qualitative data helps statisticians to create parameters which allow the observation of still larger data sets (McLeod, 2019). The qualitative data for the present research will be extracted to a great extent from the World Health Organisation for the years 2012 to 2020 as well as from journals which contain previous research in the field. Using the phenomenological approach, this research will illumine particular details related to the topic, and will pinpoint the phenomena in a way that they are discerned by the actors in a circumstance (Research Gate, 1999).
The research will commence in the first week of the month of September, 2020 and will end in the month of October, 2020. The Gantt chart for the current research work is illustrated below:
Findings and Data Interpretation
Conclusion and Recommendations
Ethical considerations are the most essential areas of any research. Researches may even fail if the coverage of this area is found to be missing (Business Research Methodology, n.d.). Bryman and Bell (2007) have enumerated some ethical considerations for research. They are as follows.
Feigin, et al. (2017) have pointed out that although the rate of stroke has declined between 1990 and 2013, the all-round stroke burden in relation to the number of people affected and got permanently disabled, in both women and men, has increased. Prevention of stroke is a complicated medical and political issue. Nevertheless, it is practicable. There is an alarming need to primary prevention at rest homes and rehabilitation centres. Katan and Luft (2018) have mentioned that stroke is the second most common reason for maximum number of deaths worldwide. The chances of stroke increase with increase in age. In poor and developing nations, stroke affects young persons too. Srivastava and Vishnu (2018) have given high importance to exercises after stroke and have also mentioned that these should ne be taken for granted. Exercises help regain motor activity in the parts of the body which have got impaired due to stroke. All rest homes have staff which is trained in giving these exercise therapies to the patients.
Every research has one or the other kind of limitations and it is nothing to be surprised about. For instance, for the current research, the CoViD-19 pandemic acted as a great barrier in reaching out to patients in rest homes and conducting research in the field. The researchers were not allowed to visit most of the rest homes and interact with patients there. This created a huge problem in the collection of data and the study of the population. The researchers had to make do with only studying other research conducted in the same field and collect most of the data through online interactions with some rest homes’ personnel and some participants who were able to communicate through e-Mails and social media. However, it is crucially essential for one to be trying hard to reduce the range of these impediments to the research. It is equally essential to provide a separate heading for limitations wherever appropriate in the research paper. If one does not specify these limitations in the research paper, they would be pointed out to them by their research assessors. Rather than just listing and describing the shortcomings of the research, the researcher should also mention how these barriers have affected the results of the research. Business Research Methodology (n.d.) has identified some limitations to research. These are as follows.
Bryman, A. & Bell, E. (2007). Business Research Methods. Oxford: Oxford University Press.
Business Research Methodology. (n.d.). Ethical considerations. Retrieved, October 3, 2020, from: https://research-methodology.net/research-methodology/ethical-considerations/
Business Research Methodology. (n.d.). Research limitations. Retrieved, October 3, 2020, from: https://research-methodology.net/research-methods/research-limitations/
Centers for Disease Control and Prevention. (n.d.). Types of stroke. Retrieved, October 2, 2020, from: https://www.cdc.gov/stroke/types_of_stroke.htm
Cowman, S., Royston, M., Hickey, A., Horgan, F., McGee, H. & O'Neill, D. (2010). Stroke and nursing home care: a national survey of nursing homes. BMC geriatrics, 10(1), 1-6. DOI: https://doi.org/10.1186/1471-2318-10-4
Feigin, V. L., Norrving, B., & Mensah, G. A. (2017). Global burden of stroke. Circulation research, 120(3), 439-448. DOI: https://doi.org/10.1161/CIRCRESAHA.116.308413
Flint Rehab. (2020). Therapeutic fine motor activities for adults after stroke. Retrieved, October 3, 2020, from: https://www.flintrehab.com/fine-motor-skills-after-stroke/
Goldenberg, C. (2017). Activities for regaining fine motor skills after a stroke. Retrieved, October 2, 2020, from: http://www.reliantathomecare.com/activities-for-regaining-fine-motor-skills-after-a-stroke/
Gonzalez, M. (2016). 10 lifestyle changes that can reduce your risk for stroke. Retrieved, September 30, 2020, from: https://www.nebraskamed.com/neurological-care/stroke/10-lifestyle-changes-that-can-reduce-your-risk-for-stroke
Katan, M. & Luft, A. (2018). Global burden of stroke. In Seminars in Neurology, 38(2), 208-211. DOI: https://doi.org/10.5167/uzh-159894
Kim, S. S., Lee, H. J., & You, Y. Y. (2015). Effects of ankle strengthening exercises combined with motor imagery training on the timed up and go test score and weight bearing ratio in stroke patients. Journal of physical therapy science, 27(7), 2303-2305. DOI: https://doi.org/10.1589/jpts.27.2303
Lee, S. I., Adans-Dester, C. P., Grimaldi, M., Dowling, A. V., Horak, P. C., Black-Schaffer, R. M., Bonato, P. & Gwin, J. T. (2018). Enabling stroke rehabilitation in home and community settings: a wearable sensor-based approach for upper-limb motor training. IEEE journal of translational engineering in health and medicine, 6, 1-11. DOI: 10.1109/JTEHM.2018.2829208
Massachusetts Association of Residential Care Homes. (n.d.). A rest home - An alternative for some. Retrieved, October 1, 2020, from: https://maresidentialcarehomes.org/an-alternative-for-some/
McIntosh, J. (2020). Everything you need to know about stroke. Retrieved, September 30, 2020, from: https://www.medicalnewstoday.com/articles/7624
McLeod, S. (2019). What’s the difference between qualitative and quantitative research? Retrieved, October 4, 2020, from: https://www.simplypsychology.org/qualitative-quantitative.html
Merriam-Webster. (n.d.) Rest home. Retrieved, October 2, 2020, from: https://www.merriam-webster.com/dictionary/rest%20home
Najafabadi, M. M., Azad, A., Mehdizadeh, H., Behzadipour, S., Fakhar, M., Sharabiani, P. T. A., Parnianpour, M., Taghizadeh, G. & Khalaf, K. (2019). Improvement of upper limb motor control and function after competitive and noncompetitive volleyball exercises in chronic stroke survivors: A randomized clinical trial. Archives of physical medicine and rehabilitation, 100(3), 401-411. DOI: https://doi.org/10.1016/j.apmr.2018.10.012
Research Gate. (1999). An introduction to phenomenological research. Retrieved, October 4, 2020, from: https://www.researchgate.net/publication/255647619_An_introduction_to_phenomenological_research
Srivastava, M. P. & Vishnu, V. Y. (2018). Exercises after stroke: The essential endurance. Neurology India, 66(5), 1306. Retrieved, October 3, 2020, from: https://www.neurologyindia.com/article.asp?issn=0028-3886;year=2018;volume=66;issue=5;spage=1306;epage=1308;aulast=Srivastava
The Internet Stroke Center. (n.d.). Stroke statistics. Retrieved, September 30, 2020, from: http://www.strokecenter.org/patients/about-stroke/stroke-statistics/#:~:text=Nearly%20three%2Dquarters%20of%20all,under%20the%20age%20of%2065.
The Iowa Clinic. (2018). How to spot a stroke: 5 sure signs and 4 life-saving letters. Retrieved, October 2, 2020, from: https://www.iowaclinic.com/primary-care/how-to-spot-a-stroke-5-sure-signs-and-4-lifesaving-letters/
Webmd. (n.d.). Top causes of stroke. Retrieved, September 30, 2020, from: https://www.webmd.com/stroke/guide/stroke-causes-risks#1
Webmd. (n.d.). Types of stroke. Retrieved, September 30, 2020, from: https://www.webmd.com/stroke/guide/types-stroke#1
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