Stroke Recovery: Regaining Letter Identification And Beyond

can a stroke victim regain & letter idenification

A stroke is a medical emergency that requires immediate attention. It occurs when a blood vessel to a part of the brain becomes clogged or bursts, affecting the brain's ability to function properly. The effects of a stroke vary depending on the location and severity of the stroke, but often include physical, cognitive, and emotional symptoms. One common effect is reading difficulties, also known as acquired dyslexia or alexia, which can interfere with daily tasks such as following written instructions or using a computer. The good news is that stroke patients can regain their ability to read and identify letters through spontaneous recovery, direct practice, or compensatory strategies. The rehabilitation process is crucial for improving function and independence, and it often involves a team of specialists, including physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses. The most rapid recovery usually occurs during the first three to four months, but improvements can continue well into the first and second years.

medshun

Reading difficulties, also known as acquired dyslexia or alexia, can cause issues with following instructions, paying bills, or using a computer

Reading difficulties, also known as acquired dyslexia or alexia, are common after a stroke and can cause issues with following instructions, paying bills, or using a computer. This can occur even if the person's writing ability is intact. The ease and pleasure of reading are often replaced by effort and frustration, and this inability to read can interfere with work and recreation.

There are many different types of dyslexia caused by strokes, and this variety is due to the way normal reading ability is organised in the brain, as well as the size and location of the stroke. The brain's left hemisphere supports most language functions, including reading, but the right hemisphere also has some normal reading ability. This means that a person with a left hemisphere stroke may be able to regain some reading ability through the injured left hemisphere or the right hemisphere.

Silent reading is often easier than reading aloud following a stroke because word retrieval is a lingering challenge for most stroke patients. This difficulty in recalling words for speech can affect reading aloud and conversation. Some individuals may also have trouble recognising written words or abstract ones, which may be harder to read than regularly spelled or concrete words. There may be a difference in a survivor's ability to read single words versus sentences or paragraphs.

There are some strategies that can help those with reading difficulties:

  • "Sounding out" letters: Presenting individual letters or letter combinations such as "B" or "CH" and asking the person to say the corresponding sound. It is important to note that this exercise requires the person to produce the sound, not the name, of the letter. For example, the letter "S" makes the "sssssss" sound. Start with a small set of letters and gradually add more letters over multiple practice sessions.
  • Recognising whole words: Some people have particular difficulty reading whole words that cannot be sounded out, such as "yacht" or "island". Pairing a written word with the corresponding picture can help the person recognise the word and understand its meaning. This can be done by reading magazine or newspaper headlines with associated pictures, surfing the internet for web pages with words and pictures, or watching television with written words on the bottom of the screen.
  • Focusing visual attention: Some people with acquired dyslexia have difficulty reading sentences or paragraphs because they can't focus their visual attention on one word at a time. Visual distraction can be reduced by cutting a "window" in a piece of paper and then moving the window along a line of text so that it can be read one word at a time.

There are also some ways to compensate for reading difficulties:

  • Audiotape resources: Many individuals use audiotape resources such as Books on Tape. Instructional materials for hobbies and interests are available on audiotape and videotape, and computers can also scan text and read it aloud.
  • Reducing reading demands: The reading demands of daily activities can be reduced with new routines or strategies. For example, instead of a written shopping list, take recognisable product logos to the grocery store.

medshun

Aphasia, a language disorder caused by strokes in the left side of the brain, affects one's ability to communicate

Aphasia is a language disorder that affects an individual's ability to communicate. It is caused by damage to the language-dominant side of the brain, which, for most people, is the left side. Aphasia impairs one's ability to express and understand language, as well as their ability to read and write. While it mostly occurs following a stroke or head injury, it can also develop slowly due to a brain tumour or progressive neurological disease.

The left side of the brain contains different aspects of language in different parts, and the type of aphasia a person experiences depends on which part of the brain is affected by the stroke. For example, a stroke that affects the frontal regions of the left hemisphere results in Broca's aphasia, which impacts how words are strung together to form complete sentences. People with Broca's aphasia may leave out small words such as "is" or "the", speak in short phrases, and have difficulty understanding sentences. On the other hand, a stroke that affects the temporal lobe of the brain may result in Wernicke's aphasia, the most common type of fluent aphasia. People with Wernicke's aphasia may speak in long, complete sentences that are meaningless, adding unnecessary words or even creating made-up words. They also have trouble understanding speech.

Global aphasia, another type of aphasia, results from damage to extensive portions of the language areas of the brain. Individuals with global aphasia have severe communication difficulties and may be extremely limited in their ability to speak or comprehend language. They may be unable to say a few words or may repeat the same words or phrases over and over again.

Aphasia can be diagnosed using language tests conducted by a speech-language pathologist. These tests include studying speech, naming, repetition, comprehension, reading, and writing. Imaging procedures such as CT scans, MRI scans, and positron emission tomography can also be used to look at the brain.

Treatment for aphasia depends on the individual's symptoms, age, general health, and the severity of the condition. The goal of treatment is to improve the ability to communicate through methods such as speech-language therapy, nonverbal communication therapies, and group therapy for patients and their families. While some people with aphasia fully recover without treatment, most people continue to have some degree of aphasia. Speech therapy can help individuals recover some speech and language functions over time, but communication can still be challenging and frustrating for both the person with aphasia and their loved ones. It is important for family members to learn effective communication strategies and to be patient with their loved one.

medshun

Physical therapy can help stroke victims with dizziness, imbalance, and completing daily activities

Stroke victims often experience dizziness and imbalance, which can be addressed through physical therapy. Vestibular rehabilitation (VR) is a specialized form of physical therapy that addresses problems in the vestibular system, which is responsible for maintaining balance and equilibrium. VR can help reduce dizziness with head movements, sensitivity to busy environments, and loss of balance. It uses specific exercises involving head and eye movements to retrain the vestibular system and decrease sensitivity to visual movement, thus improving balance and coordination.

In addition to VR, there are other physical therapy interventions that can help stroke victims with dizziness, imbalance, and completing daily activities. These include:

  • Passive and active range of motion exercises: Passive exercises involve assisting the affected side through movement, either by the individual's non-affected side or with the help of a caregiver or therapist. Active exercises are performed independently without assistance.
  • Gait training: This includes task-specific overground locomotor training and treadmill training to improve walking endurance and speed.
  • Strengthening exercises: Progressive resistance exercises, virtual learning, and muscle re-education can help improve muscle strength and endurance.
  • Postural control and balance exercises: These focus on improving postural alignment, symmetry, and use of the affected side, as well as manipulating the base and surface of support.
  • Flexibility and joint integrity exercises: Active and passive range of motion exercises, stretching, soft tissue mobilization, and robot-assisted therapy can help improve joint mobility and integrity.

The goal of physical therapy is to help stroke victims regain functional independence and improve their ability to perform daily activities. By addressing dizziness and imbalance through specialized therapies and exercises, stroke victims can enhance their overall quality of life and reduce the impact of stroke on their daily routines.

medshun

Post-stroke depression is common, affecting 30-50% of survivors, and can hinder recovery

Post-stroke depression is a common complication, affecting around a third of stroke survivors. It can have a detrimental effect on a patient's quality of life and functional recovery. It is often caused by biochemical changes in the brain, which can prevent the person from feeling positive emotions.

Symptoms of post-stroke depression may include persistent sadness, restlessness, feelings of hopelessness, loss of interest in activities, decreased energy, difficulty concentrating, changes in appetite and weight, and thoughts of death or suicide. It is important to note that if these feelings persist for longer than two weeks and are accompanied by thoughts or actions of self-harm, immediate professional help should be sought.

Post-stroke depression is often accompanied by anxiety, and this combination can further hinder the recovery process. However, effective treatments and strategies are available, and the correct support can improve a patient's physical, cognitive, and intellectual recovery.

Research has shown that post-stroke depression is more prevalent in younger patients, female patients, and those with higher disability scores. It is also more common in patients with localized strokes in the medial left hemisphere.

medshun

Stroke rehabilitation includes physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses

Stroke rehabilitation is a multidisciplinary approach involving physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses. Each of these professionals plays a crucial role in helping stroke victims regain their physical and cognitive functions and improve their quality of life.

Physiatrists

Physiatrists are doctors who specialize in physical medicine and rehabilitation. They focus on restoring functional abilities and improving quality of life for people with disabilities or injuries. Physiatrists are involved in the medical and functional assessment of stroke patients and play a key role in determining the most appropriate rehabilitation facility for each patient. They work closely with other members of the interdisciplinary rehabilitation team to address the patient's rehabilitation needs.

Neurologists

Neurologists are doctors who specialize in treating conditions of the brain and nervous system. After a stroke, neurologists assess the patient's condition and functioning, including physical and neurological examinations, to develop a treatment plan. They may recommend surgery or other treatment methods to help restore lost functioning. Neurologists are crucial in the recovery process as they help address the decreased cognitive functioning that can occur even after the stroke event.

Physical and Occupational Therapists

Physical therapists work with stroke patients to improve their strength, coordination, and balance. They may use exercises, stretching, and range-of-motion activities, as well as training on mobility aids. The goal is to help patients regain the ability to perform everyday activities such as walking, dressing, and bathing.

Occupational therapists, on the other hand, focus on helping stroke patients regain their ability to perform activities of daily living (ADLs). This may involve adapting the patient's environment or using adaptive equipment to facilitate their independence. Occupational therapists play a crucial role in helping stroke victims regain independence and confidence in their daily lives.

Speech-Language Pathologists

Speech-language pathologists (SLPs) are essential in the rehabilitation process, especially for stroke survivors with dysphagia (swallowing difficulties) and communication impairments. SLPs are involved in screening, formal assessment, and management of these issues. They also educate carers and staff on strategies to support the patient and make necessary environmental modifications. SLPs play a vital role in improving the patient's ability to communicate and participate in their rehabilitation program effectively.

Nurses

Nurses play a central role in stroke rehabilitation by providing holistic nursing care to patients and their families or carers. They help address the significant negative effects of stroke on the lives of patients and their loved ones. Nurses also play a crucial role in stroke prevention by implementing effective stroke prevention strategies and contributing to improved outcomes.

Frequently asked questions

The recovery timeline for stroke patients varies depending on several factors, including the severity of the stroke, the area of the brain affected, and the patient's health before the stroke. However, the first three months after a stroke are considered the most crucial for recovery, with the fastest improvements usually occurring during this period. Some survivors may continue to recover well into the first and second year.

The long-term effects of a stroke differ from person to person. They may include cognitive symptoms such as memory problems and aphasia (a language disorder affecting communication abilities), physical symptoms such as weakness, paralysis, and difficulty swallowing, and emotional symptoms like depression and impulsivity.

You can use the acronym B.E.F.A.S.T. to remember the warning signs of a stroke:

- Balance: Sudden loss of balance

- Eyes: Vision loss

- Face: Drooping or uneven smile

- Arm: Weakness or numbness in one arm

- Speech: Slurred speech or difficulty speaking

- Time: Call 911 immediately if you notice any of these signs

Written by
Reviewed by
Share this post
Print
Did this article help you?

Leave a comment