With so much left unknown about how the brain repairs itself after a stroke, it is hard to predict exactly how much a patient will recover. However, with the help of medical rehabilitation, post-stroke patients can achieve the best possible long-term outcome.
More than 700,000 people in the U.S. experience a stroke each year and 10 percent of them recover almost completely, 25 percent recover with minor impairments, 40 percent experience moderate to severe impairments and 10 percent require care at a long-term care facility. For all of these survivors, rehabilitation can substantially help them relearn skills such as talking, eating, dressing and walking, that were lost due to brain damage. Though therapy cannot reverse the effects of stroke in that it cannot undo the injury to the brain, it can help patients regain as much independence as possible.
Working towards Recovery
Rehabilitation therapy can begin as early as a day or two after the stroke, once the patient’s condition has been stabilized. At an acute rehabilitation hospital like Burke, post-stroke patients will have a team of clinicians, from physicians, nurses, speech therapists, physical and occupational therapists to a variety of other rehabilitation specialists like neuropsychologists, who will design and implement the patient’s therapy plan.
Along with medical management, patients will receive at least three hours of therapy daily that comprise:
- - Physical therapy – to help improve muscle strength and coordination, decrease muscle tension (spasticity) and regain range of motion. Physical therapy can help with paralysis, which is one of the most common disabilities resulting from stroke, and ataxia, which is when the body has trouble controlling movement. The latter can lead to problems with body posture, walking and balance.
- - Occupational therapy – to help patients re-learn how to do familiar tasks like eating and dressing, to help them regain as much independence as possible. Occupational therapy also helps patients learn to use adaptive equipment like walking aids in daily living.
- - Speech therapy – to help patients regain abilities like swallowing, speaking, listening, writing and comprehension. At least 25 percent of stroke survivors experience language impairments such as aphasia (inability to convey thoughts) and dysphagia (problems swallowing).
Stroke patients may also meet with a neuropsychologist who can help them with cognitive impairments including personality changes, depression, anosognia (inability to recognize physical impairments), neglect (inability to respond to stimuli) and apraxia (inability to carry our learner purposeful movement), brought on by stroke. Burke also offers robot-assisted therapy to assist patients perform repetitive motions with their impaired limbs, helping them rebuild strength and function.
There are many facets that come in to play during recovery and each person will have varying results. It’s hard to predict how many abilities may be recovered and how soon, but in general, success depends on the severity of the stroke, motivation, skill of the rehab team, a good support network, timing of rehabilitation (the sooner started, the better), and continuing rehab activities outside of therapy.
The recovery process can be long and at times, a frustrating experience. These difficulties are common and normal, but if patients are dedicated to working toward improvement they can increase their chances for success.
—Carolin Dohle, M.D.
Associate Director, Stroke Rehabilitation Program
To read other blog posts by Dr. Dohle and other Burke physicians, please visit the Rehab Insights blog.