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Stroke rehabilitation

Stroke Rehabilitation

Once stroke patients do not need intensive care any more as life-threatening problems are under control, acute care and stroke rehabilitation is started immediately (often within 24-48 hours after the stroke). Stroke rehabilitation aims to enable physically or cognitively impaired patients to function at an optimal level and regain skills they need to maximize their quality of life.  

Stroke rehabilitation targets all kinds of disabilities, be it:

  • Sensory challenges
    • pain, numbness, lost sensation
    • inability to recognize objects
    • chronic pain syndromes due to brain damage
    • inability to respond to stimuli coming from the stroke impaired side
    • incontinence
  • Motor impairments
    • paralysis
    • coordination-ataxia
    • weakness
    • dysphagia (the inability to swallow)
  • Communication problems
    • global aphasia
    • Wernicke aphasia (fluent but incoherent speech, patients are unable to understand written and spoken language)
    • Broca aphasia (patients are unable to articulate their thoughts)
  • Cognitive challenges
    • concentration
    • problem solving
    • memory
    • inability to acknowledge the health condition and limitations after stroke
    • planning
  • Participation in life-activities
    • getting dressed
    • taking a shower
    • eating
  • Emotional, psychological disturbances
    • overcoming the psychological trauma caused by stroke
    • irritation, anger
    • depression
    • social withdrawal

Every patient should be treated in specialized stroke rehabilitation centers where a multidisciplinary team can serve their needs and provide highly intensive preventive, preservative and progressive care, which continues way after discharge from hospital.

Who are these cooperating professionals that perform the stroke rehabilitation program?

  • Neurologists
  • Rehabilitation nurses
  • Psychologists
  • Speech pathologist
  • Physiotherapist
  • Occupational therapist
  • Recreational therapists
  • Orthopedic specialist
  • Dietitian
  • Social workers

What Happens During Stroke Rehabilitation?

A stroke rehabilitation program may happen is several venues of care: acute hospital care, inpatient stroke rehabilitation centers, outpatient rehabilitation units and home care.

Stroke rehab is a long procedure: the most amount of recovery happens in the first 2-6 months, but with proper care improvement continues for years.

Every stroke rehabilitation program should be highly individualized, responding to the patients’ unique needs, goals and impairments. Stroke rehabilitation specialists must assess carefully the area and extent of brain damage and set up a progressive rehabilitation plan with set goals and time prognosis.  The usual post stroke set up is as follows:

  1. Still in acute care patients are encouraged to change postures in bed frequently and they are engaged in passive or, if possible, active motion activities, which involve repeated assisted exercises, mainly performed on impaired limbs. They are prompted to speak, perform simple instructions while their condition is evaluated.
  2. Patients are asked to sit up, leave bed, stand, bear their own weight and walk with assistance. Walking aids are provided, muscles are stimulated and strengthened.
  3. All the way the therapy is progressing toward more complex activities, addressing all areas of impairment (speech, sensory, cognitive)
  4. Preparing patients to perform daily activities and perform social functions independently
  5. Ongoing therapies if necessary to maintain or refine functions.