Stroke Recovery and Rehabilitation
The best way to begin your road to recovery is to start getting educated about the resources that are available to you.
In the beginning, you and your doctor and physical therapist will address your individual diagnosis. Once you and your medical team determine the type of rehabilitation regimen you will require, you can begin to research the “best practices” associated with your recommended rehabilitation protocol.
The purpose of recovery and rehabilitation is to retrain functions that were lost or impaired due to brain injury caused by a stroke.
There are both health concerns and rehabilitation protocol to be considered.
When patients leave the hospital or inpatient rehab following a stroke, there is no comprehensive guide recommending resources, what to expect, or what to do next. This leads to a tremendous burden on the spouse or caregiver, and isolation of the family and stroke survivor. Often, stroke survivors become depressed and ‘give up’ or are simply afraid to get out and try things.
You may ask ‘how long should I do rehab?’. There are differing opinions. You may be told to expect no changes after the first 12 months. Or you may be told not to bother with rehab. The truth is the brain has plasticity and an amazing capacity to heal itself. There are stroke survivors who continue rehab and improve for years after their stroke. Suffering a stroke does not mean the end of living but it can mean a new reality.
During COVID-19 physical distancing, we are meeting virtually on Zoom. Here’s a cheat sheet on how to download Zoom and attend a meeting.
Once somebody experiences a stroke, they experience a broad range of emotions and many more questions. Some of these questions don’t have easy answers, but the single most important thing to remember is to never lose hope and never stop trying to improve.
New therapies are always being discovered and patients who are dedicated often experience drastic improvement. Many questions include:
- Am I going to get better?
- How long does rehabilitation take for my particular situation?
- Are there ways to speed up my recovery?
Health concerns include but are not limited to:
- Assessment and degree of damage done by the stroke
- Type and severity of injury to upper and lower extremities
- Assessment of cognitive function, speech impairment and possible problem swallowing (dysphagia)
- Issue with posture, walking and balance
- Sensory disturbances including pain, tingling and numbness
- Damage to sense of touch or to determine temperature, inability to recognize objects or their own body parts
- Chronic pain syndrome caused by immobility (frozen joint)
- Loss of bladder control and bowel control caused by inability to move normally
- Problems using or understanding language (aphasia)
- Problems with the ability to write and read
- Problems with memory or the proper arrangement of thoughts, shortened attention span and issues with short term memory also can occur
- Mental health issues, anxiety, depression, helplessness and anger can all occur after a stroke. Counseling and medication may be necessary to mitigate these common maladies associated with stroke
- If you’ve had a stroke there is a 23% chance you will suffer a second stroke which is why it is
imperative to work with your physician to mitigate stroke risk
As you can see, it is critical to complete a thorough diagnosis after a stroke to determine exactly which health issues require rehabilitation.
Once the determination is made, a rehabilitation protocol can be developed with the patient and their medical team. The Stroke Rehabilitation Team is often made up of specialists uniquely qualitied to help improve the patient’s specific condition.
The primary physician will continuously diagnose and treat any medical issues as well as prescribing the appropriate medications. The physician will also recommend specialists including neurologists, internists, geriatricians, physical therapists and more.
Other professionals will also be considered based on the needs of the patient. As the patient progresses through the stages of rehabilitation, new medical professionals may be introduced as needed.
These other professionals include but are not limited to:
- Psychologists for mental health and cognitive assistance
- Physical Therapist for assistance in balance, strength, coordination and range of motion issues, help with motor and sensory improvements, overall evaluation of physical function and movement issues
- Speech and Language Therapist to help patients learn to speak, read and write again. They create problem solving exercises to help patients regain cognitive function related to speaking and understanding speech
- Occupational Therapist to teach stroke patients how to perform simple and complicated daily tasks like personal care, meal preparation and simple chores
- Vocational Therapists to assist in preparing post stroke patients for the job force. They identify strengths and weaknesses and help improve work related skill sets for employment. They can also assist in preparation for job interviews, resume writing and preparation and job placement connections
Types of Rehabilitation:
- Inpatient Rehabilitation – Full-service rehabilitation at designated facility, typically fully staffed with physicians, physical therapists and rehabilitation specialists. These facilities typically have a full range of rehabilitation equipment including specialized diagnostic equipment, etc. This type of facility provides important rehabilitation daily and can last anywhere from one to six weeks depending on the type of rehabilitation the patient requires
- Outpatient Rehabilitation – Outpatient facilities are often attached to hospitals or large medical facilities. They offer the same or similar services as inpatient facilities, but the patient is typically given a weekly outpatient rehab schedule to follow. The outpatient facilities are usually staffed with qualified physicians, therapists and specialists trained to provide service to patients.
- Skilled Nursing Facilities – These facilities are usually staffed by skilled medical professionals who specialize in physical therapy. The patient will visit the facility and focus on specific rehabilitation geared toward their particular medical issues
- Homebased Rehabilitation Programs – The home base rehabilitation programs involve a trained physical therapist coming to the home providing great flexibility to the patient. The therapist will work on a variety of rehabilitation exercises based on the patient’s immediate needs. Things like walking, mobility, balance and at home tasks can all be enhanced with in home therapy
- Tele-health – Tele-health increased dramatically with the Covid-19 pandemic incident. Physicians, therapists and patients can now stay connected and share valuable updates and information related to a patient’s progress in stroke rehabilitation
Questions to ask your Speech-Language Pathologist
(Overland Speech and Swallowing Rehabilitation)
Did you know it’s okay to interview your new therapist? Even encouraged.
Check out these tips on questions to ask to make sure you find the right SLP for your needs.
Technology Applications in Stroke Rehabilitation
Treadmill/Stopwatch – one of the most basic and useful forms of technology is of course the treadmill and the stopwatch. It’s critically important to measure results and set timelines and goals for incremental improvement in rehabilitation protocols. Some therapies take longer or are effective shorter term, but technology can improve the assisted results in a rehabilitation regimen
Brain Stimulation – Direct current stimulation using trans cranial direct current is designed to stimulate the brain and improve function of the extremities
Biofeedback – Various forms of biofeedback technologies and vibration technologies are being tested to assist in rehabilitation of both the upper and lower extremities
Telehealth – Telehealth uses both audio and video technology to create a valuable feedback loop between physician’s and their patients in real time. This technology will grow and become a normal part of rehabilitation treatment in the future
Caregiver Support Group:
Survivor Support Group:
- Meetings are scheduled for the second and fourth Tuesday of every month at 3:00 pm (PST)
- ZOOM ID 267 166 8755
- For more information, contact 541-323-5641 or email Keith Taylor at firstname.lastname@example.org
Offers support for Central Oregon Seniors who find connecting with the community challenging
Institute on Aging’s 24-hour toll-free Friendship Line is the only accredited crisis line in the country for people aged 60 years and older, and adults living with disabilities. We also make on-going outreach calls to lonely older adults. While there are other organizations that respond to the needs of people who may be contemplating suicide, none provides the type of services that IOA’s Friendship Line offers to respond to the public health problem of suicide among the elderly. Knowing that older people do not contact traditional suicide prevention centers on a regular basis even if they are considering suicide, we created the only program nationwide that reaches out to lonely, depressed, isolated, frail and/or suicidal older adults. Our trained volunteers specialize in offering a caring ear and having a friendly conversation with depressed older adults.
TOLL FREE: 800-971-0016
The Golden Rules for Maximizing Stroke Recovery (From Strokemark)
The long and arduous process of rehabilitation begins immediately after a stroke. But where should you get started with your stroke recovery and what are the most important things for you to know? Under each rule, you will find links to Strokemark articles that offer more detailed information.
1. Think and act like a professional athlete
2. Provide the right conditions to recover
3. Improve your concentration
4. Improve the adaptive capacity of your brain
5. Improve your strength
6. Make your heart work
7. Avoid unnecessary movements
8. Train often and for long periods of time
9. Don’t get frustrated
10. Don’t give up!