Evoking Powers of Occupation From Occupation-Based Practices After Stroke: A Scoping Review

Abstract

Occupation-based practice (OBP) is an integral part of stroke rehabilitation, focusing on engaging individuals in daily activities. However, the mechanisms that underpin its positive outcomes remain insufficiently explored. This scoping review explores reported OBPs, including interventions across hospitals, communities, or both settings for stroke rehabilitation, and identifies the emerging powers of occupation within these practices. Employing the PRISMA extension for scoping reviews was applied with a deductive research approach. A total of 45 articles were selected. Findings revealed that OBPs can evoke all nine powers of occupation proposed by Bontje, which include therapeutic change, self-expression, participation, and habit formation. Hospital-based practices primarily focused on enhancing physical and cognitive functions, whereas community-based approaches concentrated on fostering independence and social integration. In summary, OBPs are essential tools in stroke rehabilitation, offering a comprehensive approach to address the physical, emotional, and social needs of individuals with stroke during their recovery journey.

Plain Language Summary

A Review of Research on the Powers of Occupation from Occupation-Based Practices in Stroke Rehabilitation Across Hospital and Community Settings

Stroke is a major global health issue that often leads to lasting disabilities, impacting daily lives, families, and communities. This review explores how engaging in meaningful activities, like eating, working, and gardening, supports stroke survivors in health and well-being. These activities, known as “occupation-based practices” (OBPs), are guided by occupational therapists. We analyzed 45 research reports on OBPs from 2000 to 2023, with 25 studies conducted in hospitals, 16 in homes or communities, and five in both settings. The review confirmed that nine “powers” impact the health and well-being of stroke survivors through these activities. In hospitals, the focus was on self-care and recovery of impairments, while at home and in the community, individuals engaged in cooking and outdoor activities. The main benefits of OBPs included healing, staying active, fostering growth, providing purpose, and supporting health. OBPs not only promote physical recovery but also improve mental well-being and social connections. They are most effective when aligned with personal interests, whether in a hospital or at home. Overall, OBPs can greatly aid stroke survivors in reintegrating into life by making recovery meaningful and relevant to their daily activities.