Stepping Forward: Rehabilitation and Recovery after Stroke

A stroke is an emergency condition resulting in impaired mobility, speech, swallow, sensory function, bladder and bowel movements and cognitive and executive tasks. Stroke rehabilitation is an essential part of recovery after suffering from a stroke. Although the stroke rehabilitation program may differ for individuals depending on their specific needs and health conditions, having an idea about what to expect during stroke rehabilitation can be beneficial. The care team for stroke rehabilitation may consist of rehabilitation physicians, nurses, physical and occupational therapists, speech and language pathologists, psychologists and counsellors, among others.

Stroke Rehabilitation: What to expect?

Stroke rehabilitation is a recovery program customised according to the specific needs of the patients, which may be designed after a thorough evaluation of the patient’s health, overall fitness, loss of specific functions and recovery potential. Activities in the stroke rehabilitation program may help patients relearn certain skills lost after the stroke. Depending on the impairment, stroke rehabilitation may help restore speech, movement, muscle strength, and daily living skills. The objective of a stroke rehabilitation program is to improve the quality of life after suffering from a stroke.

What are the effects of Stroke?

There may be long-term effects of a stroke, which can vary from person to person. These effects may include:

• Motor inabilities: Weakness, paralysis, muscle tightness and pain and difficulty in swallowing.
• Cognitive impairment: Speech and memory deficits.
• Emotional side-effects: Impulsiveness and depression.

Physical and occupational therapy can help restore the motor skills affected by stroke, including their ability to perform daily life activities such as walking, eating, or self-care. For patients experiencing swallowing difficulties, swallow re-training and diet modification may be useful.

Priorities in Stroke Rehabilitation

After a stroke, daily life activities such as eating, feeding, bathing, walking, or even speaking may be impacted. Hobby or work-related skills may also require training and rehabilitation support. Apart from physical and motor problems, a stroke can severely impact the mental health of patients, along with their cognitive abilities. The rehabilitation team can help address these challenges and create a customised action plan to improve overall function and deal with the mental health challenges faced by the patients.

What happens in Stroke Rehabilitation?

The rehabilitation program may vary depending upon the part of the body and the type of ability impacted by the stroke. To help restore physical activities in patients, the following training may be performed:

• Mobility training: This involves training using mobility aids such as walkers, canes, and wheelchairs. Braces may also be used to stabilise the lower limbs helping to bear the weight of the body during the process of regaining walking ability and strength.
• Range-of-motion therapy: These exercises are designed to ease muscle tension or spasticity and help regain certain motions through range-of-motion therapy.
• Skills retraining exercises: A stroke may affect skilled movements. Specific exercises to improve balance, swallow and skilled upper limb movements can aid in improving muscle strength and coordination throughout the body.
• Constraint-induced therapy: In some cases, restricting the movement of the unaffected limb for a period of time may be beneficial for regaining motor strength and mobility, as well as improving function in the affected limb.
• Latest advances: Availability of technological advances in terms of robotic devices for training limb movements, virtual reality and non-invasive brain stimulation can augment results of conventional rehabilitation.

There may also be a need for improving cognitive activities and emotional functioning alongside communication. To help with that, specific training may be performed.

• Cognitive and mood disorders: Cognitive and perceptual training may be helpful in regaining lost mental abilities such as memory, problem-solving, social skills and spatial orientation among many others. Counselling and group activities may help patients deal with other mental health problems such as depression and impulsiveness. Medications may also be an effective way of dealing with depression.
• Communication disorders: Language therapy may also be required to regain lost speech and other related abilities such as naming, writing and comprehending.

When does Stroke Rehabilitation begin?

Rehabilitation after stroke may begin as early as 24 hours to 48 hours, depending upon the amount of time required to keep the patient under observation in an intensive care unit (ICU). The stroke rehabilitation care team may include rehabilitation physicians, neurologists, other doctors, physical and occupational therapists, speech-language pathologists, neuropsychologists and nurses.

How long does Stroke Rehabilitation take?

The amount of time required for being in the stroke rehabilitation program may depend upon the severity of the stroke and related complications. The treatment and rehabilitation plan may be discussed with the patient, depending upon their individual needs as well as work-related skill requirements. The time required for recovery may vary where some patients may recover faster, while others may require long-term rehabilitation, possibly spanning months or even years.

The stroke rehabilitation program design may be continuously upgraded and changed, depending upon the needs of the patients as they work through therapy.

What can affect Stroke Rehabilitation?

A successful stroke rehabilitation may depend upon several factors apart from the degree of functions affected by the stroke. These factors include:

• Physical factors: These may involve the severity of the stroke, affecting both cognitive and physical abilities.
• Emotional factors: Mood and motivation can significantly impact stroke rehabilitation and an individual's ability to adhere to rehabilitation activities outside of therapy sessions.
• Social factors: The support of friends and family can play a crucial role in expediting recovery and progress.
• Therapeutic factors: The early initiation of rehabilitation and the expertise of the stroke rehabilitation care team also influence the progress and recovery process.

Recovering from a stroke may be a long-term effort and may require dedication and willingness to work continuously towards improvement. At Hinduja Hospital, we offer comprehensive stroke rehabilitation services in Mumbai for a broad range of health conditions affecting motor, cognitive, and behavioural abilities of patients, such as in the case of a stroke. Our multi-disciplinary team of highly dedicated physical & occupational therapists, neuropsychologists, speech pathologists, and nurses under the overall supervision and direction of rehabilitation physicians take immense care to provide the best quality of services with utmost expertise and confidentiality. We ensure faster recovery and a shorter hospital stay while helping to improve the quality of life and make a difference in the world.

FAQs:

Can movement come back after a stroke?

Intensive practice and task specific training techniques in modern rehabilitation may help regain movement over a course of a few weeks to a few months after stroke.

How long does it take to recover after a stroke?

Recovery after a stroke can vary from person to person depending upon age, the severity of the stroke and the damage caused by it. Broadly, it may take few months to about 2 years to recover.

What are the signs of recovery after a stroke?

One of the best indicators of progress and recovery after a stroke through rehabilitation may be judged by the degree of independence experienced by the patients in performing various functions and daily life activities, such as eating, dressing, etc.