
Stroke rehabilitation can begin as soon as 24 hours after a stroke, with the goal of helping patients regain their independence and improve their quality of life. The timeframe for recovery varies depending on factors such as the severity of the stroke, age, medical history, and prior level of function. Rehabilitation typically involves working with a team of health professionals, including speech therapists, occupational therapists, and physical therapists, to address the physical and cognitive effects of the stroke. While recovery can be a challenging and lengthy process, it is important to start as soon as possible to increase the chances of regaining lost skills and abilities.
Characteristics | Values |
---|---|
How soon can rehab start? | Within 24 hours of a stroke, or within a day or two. |
How long does rehab last? | Weeks, months, or even years. |
Who is on the rehab team? | Physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, nurses, healthcare assistants, rehabilitation assistants, eye specialists |
What does rehab involve? | Setting goals, exercises and activities to re-learn skills, learning new ways of doing things |
What is the goal of rehab? | To help the patient regain their independence and improve their quality of life |
What You'll Learn
Rehabilitation can begin within 24 hours of a stroke
Rehabilitation after a stroke can begin as soon as the patient is stable, which is often within a day or two of the stroke. The faster you receive treatment after a stroke, the better. Starting rehabilitation as soon as possible is vital for recovery.
Initial treatment and hospital stay
After experiencing a stroke, a person will likely be admitted to an emergency department to stabilize their condition and determine the type of stroke. Depending on the severity of the stroke, the patient may need to spend time in intensive care or acute care. The typical length of a hospital stay after a stroke is five to seven days. During this time, the stroke care team will evaluate the effects of the stroke to determine the rehabilitation plan.
The rehabilitation team
The rehabilitation team includes physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses. They meet daily to discuss the patient's condition, and some form of therapy is delivered as often as every hour during the first day or two.
Types of therapy
Therapy sessions are conducted up to six times a day while the patient is in the hospital. Types of therapy include:
- Speech therapy: helps people who have problems producing or understanding speech, as well as those with swallowing disorders.
- Physical therapy: helps patients relearn movement and coordination skills.
- Occupational therapy: focuses on improving daily activities, such as eating, drinking, dressing, bathing, reading, and writing.
- Recreational therapy: helps patients regain social skills.
- Psychotherapy: addresses post-stroke depression or other mental health challenges.
The rehabilitation process
Therapists work with patients to set achievable goals and create a plan to improve cognitive function and develop resilience. Rehabilitation can be challenging, both physically and mentally, but it helps patients make progress in speaking, walking, and other key skills. Family members and friends can also get involved to provide support and help with regular practice.
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The recovery process can be slow and uncertain
The recovery process after a stroke can be slow and uncertain. The timeframe for recovery varies from person to person, depending on factors such as the severity of the stroke, age, medical history, and prior level of function. While some people may recover quickly, for others, it can be a lengthy process that requires patience, perseverance, and hard work.
Rehabilitation plays a crucial role in the recovery process, helping individuals regain their independence and improve their quality of life. It typically begins within a day or two after the stroke, during the initial hospital stay, and can continue for weeks, months, or even years. The rehabilitation team consists of various specialists, including physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses. They work together to address the physical, cognitive, and emotional impacts of the stroke.
In the first few weeks after a stroke, individuals usually undergo intensive inpatient rehabilitation, focusing on restoring their ability to perform daily activities. This may include physical therapy to improve movement and coordination, speech therapy to address communication and swallowing issues, and occupational therapy to relearn essential skills for daily living. The recovery process during this initial phase can be challenging, both physically and mentally, and it often takes a lot of effort and determination to continue with rehabilitation.
While the quickest recovery typically occurs in the first three to four months after a stroke, improvements can continue to be made even after this period. After six months, the rate of recovery slows down, but it doesn't end. Some stroke survivors may continue to see progress for up to 18 months or longer, depending on the ongoing rehabilitation they receive.
It's important to remember that every stroke is unique, and there is no set pattern for recovery. While some individuals may recover almost completely or with minimal impairments, others may experience moderate to severe disabilities that require special care or long-term assistance. The road to recovery can be uncertain, and setbacks or challenges may arise along the way. However, with dedication to rehabilitation and support from loved ones, individuals can maximize their potential for recovery and work towards regaining their independence.
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A swallowing test is important to ensure safe eating and drinking
A stroke is a medical emergency, and the faster you receive treatment, the better. Rehabilitation should start as soon as possible, ideally within 24 hours of a stroke. The rehabilitation team includes physiatrists, neurologists, physical and occupational therapists, speech-language pathologists, and nurses.
A stroke can affect a person's ability to swallow, a condition known as dysphagia. Dysphagia is a common complication following a stroke, and it can have serious consequences. It is important to undergo a swallowing test as soon as possible after a stroke to identify any issues with swallowing. This is because if you have dysphagia, food or drink can enter your lungs instead of your stomach, leading to aspiration pneumonia, malnutrition, dehydration, and weight loss.
A swallowing test will help determine if you need to change the way you eat and drink to ensure safe eating and drinking. Your hospital team will check your swallowing function before you start eating and drinking again. They may use a variety of methods, including a bedside water-swallowing test, a videofluoroscopy (VFS) or modified barium swallow (where you swallow barium and food of different consistencies while an X-ray watches the process), or a fibre-optic endoscopic evaluation of swallowing (FEES), where a small camera is inserted into your nose.
If you have dysphagia, your speech pathologist can advise you on how to modify your diet and eating and drinking techniques to improve your swallowing function. They may recommend a texture-modified diet, such as thick fluids or soft foods, and different positions or movements when eating and drinking. They may also suggest swallowing exercises to strengthen the muscles used for swallowing and improve coordination.
In some cases, if you are unable to eat or drink safely, alternative feeding methods may be necessary, such as a nasogastric tube (NGT) or a percutaneous endoscopic gastrostomy (PEG).
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Physical therapy helps with movement and coordination
Physical therapy is one of the main rehabilitation therapies used to decrease disability and improve movement after a stroke. It can help stroke survivors regain their sense of self-movement (proprioception) and potentially help them regain movement patterns such as getting out of a chair, walking, and climbing stairs.
The type of physical therapy program will be customised to the individual's needs, depending on factors such as the type of movement lost and the degree of disability. For example, the program might focus on simple tasks like trying to pick up an object, or it may involve more complex motor tasks like walking.
- Task-oriented training: This involves going through real-life motions, such as getting up from a chair.
- Strength training: This can be done using weights, the patient's body weight, or bands.
- Walking or balance training: This helps improve the patient's balance and coordination.
- Constraint-induced movement therapy: The patient's strong arm is constrained so they are forced to use their weak arm.
- Electrical stimulation: This technique activates the nerves of the injured muscles.
- Virtual reality or video game tools: These can make the therapy more engaging and interactive.
- Biofeedback: This technique helps the patient gain control over their mind-body connection.
- Aquatic therapy: This involves doing exercises in the water, which can be beneficial for stroke patients.
The duration of physical therapy depends on the severity of the stroke and the patient's level of disability. It may be necessary for months or even years, with several sessions per week. The most rapid recovery usually occurs within the first three to four months.
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Speech therapy helps with communication and swallowing
According to Johns Hopkins stroke rehabilitation specialist Preeti Raghavan, M.D., "starting rehabilitation as soon as possible after the cause of the stroke is treated is vital in stroke recovery". At Johns Hopkins, rehabilitation starts around 24 hours after a stroke. The typical length of a hospital stay after a stroke is five to seven days, during which the stroke care team will evaluate the effects of the stroke and determine the rehabilitation plan.
Speech therapy is one of the most important rehabilitation treatments for stroke patients, helping them to regain important cognitive and communication functions. Speech-language pathologists (SLPs), or speech therapists, are responsible for diagnosing, assessing, and treating disorders related to language, voice, cognition, and the ability to swallow, chew, and more.
Communication
A stroke can cause difficulties with communication, known as aphasia, which affects around 20 to 40 percent of stroke patients. Aphasia is a language-processing disorder that occurs when the brain sustains damage, impairing a person's ability to process and use language. People with aphasia may have trouble understanding what is being said, expressing themselves, reading, writing, and working with numbers. Speech therapy can help stroke patients improve their communication skills by addressing these issues and teaching them strategies to compensate for any remaining deficits.
Swallowing
Difficulty swallowing, or dysphagia, is a common side effect of stroke, as it often affects the muscles involved in chewing and swallowing, such as the lips, cheeks, tongue, jaw, and throat. Speech therapy can help stroke patients relearn how to swallow and use the muscles necessary for this function, as well as for forming sounds in speech.
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Frequently asked questions
Rehabilitation after a stroke can begin as soon as 24 hours after the stroke, but this depends on the patient's health and their doctor's recommendation.
Rehab after a stroke can include working with speech, physical, and occupational therapists. Speech therapy helps people who have problems producing or understanding speech. Physical therapy uses exercises to help restore movement and coordination skills. Occupational therapy focuses on improving daily activities, such as eating, drinking, dressing, and bathing.
There is no set timeframe for recovery from a stroke, as it varies from person to person. Recovery can take weeks, months, or even years. The first three months after a stroke are the most crucial for recovery, and most patients will complete an inpatient rehabilitation program or make significant progress in their outpatient therapy sessions during this time.
Starting rehab as soon as possible after a stroke is vital to the recovery process as it can increase the chances of regaining affected brain and body functions. The sooner rehabilitation begins, the more likely it is to regain lost skills and abilities.