Stroke rehabilitation helps millions each year.
If you’ve suffered a stroke, you are in the company of almost 800,000 other Americans who experience a stroke every year. More than 7 million have had a stroke, and many are still living with the effects of this condition.
The effects of stroke can differ widely, depending on which part of the brain is damaged and the severity of the stroke. While the effects of stroke can be quite serious, the research news is not all bad: 10% of stroke survivors recover completely and another 25% recover with minor impairments, according to the National Stroke Association. While rehabilitation cannot “heal” stroke, it can help you achieve the best possible outcome and improve independent living and quality of life.
When and How Does Recovery Begin?
Rehabilitation aims to help patients “relearn” skills that are lost or impaired when stroke occurs. Think of how you first learned a new skill, such as riding a bicycle. The ability to learn the skill came with practice. It’s the same with recovery from stroke. Rehabilitation professionals agree that the most important key to success is carefully directed well-focused repetitive practice. Recovery also involves learning new ways of doing things. For example, you may learn to bathe or dress yourself using one hand.
Rehabilitation therapy begins in the hospital within 24 to 48 hours after the stroke occurs. Because the stroke may cause weakness or paralysis, the first part of recovery will involve independent movement. A therapist may help you move your limbs at first. This is called “passive” therapy. You may also be encouraged to perform exercises on your own if you can.
Regaining the ability to carry out the basic activities of daily living is the first step to returning to independent living. Ongoing therapy with a variety of therapists may be needed for months or even years.
Where Will Rehabilitation Occur?
Rehabilitation will usually begin as a form of inpatient care as soon as your medical condition becomes stable. Then, when you are ready for discharge, a hospital social worker will help develop a plan for continuing care and rehabilitation. Some of the options include:
- Discharge to a skilled nursing or other licensed care facility that specializes in rehabilitation therapy. A stay in such a sub-acute or transitional care setting typically lasts two or three weeks, while the patient receives rehabilitation therapy in preparation for returning home.
- Return home, with arrangements made for ongoing therapy on an outpatient basis. Outpatient rehab facilities typically provide access to physicians and the full range of therapists specializing in stroke rehabilitation. A typical program might include visits several days each week participating in therapy sessions and working on a personalized plan for rehabilitation reviewed and approved by your physician.
- Return home with home rehabilitation. This allows for great flexibility with scheduling and gives you the advantage of practicing skills and developing compensatory strategies in your own living environment. A disadvantage is that you won’t have access to the specialized rehabilitation equipment available in an outpatient setting.
What is Involved in Stroke Rehabilitation?
Generally, stroke can cause five types of disabilities:
- paralysis or problems controlling movement
- sensory disturbances, including pain
- problems using or understanding language
- problems with thinking and memory
- emotional disturbances.
The kind of rehabilitation your doctor prescribes depends on the type and degree of disability your stroke has caused. Post-stroke rehabilitation involves teamwork, with various healthcare professionals working with you to achieve a specific set of goals.
Neurologists usually lead acute-care stroke teams and direct patient care during hospitalization, and they sometimes remain in charge of long-term rehabilitation. However, physicians trained in other specialties often assume responsibility after the acute stage has passed, including physiatrists, physicians who specialize in physical medicine and rehabilitation.
Your own doctor will have the primary responsibility for recommending a rehabilitation plan that will best address your needs. Your doctor may also recommend lifestyle changes and/or medication to help prevent a second stroke. These changes may include controlling high blood pressure or diabetes, and eliminating risk factors such as cigarette smoking, excessive weight, a high-cholesterol diet, and high alcohol consumption.
Other health care professionals who may help with your recovery include:
- Rehabilitation nurses, who specialize in nursing care for people with disabilities
- Physical therapists, who help restore physical functioning by evaluating and treating problems with movement, balance and coordination
- Occupational therapists, who provide exercises and practice to help you perform activities of daily living
- Speech-language pathologists, who will help you improve your language skills
- Social workers, who may help you with financial decisions and help you plan the return to home or a new living place
- Psychologists or other mental health professionals, who can help with emotional and behavioral changes that may occur after stroke, as well as depression, a common side effect
- Therapeutic recreation specialists, who can assist you in resuming as fully as possible the hobbies and leisure time activities you enjoyed before your stroke
For More Information
Sponsor of American Stroke Month http://www.strokeassociation.org/STROKEORG/AboutStroke/AmericanStrokeMonth/American-Stroke-Month_UCM_459942_SubHomePage.jsp, the American Stroke Association (www.strokeassociation.org) offers consumer information about stroke prevention and treatment.
The National Stroke Association (www.stroke.org) offers resources, information and support for stroke patients and family caregivers. Visit their website for more information about this year’s National Stroke Awareness Month http://www.stroke.org/site/PageServer?pagename=awareness