Stroke is one of the leading causes of long-term adult disability. The very word “stroke” indicates that no one is ever prepared for this sudden, often catastrophic event. Stroke survivors and their families can find workable solutions to most difficult situations by approaching every problem with patience, ingenuity, perseverance and creativity. Early recovery and rehabilitation can improve functions and sometimes remarkable recoveries for someone who suffered a stroke.
There’s still so much we don’t know about how the brain compensates for the damage caused by stroke. In some cases, the brain cells may be only temporarily damaged, not killed, and may resume functioning over time. In other cases, the brain can reorganize its own functioning. Every once in a while, a region of the brain “takes over” for a region damaged by the stroke. Stroke survivors sometimes experience remarkable and unanticipated recoveries that can’t be explained. General recovery guidelines show:
- 10% of stroke survivors recover almost completely
- 25% recover with minor impairments
- 40% experience moderate to severe impairments requiring special care
- 10% require care in a nursing home or other long-term care facility
- 15% die shortly after the stroke
What’s involved in stroke rehabilitation?
There are numerous approaches to stroke rehabilitation, some of which are still in the early stages of development. Behavioural performance in any area, such as sensory-motor and cognitive function, is most likely to improve when motor activity is wilful, repetitive and task specific.
Stroke rehabilitation may include some or all of the following activities, depending on the part of the body or type of ability affected.
- Strengthening motor skills involves using exercises to help improve your muscle strength and coordination, including therapy to help with swallowing.
- Mobility training may include learning to use walking aids, such as a walker or canes, or a plastic brace (orthosis) to stabilize and assist ankle strength to help support your body’s weight while you relearn how to walk
- Constraint-induced therapy, also known as forced-use therapy, involves restricting use of an unaffected limb while you practice moving the affected limb to help improve its function.
- Range-of-motion therapy uses exercises and other treatments to help lessen muscle tension (spasticity) and regain range of motion. Sometimes medication can help as well.
Technology-assisted physical activities:
- Functional electrical stimulation involves using electricity to stimulate weakened muscles, causing them to contract. This may help with muscle re-education.
- Alternative medicine treatments, such as massage, herbal therapy and acupuncture, ayurveda etc.
- Enhanced External Counter Pulsation therapy (EECP).
- Robotic technology uses robotic devices to assist impaired limbs with performing repetitive motions, helping them regain strength and function.
- Wireless technology, such as a simple activity monitor, is being evaluated for its benefit in increasing post-stroke activity.
- Virtual reality, such as the use of video games, is an emerging, computer-based therapy that involves interacting with a simulated, real-time environment.
- Non invasive brain stimulation. Techniques such as transcranial magnetic stimulation (TMS) have been used with some success to help improve a variety of motor skills.
- Biological therapies, such as stem cells rehabilitation
Cognitive and emotional activities:
- Therapy for communication disorders can help you regain lost abilities in speaking, listening, writing and comprehension.
- Psychological evaluation and treatment may involve testing your cognitive skills and emotional adjustment, counselling with a mental health professional, or participating in support groups.
- Medications are sometimes used to treat depression in people who have had a stroke. Drugs that affect movement are also used.
Depending on the severity of the stroke, the long-term goal of rehabilitation is to improve function so that the stroke survivor can become as independent as possible. This must be accomplished in a way that preserves dignity and motivates the survivor to relearn basic skills that the stroke may have impaired – skills like bathing, eating, dressing and walking.
Your Recovery Team
To help you meet your stroke recovery goals, your rehab program will be planned by a team of professionals. This team may include some of the following:
- Eastern medicine specialist (Acupuncture, EECP, Ayurveda etc): specialize in various therapies that treats the root cause of the diseases in order to prevent and reverse chronic ailment for a total approach to health.
- Physiatrist. Specializes in rehabilitation following injuries, accidents or illness
- Neurologist. Specializes in the prevention, diagnosis and treatment of stroke and other diseases of the brain and spinal cord
- Rehabilitation Nurse. Specializes in helping people with disabilities; helps survivors manage health problems that affect stroke (diabetes, high blood pressure) and adjust to life after stroke
- Physical Therapist (PT). Helps stroke survivors with problems in moving and balance; suggests exercises to strengthen muscles for walking, standing and other activities
- Occupational Therapist (OT). Helps stroke survivors learn strategies to manage daily activities such as eating, bathing, dressing, writing or cooking
- Speech-Language Pathologists (SLP). Helps stroke survivors re-learn language skills (talking, reading and writing); shares strategies to help with swallowing problems
- Dietician. Teaches survivors about healthy eating and special diets (low salt, low fat, low calorie)
- Social Worker. Helps survivors make decisions about rehab programs, living arrangements, insurance, and support services in the home
- Neuropsychologist. Diagnoses and treats survivors who may be facing changes in thinking, memory, and behaviour after stroke
- Case Manager. Helps survivors facilitate follow-up to acute care, coordinate care from multiple providers, and link to local services
- Recreation Therapist. Helps stroke survivors learn strategies to improve the thinking and movement skills needed to join in recreational activities