Functional Gains in CVA Patients: A Nursing Approach


  • Nancy Ann Lewis MSN, RN, CRRN

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    • Nancy Ann Lewis, MSN RN CRRN, is a nursing supervisor/coordinator at Harmarville Rehabilitation Center, Inc. in Pittsburgh, PA.


This study compares the functional gains of CVA patients treated with the traditional nursing approach (N = 38) and CVA patients treated with a therapeutic nursing approach based on Bobath neurodevelopmental principles. The therapeutic nursing approach was developed to update nursing care of CVA patients at a large rehabilitation center. This approach focused care on bilateral activity—stimulation, involvement, and sensory input on the affected side; and integration of nursing—physical therapy, and occupational therapy. Functional abilities were measured using the modified Barthel Index administered on admission and discharge. The CVA patients treated with the therapeutic nursing approach demonstrated a significantly higher level of functional gain than CVA patients treated with the traditional nursing approach (p = ◂.05) with right CVA patients (left hemiplegics) making the most improvement. In this situation, the therapeutic nursing approach appeared to be the treatment of choice for the care of CVA patients.