Stroke Recovery: Regaining Mobility And Moving Forward

A stroke occurs when the blood supply to the brain is disrupted, killing brain cells. This can cause a loss of mobility, with the majority of strokes injuring the motor fibres connected to movement. The effects of a stroke can include muscle weakness or paralysis, spasticity, foot drop, loss of sensation, tiredness, coordination problems, and balance issues. However, it is possible to regain movement after a stroke through rehabilitation and physical therapy. The recovery process may involve relearning basic tasks and rebuilding strength and balance. While recovery takes time, moving more after a stroke can boost your recovery, confidence, and wellbeing, as well as reduce the risk of another stroke.

Recovery and rehabilitation

The road to recovery after a stroke is often challenging and differs from person to person. However, rehabilitation and physical therapy are crucial in regaining movement, independence, and confidence.

Regaining Movement and Independence

Post-stroke, individuals often experience difficulty with movement, thinking, and speaking. Rehabilitation helps to address these issues and restore independence in performing daily tasks such as dressing, cooking, and travelling. Physical therapy focuses on improving muscle strength, balance, and coordination, which are commonly affected by a stroke. It is important to start slowly and gradually increase the intensity of exercises to avoid overexertion.

Improving Confidence and Emotional Wellbeing

The process of recovery can be emotionally challenging, and it is common to experience anxiety, stress, and even depression. Engaging in physical activity and exercise can help reduce these negative feelings and boost confidence. Setting and achieving movement goals, trying new things, and meeting new people can all contribute to improved emotional wellbeing.

Timeline for Recovery

The first six months after a stroke are typically when the most significant improvements in movement and balance occur. However, it is important to note that recovery can continue beyond this period, albeit at a slower pace. In some cases, it may take up to two years to fully regain certain functions, such as speaking and driving.

Support Systems

Family and friends play a vital role in the recovery process by providing emotional support and encouragement. Additionally, support groups, stroke clubs, and online communities offer opportunities to connect with other stroke survivors, share experiences, and provide mutual encouragement. Seeking professional help from therapists, doctors, and counsellors is also an important aspect of the recovery journey.

Preventing Another Stroke

The risk of a second stroke is significantly higher after the first, so it is crucial to make lifestyle changes and, in some cases, take prescribed medications to prevent another stroke. This includes maintaining a healthy diet, controlling illnesses such as diabetes and high blood pressure, and engaging in regular physical activity.

Regaining strength and balance

Start Slowly and Build Up

It's important to be patient with yourself and not push too hard, too soon. Everyone's recovery is different, so focus on what works for you and gradually add more movement into your daily routine. Whether seated, walking, alone, or with others, there are numerous ways to stay active.

Gait Training and Balance Training

Gait training and balance training are crucial components of post-stroke rehabilitation. These exercises help you improve your walking, balance, and coordination, as well as strengthen your hips, knees, and ankles to support your body's movement. Common gait deviations after a stroke include decreased gait speed, step length, stance time on the weakened leg, and standing balance. Strengthening key muscle groups can help improve gait quality and reduce the risk of falling.

Consistent Rehabilitative Exercise

Pursuing consistent exercise therapy can help improve strength and coordination in the legs and core, leading to better balance. Physical therapists can recommend specific leg and core exercises, such as functional weight-shifting exercises, balance tasks, and gait training, to enhance your recovery.

Address Foot Drop

Foot drop is a common issue after a stroke, causing the front portion of the foot to drag on the floor, affecting balance and increasing the risk of falling. While braces like an ankle-foot orthosis (AFO) can prevent foot drop, it's also important to address the root cause by practicing foot drop exercises.

Aquatic Therapy

Aquatic therapy, or hydrotherapy, involves practicing rehabilitative exercises in a warm pool. The warmth of the water reduces muscle pain and tension, while the water's resistance builds strength. The buoyancy of the water also reduces the fear of falling, making it an excellent option for improving balance.

Virtual Reality Training Programs

Virtual reality training programs have emerged as a motivating and engaging form of therapy for stroke survivors. These programs often use familiar devices and provide detailed feedback on performance. They can be an effective way to improve balance and are easily accessible for home use.

Yoga

Yoga is a recommended practice for improving balance and motor skills. The postures are adaptable to different skill levels and can be modified based on recommendations from a physical or occupational therapist. Yoga also promotes relaxation, mindfulness, and stress reduction, contributing to overall well-being.

Remember, recovery is a unique process for everyone, and it's essential to consult with your healthcare team to determine the best rehabilitation methods for your specific needs. With consistent practice and dedication, you can work towards regaining strength and balance and improving your overall quality of life.

Independence and confidence

Regaining independence is a key motivator for stroke survivors to get moving again. Post-stroke mobility loss can lead to difficulty walking and having to learn to walk again. This can be a scary and frustrating experience, as it affects your ability to take care of yourself and perform essential tasks like dressing, cooking, and travelling. However, the good news is that the likelihood of regaining function after a stroke increases with the intensity of rehabilitation.

Rehabilitation nurses, physical therapists, and occupational therapists will be crucial in your recovery journey. They will help you relearn basic tasks, such as getting out of a chair or into bed safely, and teach you exercises to rebuild strength and balance. Canes, walkers, and wheelchairs may also be necessary aids during this process. It is important to start slowly and build up your activities over time, discovering what works best for your body.

Being active and moving more can also boost your confidence. Doing something you love and setting movement goals will make you feel good and improve your emotional well-being. It can help reduce feelings of anxiety and stress, and trying new things and meeting new people can further build your confidence.

Remember, recovery takes time, and it's important not to be too hard on yourself. Work closely with your rehab team, and focus on the progress you are making, no matter how small it may seem.

Emotional wellbeing

A stroke can have a huge impact on your emotional wellbeing, and it is normal to experience a wide range of emotions after such a monumental change. You may feel a sense of loss, grief, shock, denial, anger, guilt, frustration, apathy, or a lack of motivation. These emotions can be caused by the physical changes in the brain, or they may be a result of how the stroke has affected your life and abilities.

Acknowledging Your Emotions

It is important to acknowledge and accept your emotions as valid and normal. This can help you cope with them in a healthy way and avoid becoming overwhelmed during your recovery. Realise that you are not alone in experiencing these emotions, and seek support from loved ones, stroke support groups, or mental health professionals.

Common Emotional Changes

• Depression: It is common to experience depression after a stroke, usually within the first year. Signs of depression include feeling sad, empty, irritable, helpless, or hopeless. You may also experience changes in appetite and sleep, lose interest in previously enjoyed activities, and have frequent negative thoughts. If you are having suicidal thoughts, seek immediate help from a crisis team or a helpline.
• Anxiety: Anxiety is also a common emotion after a stroke, with one in four people experiencing it within the first five years. You may feel worried, fearful, restless, or irritable. Physical symptoms can include a racing heart, restlessness, difficulty sleeping, and tiredness. If your anxiety is interfering with your daily life, seek help from a doctor or mental health professional.
• Pseudobulbar Affect (PBA): PBA is characterised by sudden and unpredictable changes in emotions, such as laughing at something sad or crying at something funny. It can make you feel like you've lost control over your emotional responses. PBA is often confused with depression but is a separate condition that can occur simultaneously.
• Anger and Frustration: You may experience anger and frustration due to the changes and losses in your life after a stroke. It can be challenging to control your temper, and this can affect your wellbeing and recovery.
• Apathy and Lack of Motivation: You may feel unmotivated to engage in activities you once enjoyed or accomplish tasks, which can impact your recovery and sense of purpose.

Ways to Improve Emotional Wellbeing

• Connect with Others: Talk to loved ones, join support groups, or participate in online communities specifically for stroke survivors. Sharing your experiences and connecting with others who understand your struggles can be beneficial.
• Engage in Enjoyable Activities: Find activities that bring you joy, such as watching your favourite film, pursuing a hobby, or spending time in nature. These activities can help take your mind off negative thoughts and improve your overall wellbeing.
• Limit Negative Information: Reduce your consumption of negative news or information, as it can contribute to feelings of anxiety. Set aside a short and fixed amount of time to stay informed without overwhelming yourself.
• Seek Professional Help: Discuss your emotional concerns with your doctor, therapist, or counsellor. They can provide guidance, prescribe medication if needed, and help you develop healthy coping mechanisms.
• Stay Active: Exercise and physical activity can boost your mood and improve your emotional wellbeing. Even a short walk or light gardening can have a positive impact.
• Practice Relaxation and Mindfulness: Learn relaxation techniques, such as breathing exercises, meditation, or yoga, to help you manage stress and anxiety. These practices can encourage you to focus on the present moment and improve your overall sense of calm.

Driving and safety

The ability to drive is often a major concern for stroke survivors. While it can be a source of independence and freedom, safety is of utmost importance. Before getting behind the wheel, it is crucial to assess your ability to operate a motor vehicle safely. Here are some considerations and steps to help you determine if it is safe for you to drive after a stroke:

• Consult with your healthcare professional or doctor: Discuss with them whether it is safe for you to drive and if any modifications to your vehicle are necessary. They can provide a professional opinion on how the stroke might have impacted your driving abilities.
• Check with your state's department of motor vehicles: Find out if your physician needs to report your health status before you can drive again and inquire about any other specific requirements or rules that apply to individuals who have had a stroke.
• Consider modifications: Contact a rehabilitation specialist to assess your driving ability and determine if modifications to your vehicle are necessary. They can help you regain confidence and independence on the road.
• Enroll in a driving assessment or training program: These programs can provide a behind-the-wheel evaluation and test your vision perception, functional ability, reaction time, judgment, and cognitive abilities. They can also offer suggestions for modifying your vehicle and improving your driving skills.
• Be aware of warning signs: Pay attention to any warning signs of unsafe driving, such as driving too fast or too slow, needing help from passengers, making poor distance decisions, getting easily frustrated or confused, or drifting across lane markings. If you or your loved ones notice these signs, consider taking a driving test or assessment.
• Alternative transportation options: If you are unable to drive or need to refrain from driving for a period, there are other transportation options available, such as public transportation, paratransit services, voucher programs, or volunteer-based transportation programs.

Remember, each person's recovery from a stroke is unique, and the impact on driving abilities can vary. It is important to be patient with yourself and prioritize safety for yourself and others on the road.

Frequently asked questions