Getting back on your feet is likely one of your top concerns after a stroke, and stroke rehabilitation can help. The goal of a stroke rehabilitation program is to help you relearn skills lost when stroke affected part of your brain. Participating in stroke rehabilitation helps you regain independence and improve your quality of life.
The severity of stroke complications and each person's ability to recover lost abilities varies widely. However, stroke rehabilitation can usually help you achieve the best long-term outcomes.
What's involved in stroke rehabilitation?
Stroke rehabilitation may include some or all of the following activities:
- Therapy for communication disorders can help you regain lost abilities in speaking, listening, writing and comprehension.
- Strengthening motor skills involves using exercises to help improve your muscle strength and coordination.
- Mobility training may include learning to use walking aids, such as a walker or canes, or a plastic brace to stabilize and assist ankle strength (orthosis) to help support your body's weight while you relearn how to walk.
- Range of motion therapy uses exercises and other treatments to help lessen muscle tension (spasticity) and regain range of motion.
- Psychological evaluation may involve testing your cognitive skills, counseling with a mental health professional, participating in support groups, and using medicines for mood if needed.
- Constraint-induced therapy, also known as "forced-use" therapy, involves restricting use of an unaffected limb while you practice moving the affected limb. Forcing you to use the affected arm or leg can help improve its function.
- Electrical stimulation involves using electricity to stimulate weakened muscles, causing them to contract. This may help with muscle re-education in some individuals.
- Robotic technology uses robotic devices to assist impaired limbs with performing repetitive motions, helping them regain strength and function.
- Virtual reality is an emerging, computer-based therapy that involves interacting with a simulated, real-time environment.
When should stroke rehabilitation begin?
Stroke rehabilitation should begin as soon as possible after a stroke. The first priority is to stabilize your medical condition and get life-threatening conditions under control. Doctors also take measures to prevent another stroke and limit any stroke-related complications. However, once these steps have been taken, it's common for stroke rehabilitation to start during your acute hospital stay. The sooner you begin stroke rehabilitation, the more likely you are to regain lost abilities and skills.
How long does stroke rehabilitation last?
The duration of your stroke rehabilitation depends on the severity of your stroke and related complications. While some stroke survivors recover quickly, most stroke survivors need some form of stroke rehabilitation long term, possibly months or years, after their stroke. Your stroke rehabilitation plan will change during your recovery as you relearn skills and your needs change.
The length of each stroke rehabilitation therapy session varies depending on your recovery, severity of your symptoms and responsiveness to therapy.
Where does stroke rehabilitation take place?
You'll probably begin stroke rehabilitation while you're still in the hospital. Before you leave, you and your family work with hospital social workers and your care team to determine the best rehabilitation setting for you depending on your needs, what insurance will cover, and what is most convenient for you and your family. These options include:
- Inpatient rehabilitation units. These facilities are either free-standing or part of a larger hospital or clinic. You may stay at the facility for several weeks as part of an intensive rehabilitation program.
- Outpatient units. These facilities are often part of a hospital or clinic. You may spend several hours a day at the unit relearning skills, but you return home each night.
- Skilled nursing facilities. The type of care available at a nursing facility — sometimes referred to as a nursing home — varies. Some facilities specialize in rehabilitation, while others offer less intense therapy options.
- Home-based programs. This type of program — having therapy done in your home — allows greater flexibility than other options. One drawback is you likely won't have access to specialized rehabilitation equipment in your home. In addition, insurance strictly controls who qualifies for home-based therapy.
Talk to your doctor and family about the best option for you.
Who participates in your stroke rehabilitation team?
Stroke rehabilitation involves a variety of specialists, which include:
- Physicians include your primary care doctor as well as specialists in physical medicine and rehabilitation (physiatrists) and neurologists. They help guide your care and prevent complications. They can also offer symptom-modifying medications and treatment options for managing bowel and bladder complications of stroke.
- Rehabilitation nurses specialize in caring for those with limitations to activities. They help incorporate skills learned in physical, occupational and speech therapy into your daily routines.
- Physical therapists help you relearn physical tasks, such as walking and keeping your balance.
- Occupational therapists work with you to relearn functional hand and arm use for daily skills, such as bathing, tying your shoes or buttoning your shirt. They can also address safety issues in your home by suggesting changes or proper home equipment, and they can help with cognitive organizational tasks.
- Speech and language pathologists help improve your language skills and ability to swallow. They may also teach you how to use compensation tools to address memory and thinking problems.
- Dietitians assist you with creating healthy menus, including heart-healthy, low-fat and low-salt foods.
- Social workers help you make financial decisions, as well as help you arrange new living arrangements, if necessary, and identify community resources that may support your recovery.
- Psychologists assess your thinking skills and work to ensure that your mental and emotional health concerns are addressed.
- Therapeutic recreation specialists help you resume activities and roles you enjoyed before your stroke, including hobbies and community participation.
- Vocational counselors help you address return-to-work issues if this is a goal.
What factors affect the outcome of stroke rehabilitation?
Because stroke recovery varies from person to person, it's hard to predict how many abilities you might recover and how soon. However, in general, successful stroke rehabilitation depends on:
- The severity of your stroke
- Your motivation and willfulness
- The skill of your stroke rehabilitation team
- Cooperation of your friends and family — having a good support network has a big effect on your recovery
- Timing of your rehabilitation — the sooner you start, the better you'll do
- Sticking with rehabilitation activities outside of therapy sessions
Stroke rehabilitation takes time
Recovering from a stroke can be a long and — at times — frustrating experience. The difficulties you may face are common and normal. Dedication and willingness to work toward improvement will help you gain the most benefit.