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Stroke Rehabilitation Methods, Durations, And Goals

Stroke rehabilitation is an important part of recovery after stroke.The goal is to help the patient relearn skills lost or damaged by the stroke incident.The rehabilitation goal is regain independence and improve the quality of life.

The challenge stroke health care practitioners face is that each patient’s time to recover varies widely. Researchers find that patients who participate in a focused stroke rehabilitation program —  perform much better compared to those that don’t undergo rehab.

Stroke Rehabilitation: What’s Involved?

There are several approaches. Which one is used for your loved one will depend on the part of the body affected or type of ability that has been damaged.

 

Overall, many different modalities are used. For example, these can include:

  • Motor-skill exercises. These exercises can help improve your muscle strength and coordination. You might have therapy to strengthen your swallowing.
  • Mobility training. You might learn to use mobility aids, such as a walker, canes, wheelchair or ankle brace. The ankle brace can stabilize and strengthen your ankle to help support your body’s weight while you relearn to walk.
  • Constraint-induced therapy. An unaffected limb is restrained while you practice moving the affected limb to help improve its function. This therapy is sometimes called forced-use therapy.
  • Range-of-motion therapy. Certain exercises and treatments can ease muscle tension (spasticity) and help you regain range of motion.

Another approach commonly used is technology-assisted physical activities. The technologies the health care practitioners can use include:

  • Functional electrical stimulation. Electricity is applied to weakened muscles, causing them to contract. The electrical stimulation may help re-educate your muscles.
  • Robotic technology. Robotic devices can assist impaired limbs with performing repetitive motions, helping the limbs to regain strength and function.
  • Wireless technology. An activity monitor might help you increase post-stroke activity.
  • Virtual reality. The use of video games and other computer-based therapies involves interacting with a simulated, real-time environment.

 

Stroke Rehabilitation: OT and PT Therapy Is Very Important

Getting the patient back to their pre-stroke is intensive work and key elements in the therapeutic design will include physical and occupational therapies. These therapists will focus on restoring the following modalities:

  • Therapy for cognitive disorders. Occupational therapy and speech therapy can help you with lost cognitive abilities, such as memory, processing, problem-solving, social skills, judgment and safety awareness.
  • Therapy for communication disorders. Speech therapy can help you regain lost abilities in speaking, listening, writing and comprehension.
  • Psychological evaluation and treatment. Your emotional adjustment might be tested. You might also have counseling or participate in a support group.
  • Medication. Your doctor might recommend an antidepressant or a medication that affects alertness, agitation or movement.

 

In addition, it might be very helpful to use biological therapies. These can include:

  • Noninvasive brain stimulation. Techniques such as transcranial magnetic stimulation have been used with some success in a research setting to help improve a variety of motor skills.
  • Biological therapies, such as stem cells, are being investigated, but should only be used as part of a clinical trial.
  • Alternative medicine. Treatments such as massage, herbal therapy, acupuncture and oxygen therapy are being evaluated.

Stroke Rehabilitation: When Is The Best Time To Begin?

The sooner you begin stroke rehabilitation, the more likely you are to regain lost abilities and skills.

But, key factors your health team will also first address, are the following:

  • Stabilize your medical condition
  • Control life-threatening conditions
  • Prevent another stroke
  • Limit any stroke-related complications

In general, doctors move fast and look to start rehab within 24-48 hours after the stroke occurrence. Usually, that will mean, while the patient is still in the hospital and can be monitored during this critical phase.

 

Moreover, the rehab duration can vary widely. It depends on the severity of the stroke and related complications. Some stroke survivors recover quickly. But most need some form of long-term stroke rehabilitation, lasting possibly months or years.

Keep in mind, however, that the plan can change during the recovery process as the  patient relearns skills. Flexibility is the key.

Stroke rehab begins in the hospital. As the patient improves, plans can made to move them to a skilled nursing facility that is highly equipped to provide max services.

Factors the family must consider consider include insurance coverage and convenience to the patients family.

 

Who Are The Health Care Providers?

Stroke rehab involves a variety of specialists. They include:

  • Physicians. Your primary care doctor — as well as neurologists and specialists in physical medicine and rehabilitation.
  • Rehab nurses. Nurses who specialize in caring for people with limitations.
  • Physical therapists. These therapists help you relearn movements such as walking and keeping your balance.
  • Occupational therapists. These therapists help you relearn hand and arm use for daily skills such as bathing, tying your shoes or buttoning your shirt. They also address swallowing, learning and memory, and home safety.
  • 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 address memory, thinking and communication problems.
  • Social workers. Social workers help connect you to financial resources, plan for new living arrangements if necessary and identify community resources.
  • Psychologists. These specialists assess your thinking skills and help address your mental and emotional health concerns.
  • Therapeutic recreation specialists. These specialists help you resume activities and roles you enjoyed before your stroke, including hobbies and community participation.
  • Vocational counselors. These specialists help you address return-to-work issues if that is a goal.

Outcomes

Outcomes will, of course, vary from patient to patient. In general, the rate of recovery is greatest in the weeks and months after a stroke. Indeed, in some cases recovery has occurred within 12 to 18 months after the stroke.

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