Written by SMH Occupational Therapist Cassandra Santiago
Imagine you’re strolling through a green garden, breathing in the fresh air, feeling the sun on your face and the breeze on your cheeks. As you stop to touch the soft petals of a rose, you see a colorful butterfly fluttering from flower to flower, finally landing on a thirsty plant that needs your attention. You reach out with your watering can, as far as your arm can stretch, and sprinkle water around the plant before moving on to another that needs tending. You spot a young woman who is also visiting the garden, smile and call out a greeting.
For most, this sounds like a leisurely afternoon spent enjoying nature. But for Sarasota Memorial stroke rehabilitation patients, it describes a typical therapy session in the Rehab Pavilion’s Mobility Garden — a unique space that allows stroke survivors and others to practice everyday tasks and to do the things they enjoy, like gardening or swinging a golf club.
FUNctional Stroke Recovery
According to the American Stroke Association, 795,000 people in the US are affected by stroke each year and one in every four will have a second stroke in their lifetime.
When a person suffers a stroke, seeking immediate medical attention can lessen the physical and cognitive effects and improves recovery chances. Did you know that muscle loss can begin in as little as four hours after a stroke?
It’s imperative for stroke survivors to be active and begin the recovery process as soon as it is recommended. This means getting up and out of the hospital bed as soon as possible. Physical activity improves strength, balance, endurance and overall brain health. It also reduces the risk of depression and anxiety. For stroke patients, it can mean the difference between eventual independence and not being able to care for yourself or move around safely.
Studies have shown the benefit of traditional exercise or repetitive movements in stroke rehabilitation, but it’s how these are executed that has the most impact on a stroke survivor. With custom-tailored treatment plans, Sarasota Memorial’s stroke rehabilitation team aims to not only reduce the impact of stroke-induced disability but also to improve each patient’s quality of life. Treatment should be both functional and fun!
Rehabilitation therapy can be delivered in infinite ways, but it should always be driven by the patient’s needs and personal goals. Hobbies and interests play a vital role in motivating stroke survivors to face new challenges and push toward recovery to get back to enjoying these activities independently.
The Rehab Pavilion’s Mobility Garden is one of the many unique, therapeutic and intentionally designed healing spaces on the Sarasota Memorial campus. The accessible green space provides patients a place to safely interact with the outdoors during their hospital stay. The Mobility Garden features a meandering path that’s accessible to all types of mobility aids (wheelchairs, walkers, canes, etc.) as well as a variety of common outdoor surfaces (like grass, gravel, cobblestone, ramps, curbs and wood bridges), allowing visitors to practice getting around in the real world. Raised gardening beds afford a more ergonomic and accessible height for patients to tend to plants while also working on motor skills and balance. There’s also a putting green for avid golfers to relearn swinging a golf club.
The Mobility Garden can be used for a variety of therapeutic activities including: gardening, walking, bird watching, sensory stimulation, learning adaptive gardening or golf strategies, or simply a place to relax and enjoy nature. On any given day, you may spot Rehab patients and therapists in the Mobility Garden, seemingly enjoying some leisure time outside. But in actuality, those patients are working hard to relearn motor, sensory and cognitive skills — in a fun yet functional way.
Common therapy treatments in the Mobility Garden include:
• Walking with a walker or pushing a wheelchair through the garden to strengthen arms and legs or to improve balance.
• Reaching and bending to water or prune flowers, practicing the same movements required for bathing and dressing.
• Carrying on a focused conversation in a visually stimulating environment with a speech pathologist during cognitive and communication treatments.
• Taking a stroll to decrease stress and over stimulation, common byproducts of adapting to a new disability and being in a new environment.
Skills learned in the Mobility Garden promote physical and mental health in stroke survivors. With small modifications to a survivor’s home environment, many of these therapies can be continued when they return home. Caregivers also can be trained to help make the experience safe and enjoyable.
Suggested modifications might include:
• Raised gardening beds or container gardening on a table for wheelchair access and to prevent falls while bending
• Using lightweight tools or building up tool handles to compensate for weakened grip
• Creating level surfaces and removing tripping hazards in the yard for safe walking
• Using a stool to reach lower flower beds instead of bending.
The Mobility Garden at the Rehabilitation Pavilion is just one healing space where therapists use meaningful leisure skills to motivate physical activity during the recovery process. Each stroke survivor is unique and has a multitude of hobbies, interests and goals that give them the drive they need to make the most out of their rehabilitation journey. The most important ingredient in a successful recovery is staying active, so you can continue to do the things that bring you enjoyment.
Cassandra Santiago, OTR/L, MOT, is a neurological occupational therapist who specializes in therapies for stroke, Parkinson’s disease, seating and mobility, neurological vision impairments and concussion. She also manages the Muscular Dystrophy and ALS clinics, a partnership between SMH and the Muscular Dystrophy Association.