Stroke is the third leading cause of death and the leading cause of long-term disability. There are approximately 4 million people living with the effects of stroke in the US alone. In addition, there are millions of husbands, wives, children and friends who care for stroke survivors and whose own lives are personally affected.
According to the National Stroke Association:
- 10% of stroke survivors recover almost completely
- 25% recover with minor impairments
- 40% experience moderate to severe impairments that require special care
- 10% require care in a nursing home or other long-term facility
- 15% die shortly after the stroke
- Approximately 14% of stroke survivors experience a second stroke in the first year following a stroke.
Successful rehabilitation depends on:
- Amount of damage to the brain
- Skill on the part of the rehabilitation team
- Cooperation of family and friends. Caring family/friends can be one of the most important factors in rehabilitation
- Timing of rehabilitation – the earlier it begins the more likely survivors are to regain lost abilities and skills
The goal of rehabilitation is to help the stroke survivor to reach the highest possible level of recovery, achieve independence in activities of daily living, and be as productive as possible.
The needs of a stroke survivor are complex , which is why progress and recovery are unique for each person. One common error is to compare the outcome in our relative with another’s, which can lead to false hopes or unnecessary demotivation and depression.
Although a majority of functional abilities may be restored soon after a stroke, recovery is always an ongoing process, and improvement can and should be attempted all the time. This is to answer the common question: “Doctor, how long should I keep doing physiotherapy/rehabilitation?”
Effects of a Stroke
- Weakness on one side of the body that may affect the whole side or just the arm or leg (hemiplegia).
- Stiffness in muscles, called”Spasticity”, and painful muscle spasms
- Problems with balance and/or coordination
- Problems using language: either a difficulty understanding speech or writing aphasia; or knowing the right words but having trouble saying them clearly (dysarthria); sometimes both aphasia and dysarthria
- Being unaware of or ignoring sensations on one side of the body (bodily neglect or inattention)
- Pain, numbness or odd sensations
- Problems with memory, thinking, attention or learning
- Being unaware of the effects of a stroke
- Trouble swallowing (dysphagia)
- Problems with bowel or bladder control
- Fatigue – getting easily tired with minor exertion
- Difficulty controlling emotions (emotional lability)
Types of Rehabilitation Programs
- Hospital programs: in an acute care facility or a rehabilitation hospital
- Long-term care facility with therapy and skilled nursing care
- Outpatient programs
- Home-based programs
- Doctors: physiatrists (specialists in physical medicine and rehabilitation), neurologists, internists, geriatric specialists, family practice
- Rehabilitation Nurse: a nurse who specializes in nursing care for people with disabilities
- Physical therapists: help to restore physical functioning by evaluating and treating problems with movement, balance, and coordination
- Occupational therapists: help the patient perform activities of daily living more efficiently.
- Speech-language pathologists: to help improve language skills
- Social workers: assist with financial decisions and plan the return to the home or a new living place
- Psychologists: concerned with the mental and emotional health of patients
- Therapeutic recreation specialists: help patients return to activities they enjoyed before the stroke.