Rehabilitation Therapy after a Stroke

Stroke is one of the leading causes of long-term adult disability, affecting approximately 795,000 people each year in the U.S. The very word “stroke” indicates that no one is ever prepared for this sudden, often catastrophic event. Stroke survivors and their families can find workable solutions to most difficult situations by approaching every problem with patience, ingenuity, perseverance and creativity. Early recovery and rehabilitation can improve functions and sometimes remarkable recoveries for someone who suffered a stroke.

There’s still so much we don’t know about how the brain compensates for the damage caused by stroke. In some cases, the brain cells may be only temporarily damaged, not killed, and may resume functioning over time. In other cases, the brain can reorganize its own functioning. Every once in a while, a region of the brain “takes over” for a region damaged by the stroke. Stroke survivors sometimes experience remarkable and unanticipated recoveries that can’t be explained. General recovery guidelines show:
  • 10% of stroke survivors recover almost completely
  • 25% recover with minor impairments
  • 40% experience moderate to severe impairments requiring special care
  • 10% require care in a nursing home or other long-term care facility
  • 15% die shortly after the stroke

Rehabilitation actually starts in the hospital as soon as possible following a stroke. In patients who are stable, rehabilitation may begin within two days after the stroke has occurred, and should be continued as necessary after release from the hospital.
Depending on the severity of the stroke, rehabilitation options can include:
  • A rehabilitation unit in the hospital with inpatient therapy
  • A subacute care unit
  • A rehabilitation hospital with individualized inpatient therapy
  • Home therapy
  • Returning home with outpatient therapy
  • A long-term care facility that provides therapy and skilled nursing care

The long-term goal of rehabilitation is to improve function so that the stroke survivor can become as independent as possible. This must be accomplished in a way that preserves dignity and motivates the survivor to relearn basic skills that the stroke may have impaired – skills like bathing, eating, dressing and walking.

To help you meet your stroke recovery goals, your rehab program will be planned by a team of professionals. This team may include some of the following:
  • Physiatrist. Specializes in rehabilitation following injuries, accidents or illness
  • Neurologist. Specializes in the prevention, diagnosis and treatment of stroke and other diseases of the brain and spinal cord
  • Rehabilitation Nurse. Specializes in helping people with disabilities; helps survivors manage health problems that affect stroke (diabetes, high blood pressure) and adjust to life after stroke
  • Physical Therapist (PT). Helps stroke survivors with problems in moving and balance; suggests exercises to strengthen muscles for walking, standing and other activities
  • Occupational Therapist (OT). Helps stroke survivors learn strategies to manage daily activities such as eating, bathing, dressing, writing or cooking
  • Speech-Language Pathologists (SLP). Helps stroke survivors re-learn language skills (talking, reading and writing); shares strategies to help with swallowing problems
  • Dietician. Teaches survivors about healthy eating and special diets (low salt, low fat, low calorie)
  • Social Worker. Helps survivors make decisions about rehab programs, living arrangements, insurance, and support services in the home
  • Neuropsychologist. Diagnoses and treats survivors who may be facing changes in thinking, memory, and behavior after stroke
  • Case Manager. Helps survivors facilitate follow-up to acute care, coordinate care from multiple providers, and link to local services
  • Recreation Therapist. Helps stroke survivors learn strategies to improve the thinking and movement skills needed to join in recreational activities