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Stroke Recovery and the Role of Rehabilitation
Each year, nearly 800,000 people suffer a stroke in the United States. When it comes to treating an individual with a stroke, we know that “time is brain” and the faster a stroke is identified and treated, the better the outcome.
Patients who have had a stroke may have different needs, depending on where it occurred in the brain and what type of stroke they suffered. Some possible results of a stroke may include:
- facial droop
- weakness of arm and/or leg
- numbness and/or tingling sensations
- spasticity (constant muscle contractions)
- muscle contracture (shortening of muscle)
- neglect on one side of the body
- difficulty speaking and/or swallowing
- impaired vision
- difficulty with problem solving and/or memory
It is truly a team of medical professionals who help stroke patients recover. Rehabilitation services is an integral part of that multidisciplinary team. We work closely with physicians, to include physiatrists (specialists in physical medicine and rehabilitation), and other health care providers to ensure the best treatment plan for each patient’s individual needs.
Types of Rehabilitation
After a stroke, many patients will need some rehabilitation as part of their recovery. Depending on those needs, rehabilitation services may include physical therapy, occupational therapy, and/or speech-language pathology. We are there every step of the way.
Physical therapists (PTs) work on strengthening, mobility, range of motion, and function to build endurance and help with independence. Some activities PTs may focus on include:
- transferring in and out of bed, chairs, or cars
- walking or progressing gait with various assistive aids to improve endurance and stability
- building strength and endurance, as patients may lose function after being in the hospital following a stroke
- managing spasticity, increasing active range of motion, and avoiding muscle contractures
Depending on the presentation or type of stroke, patients may need help to perform daily functions due to weakness, neglect, spasticity, and/or impaired cognition. These deficits impact a person’s independence as they affect activities that are vital for function and quality of life. Some activities OTs may focus on include:
- personal hygiene/ dressing/ bathing/ brushing teeth
- cooking/ eating
- home management
Occupational therapists (OTs) within Lifespan care for patients in the hospital setting, and at outpatient locations. They focus on getting patients back to functioning in daily life. OTs also act as a bridge back to the community. An OT works with each individual patient to look at vocations or hobbies, and help patients get back to doing what they loved before their stroke.
Speech-Language Pathology is a vital service across all levels of care. After a stroke, patients may have difficulty swallowing liquids or solids. A speech-language pathologist (SLP) works with patients to ensure tolerance of the least restrictive diet without aspirating (food or liquid going down the wrong way). SLPs work with medical imaging to perform a procedure called a modified barium swallow. This study shows structural or functional changes related to swallowing. If changes are noted, SLPs may make recommendations to change the consistency of food or liquids to make eating safer and easier. Additionally, they can establish an exercise program to help re-strengthen swallowing muscles.
SLPs also assess and treat speech, language, and cognitive issues. Strategies for improving communication in patients who experience difficulties in speech production or language expression may include: use of picture cards, a communication book, or tablet. The use of alternative forms of communication tools help a patient engage in conversation more freely. Losing the ability to communicate can be extremely difficult. SLPs give hope, and motivate patients and caregivers, with a focus on getting our patients back to the best quality of life possible.
As physician leaders of rehabilitation, physiatrists guide patients through the recovery process after a stroke, from acute hospitalization to inpatient or subacute rehabilitation and then home. Navigating the health care system after a stroke can be challenging. Physiatrists help patients get the care they need with a focus on the patient’s independence, safety and recovery at the center of all decisions.
Stages of Rehabilitation
Often rehabilitation begins in the hospital immediately following a stroke. We look at the whole person and determine what their needs may be – from orthotics, to wheelchairs or walkers, to modified diets and communication aids. We also participate in the discharge process to ensure placement for optimal care and services at the next stage of their recovery.
For some, an important part of their recovery occurs well after the hospital stay – when they return to their daily activities, including work and hobbies. We often recommend that the individual come back for a “tune up” to see if there is anything we can do to further assist in optimizing their function.
Throughout the rehabilitation process, the goal of our team is to ensure each patient receives the services they need at the right time to improve their quality of life. Learn more about Lifespan Rehabilitation Services and Stroke Services on our website.
Patricia Wolfe, PT, MS
Pat Wolfe is the administrative director for Lifespan Rehabilitation Services. She is a leader in the American Physical Therapy Association with a passion for Women’s Health and Oncology Rehabilitation.