Stroke rehabilitation: what to expect during recovery
The goal of stroke rehabilitation is to help you relearn the skills you lost after the event. Stroke rehabilitation can help you regain independence and a better quality of life.
The severity of the stroke and each person’s ability to recover vary widely. Researchers have found that people who take part in a stroke-specific rehabilitation program typically do better than those who do no rehabilitation.
What does stroke rehabilitation consist of?
There are several approaches to stroke rehabilitation. The rehabilitation plan will depend on the part of the body or type of movement most affected by the stroke.
- 1Motor skill exercises. These exercises can help improve strength and muscle coordination. You may have a therapy program aimed at strengthening swallowing or lifting your arm.
- 2Mobility training. Therapist could teach you to use mobility aids such as a walker, cane, wheelchair or ankle brace. The ankle brace can stabilise the ankle itself, helping you support your body weight as you learn to walk again.
- 3Constraint-induced therapy (CIMT). Your “healthy” limb is restrained while you use the limb affected by the stroke so you can concentrate specifically on the latter, improving its function. This therapy is sometimes called forced-use therapy.
- 4Range-of-motion therapy. Certain range of motion exercises and treatments can relieve muscle tension (spasticity) and help you recover your movements.
Rehabilitation activities performed with the help of technology could include:
- 5Functional electrical stimulation. Electricity is applied to weakened muscles, causing them to contract. Electrical stimulation can help train the muscles.
- 6Robotic technology. Robotic devices can help damaged limbs by performing repetitive movements, helping the limbs recover strength and functionality.
- 7Wireless technology. An activity monitor could help you increase post-stroke activity. .
- 8Virtual reality. Using video games and other computer-based therapies involves interacting with a simulated real-time environment in order to relearn specific skills or tasks.
- 1Therapy for cognitive disorders. Occupational therapy and speech therapy can help you with lost cognitive skills, such as memory, processing, problem solving, social skills, judgement and safety awareness.
- 2Therapy for communication disorders. Speech therapy can help you recover lost skills in speaking, listening, writing and understanding.
- 3Psychological evaluation and treatment. Psychologists and psychiatrists may evaluate your emotional reaction to the stroke event and subsequent circumstances. You may also have counselling or join a support group.
- 4Medication. Your doctor may recommend an antidepressant or medication for attention, agitation or movement.
- 1Non-invasive brain stimulation. Techniques such as transcranial magnetic stimulation (TMS) have been used with some success in a research setting to help improve certain motor skills after stroke.
- 2Biological therapies, like stem cells, have been studied, but are still in the experimental phases of development and should only be used as part of a clinical trial.
- 3Biological therapies, like stem cells, have been studied, but are still in the experimental phases of development and should only be used as part of a clinical trial.
AMPS therapy. The stimulation provided by GONDOLA has also proven effective in the treatment of motor disorders and may be particularly helpful in people affected by strokes.
When should stroke rehabilitation begin?
The earlier you begin stroke rehabilitation, the more likely you are to recover your lost skills and abilities.
However, immediately after the stroke event, your doctors’ main priorities are to:
- Stabilise your medical conditions
- Control life-threatening conditions
- Prevent another stroke
- Limit stroke-related complications
Stroke rehabilitation often starts 24 to 48 hours after the stroke, while you are in the hospital.
How long does stroke rehabilitation last?
The duration of stroke rehabilitation depends on its severity and related complications.
Some sufferers recover quickly, but most need long-term stroke rehabilitation, which could last months or years after the stroke.
The stroke rehabilitation plan will change during recovery as improvements continue and your needs change.
Where does stroke rehabilitation take place?
You will probably begin stroke rehabilitation while still in the hospital.
Before being discharged, you and your family will work with your care team to determine the best rehabilitation program. Factors to consider include your needs and what is most convenient for you.
Talk to your doctor and family about the best option for you.
Who participates in your stroke rehabilitation team?
Stroke rehabilitation involves many specialists, as described below.
Doctors. Your GP – in addition to neurologists and specialists in physical medicine and rehabilitation – can help you prevent complications. These doctors can also help you achieve and maintain a healthy lifestyle in order to avoid another stroke.
Nurses. Nurses who specialise in caring for people with movement problems can help you incorporate what you learn during physiotherapy into your daily routine. They can also show you how to manage bowel and bladder complications, problems that can arise after a stroke.
Physiotherapists. These therapists help you relearn movements such as walking and balancing.
Occupational therapists. These therapists help you regain control of your limbs and resume your normal daily activities such as bathing, tying your shoes or buttoning your shirt. Occupational therapists can also help you with swallowing, cognitive and safety issues in your home.
Speech and language pathologists. These specialists help improve your language skills and ability to swallow. Speech and language pathologists can also work with you to develop tools to help with memory, thinking and communication problems.
Social workers. Social workers help you find financial resources, plan for new living arrangements if necessary and identify community resources.
Psychologists. These specialists evaluate your thinking skills and help address your mental and emotional health problems.
Therapeutic recreation specialists. These specialists help you get back to doing the activities you enjoy, including hobbies and community participation.
Professional consultants. These specialists help you solve problems that can arise when you return to work, if necessary.
What factors influence the outcome of stroke rehabilitation?
Stroke recovery varies from person to person. It is difficult to predict how much you will be able to recover and how long it will take. In general, correct stroke rehabilitation depends on:
Physical factors, including the severity of stroke in terms of both cognitive and physical effects
Emotional factors, your motivation and your mood, your ability to follow rehabilitation activities outside of therapy sessions
Social factors, the support of friends and family
Therapeutic factors, including starting rehabilitation as soon as possible and the skills of your care team
The recovery rate is generally higher in the weeks and months immediately following a stroke, especially the first 6 months. After this time, the patient recovery tends to stabilise.
There is, however, evidence that performance can improve even 12 to 18 months after a stroke.
GONDOLA therapy has demonstrated excellent results in improving motor impairments. Given that the underlying goals of neurorehabilitation are common to many conditions, stroke patients could also benefit from Gondola therapy, even patients whose recovery has “stabilised”, i.e. those who are more than 6 months post stroke.
Stroke rehabilitation takes time. Recovery can be a long and frustrating experience. It is normal to encounter difficulties along the way. Dedication and a desire to get better will help you gain the most benefit.