Stroke, also known as “brain attack,” is an emergency condition in which there is an injury to the brain leading to decreased blood flow. This can cause long-term damage over time. Signs and symptoms of a stroke include slurred speech, double vision, loss of speech, headache, confusion, and loss of balance.

What is Stroke Rehabilitation?

After a person had a stroke, the brain may need to recover some of what was lost. A stroke survivor experiences paralysis, loss of voluntary movement and involuntary movements, inability to walk, imbalance (ataxia), problems with thinking and memory, emotional disturbances, and aphasia. Rehabilitation programs are very important in helping patients cope-up with their physical, lingual, and mental functions. Although rehabilitation can not reverse the brain injury, it can help the patient get back to a normal life. Rehabilitation is not a one time process, it is a continuous, dedicated, and time-taking journey. 

Approaches Involved in Stroke Rehabilitation

There are plenty of techniques used for stroke rehabilitation. The rehabilitation process varies according to the type and intensity of the injury. 

  • Therapy for cognitive disorder: occupational therapists can help the patient relearn activities such as preparing meals, pressing clothes, driving, and cleaning the house.  
  • Speech therapy: stroke survivors suffer from Aphasia, a disorder that affects one’s ability to comprehend language and also impedes the patient’s ability to write and read.  A speech therapist helps the patient relearn how to communicate through different writing and speaking exercises.
  • Physical therapy: physical therapists are specialists in treating motor and sensory impairments. They help the patients do movements effectively with the help of certain exercises and assisting with the difficulty in movement, balance, and coordination. Physical therapists might use Constraint-induced therapy (An unaffected limb is restrained so that the patient focuses on the affected limb for movement.) or treadmill work. Robotic technology, wireless technology, and functional electrical stimulation are also being used as ways to maintain a patient’s physical activity. 
  • Psychological therapy: Stroke survivors go through a lot of mental health illness and psychological problems. A psychological therapist identifies their mental health issues and guides them through it. 

Types of stroke Rehabilitation programs

There are many types of a stroke treatment program, which includes the following:

  • Acute Rehabilitation: The therapist provides the patient with three or more hours of therapy five days a week. 
  • Subacute Rehabilitation: The patient is provided with one or two hours of therapy five days a week. Patients recover well in this phase and can do moderate pace exercise. 
  • Long term acute care (LTAC) rehabilitation: This rehabilitation program is provided in special hospital units. It is a long term treatment and the doctors visit patients frequently. 
  • Home Rehabilitation: patients who have mild problems and extensive family support opt for home rehabilitation. The therapy team visits them every week. 
  • Outpatient Rehabilitation: In this program, the patient travels to the rehabilitation center for a session twice a week, accompanied by a family member. 

Who participates in Stroke Rehabilitation? 

Stroke rehabilitation is a mutual process where multiple experts are helping a survivor get back to life. It involves a variety of specialists such as: 

  • Physician: They are the primary caretakers. They can guide the patient to live a healthy lifestyle and can prevent many complications. 
  • Physical Therapists: Therapists help the patient relearn activities they are finding difficulty at such as walking, running, or basic movements. 
  • Rehabilitation Nurses: Nurses provide the patient information about routine life and can also guide the patient about the bowel and bladder complications. 
  • Speech Therapists: It is very difficult for a stroke survivor to communicate properly, and a speech therapist is the only person who can help them relearn how to speak and listen or communicate properly. 
  • Occupational therapists: These therapists help the patient to re-learn hand and arm use. Occupational therapists help patients improve their sensory and motor abilities. They also teach the patient how to go through the day by making them learn simple things such as bathing, buttoning the shirt, or washing clothes. 
  • Social Workers: social workers can guide the patient financially and help them make decisions for their rehabilitation process. 
  • Psychologists: psychologists can help the patient get better mental and emotional health. Psychological counseling is very important for a stroke survivor who has gone through a lot of mental and emotional turmoil. 

Role of Technology in Stroke Rehabilitation

As technology is advancing day by day we are equipped with innovative devices and methods that can help the patient rehabilitate quickly and effectively. Some of them are: 

  • Telerehabilitation
  • I- Acquire Trial
  • Sleep SMART( stroke management and recovery trial)

What factors affect the outcome of Stroke Rehabilitation? 

Stroke recovery depends on a variety of factors and varies from person to person. The factors that affect stroke rehabilitation are: 

  • Physical Factors: physical factors include the clinical condition and the overall health of the patient. It also depends on the severity of the stroke and the physical effects it had on the patient. Out of two types of stroke, hemorrhagic stroke patients are more likely to recover early than ischemic stroke patients. 
  • Sociodemographic factors: patient’s age, gender, race, and occupation matter a lot during the rehabilitation process. Young patients are more likely to recover early than the elderly. If the patient is wealthy enough to afford all the latest technologies, the rehabilitation process becomes easier and effective. 
  • PTSD: post-traumatic stress disorder is the most frequent complication of the stroke, and the patients who are going through mental illness, anxiety, depression, and other disorders need to have psychological counseling first. 
  • Emotional factors: patients who feel lively are more likely to recover early. Motivation and mood of the patient matter a lot in the whole rehabilitation process.
  • Family support: Having a caring and loving family motivates and supports the patient to have a better mindset and to think positively. Stroke survivors need warmth and love from their families and friends. People who have immense support from their families feel motivated and recover early.  

 

Stroke rehabilitation takes patience and time, but it is always worth the effort. 

Dr. Anique Ali

References:

Duncan, P. W., Zorowitz, R., Bates, B., Choi, J. Y., Glasberg, J. J., Graham, G. D., … & Reker, D. (2005). Management of adult stroke rehabilitation care: a clinical practice guideline. Stroke, 36(9), e100-e143.

Dombovy, M. L., Sandok, B. A., & Basford, J. R. (1986). Rehabilitation for stroke: a review. Stroke, 17(3), 363-369.

Gresham, G. E., Stason, W. B., & Duncan, P. W. (2004). Post-stroke rehabilitation (Vol. 95, No. 662). Diane Publishing.

Kelley, R. E., & Borazanci, A. P. (2009). Stroke rehabilitation. Neurological research, 31(8), 832-840.