Recovering From A Stroke: Tips For Rehabilitation And Adaptation

Experiencing a stroke can be life-altering, and the recovery process is complex and different for everyone. While some may recover within days or weeks, others may take months or years and have to make significant life changes. The recovery journey is influenced by the severity of the stroke, the area of the brain affected, and the individual's overall health and support system. Here are some key aspects to focus on to get better after a stroke:

- Rehabilitation: Starting rehabilitation as soon as possible is vital. This includes physical therapy, occupational therapy, and speech therapy to address motor, speech, and cognitive functions.

- Medical Team: Work closely with your doctors, therapists, and specialists to create an effective recovery plan. They will help you set goals, provide education, and support you throughout your journey.

- Diet and Exercise: Adopt a healthy diet, such as the Mediterranean diet, and engage in daily exercise to improve your body's ability to heal and reduce the risk of another stroke.

- Mental Health: Prioritize your mental well-being as stroke survivors may experience depression, anxiety, and emotional challenges. Psychotherapy or talk therapy can help address these issues.

- Support Groups: Joining a support group can provide valuable fellowship and resources from others who have gone through similar experiences.

- Home Modifications: Consider modifying your home environment to prevent falls and improve your safety and independence, such as installing grab bars, handrails, and non-slip mats.

- Prevention of Another Stroke: Take steps to reduce your risk of having another stroke, such as treating underlying health conditions, taking prescribed medications, and maintaining a healthy lifestyle.

Rehabilitation: Physio, occupational and speech therapy to aid movement, speech and cognitive functions

Rehabilitation is a crucial aspect of recovery after a stroke, and physio, occupational, and speech therapy play vital roles in aiding movement, speech, and cognitive functions.

Physio and Occupational Therapy

Physiotherapy and physical therapy (PT) focus on improving movement, mobility, and function. Physiotherapists employ exercises, stretches, and physical activities to help individuals regain strength and increase their range of motion, making it easier to move with less pain and discomfort. PT is particularly beneficial for those experiencing movement impairments after a stroke, such as hemiplegia or hemiparesis.

Occupational therapy (OT), on the other hand, concentrates on enhancing one's ability to perform daily tasks more easily. OT aims to improve fine and gross motor skills, enabling individuals to carry out specific day-to-day activities. Occupational therapists may assist with relearning essential tasks like dressing or eating and making home modifications, such as installing grab bars in the shower, to ensure a safer environment.

Both physio and occupational therapy are crucial components of a comprehensive rehabilitation plan, with physio therapy focusing on the physical aspects of recovery, while occupational therapy helps individuals regain independence in their daily lives.

Speech Therapy

Speech therapy addresses two critical areas: swallowing and cognition. Speech therapists work with individuals to improve their ability to swallow food and liquids safely, preventing issues like choking or aspiration. They also evaluate and treat problems with cognition, which are the mental processes of gaining information, comprehending it, and making decisions.

Speech therapists assist with key cognitive issues such as orientation, helping individuals understand who they are, where they are, and the current time and date. They also work on sequencing, aiding individuals in understanding and executing a set of actions in the correct order, and memory, developing strategies for memory deficits and improving retrieval abilities.

Combined Approach

Physio, occupational, and speech therapy often work together in a rehabilitative setting. They collaborate to treat patients holistically, addressing their physical, cognitive, and functional needs. This combined approach ensures that individuals recovering from a stroke can regain their independence and improve their overall quality of life.

Prevent another stroke: Understand the warning signs and take preventative measures

Having a stroke puts you at high risk of having another one, with one in four strokes each year being a repeat. In the first three months after a stroke, a survivor's risk of having another is 15 times greater than the general population. Therefore, it's crucial to be aware of the warning signs and take preventative measures.

Warning signs of a stroke

• Facial drooping
• Arm weakness
• Slurred speech
• Vertigo
• Sudden dizziness
• Changes in vision
• A severe headache

Preventative measures

• Treat the causes of stroke, including diabetes, AFib, heart disease, high blood pressure, and high cholesterol.
• Take medications as prescribed by your doctor.
• Follow a healthy lifestyle, including a healthy diet, regular exercise, and avoiding smoking.
• Explore surgery if needed.

Diet: Consult a dietician for advice on foods to aid recovery and prevent another stroke

Diet is an important part of recovery following a stroke. Consult a dietician to ensure you are getting the right nutrition to aid your recovery and prevent another stroke.

Brain-Derived Neurotrophic Factor (BDNF)

Foods that promote Brain-Derived Neurotrophic Factor (BDNF) are important for stroke recovery. BDNF is a protein that supports the growth of new brain cells and promotes neuronal connections within the brain. This is critical for the process of neuroplasticity, the brain’s ability to rewire itself after an injury like a stroke.

Omega-3 fatty acids

Omega-3 fatty acids help maintain BDNF levels and promote neuroplasticity. Fatty fish like salmon contain an omega-3 fatty acid called EPA, which can help during stroke recovery. Flaxseeds are another great source of omega-3 fatty acids, providing alpha-linolenic acid (ALA) which boosts BDNF, neuroprotection, and neuroplasticity.

Vitamin E

Nuts and seeds are a good source of vitamin E, which is associated with lowering the risk of cognitive decline. Vitamin E is beneficial for stroke recovery due to its antioxidant properties that protect cells from free radical damage and improve cognitive function.

Avocados

Avocados are rich in oleic acid, a nutrient that helps the areas of your brain responsible for processing information to perform at optimal speed. Avocados are also a great source of antioxidants, which may also act as neuroprotective agents.

Eggs

Eggs are a beneficial source of protein for stroke patients, especially those with swallowing difficulties (dysphagia) as they are soft and can be cooked in a variety of ways. According to research, eating eggs can also help prevent another stroke.

Olive oil

Olive oil helps increase the amount of apolipoprotein in your body, a protein that can lower the risk of heart disease. However, be careful not to overconsume olive oil and only use it when appropriate, such as a salad dressing or cooking ingredient.

Whole grains

Whole grains, such as quinoa, can lower the risk of stroke. Quinoa is rich in fibre and contains all the amino acids necessary to form a complete protein, making it an excellent choice for stroke patients.

Greek yoghurt

Greek yoghurt is a great source of calcium and protein, as well as probiotics, which promote gut health and may reduce the future risk of stroke. It is also a softer food option for those with swallowing difficulties.

Caffeine

Caffeine can cause a short-term spike in blood pressure, so it should be avoided if you have high blood pressure. Green tea is a healthy alternative, as it is high in antioxidants and flavonoids. Research has shown that stroke survivors who drank several cups of green tea per day lowered their risk of death by 62%.

Vegetables

Vegetables are an essential part of a healthy, balanced diet. Legumes, such as beans, lentils, and peas, are excellent sources of potassium, iron, and protein. Beans are also rich in magnesium, which aids in neuroprotection.

Fruits

Fruits are rich in flavonoids and antioxidants, which help reduce inflammation and ischemic damage after a stroke. They also help lower cholesterol and blood pressure, reducing the risk of stroke. Citrus fruits, in particular, help protect brain cells, strengthen blood vessels, and reduce inflammation.

Alcohol

Drinking alcohol increases your risk of having another stroke, so it is important to ask your doctor for advice on alcohol consumption.

Foods to avoid

It is crucial to limit the consumption of foods containing excessive salt, sugar, and saturated fats. These can contribute to high blood pressure and cholesterol, increasing the risk of another stroke.

Mediterranean Diet

The Mediterranean Diet is a common approach to stroke prevention, focusing on fresh produce, lean protein, and healthy fats such as olive oil.

DASH Diet

The DASH Diet (Dietary Approaches to Stop Hypertension) is another great option for stroke patients, as it helps manage blood pressure by staying within the recommended daily intake of sodium.

MIND Diet

The MIND Diet is a hybrid of the Mediterranean and DASH diets, encouraging the consumption of green vegetables, berries, and beans, while discouraging the consumption of margarine, cheese, and pastries. This diet helps manage stroke risk factors such as atherosclerosis and obesity.

Mental health: Post-stroke depression is common; psychotherapy can help

Post-stroke depression is a common complication, affecting nearly 30% of stroke survivors, either in the early or late stages of recovery. It can negatively impact functional recovery and quality of life, yet it is often ignored. It is important to be aware of the signs of post-stroke depression, as it can affect a person's motivation to engage in their recovery.

Risk factors for post-stroke depression

• Increasing stroke severity
• Functional dependence
• Presence of cognitive impairment
• History of previous depression
• Communication deficits
• Social isolation

Symptoms of post-stroke depression

• Depressed mood or loss of interest or pleasure
• Weight loss
• Insomnia
• Psychomotor agitation
• Fatigue
• Feelings of worthlessness
• Diminished concentration
• Suicidal ideation

Treatment options for post-stroke depression

Post-stroke depression can be treated with either pharmacological or non-pharmacological approaches, or a combination of both.

Pharmacological treatments

Antidepressants: These can help reduce depressive symptoms and improve functional recovery. However, they may have side effects, and the choice of antidepressant should be made in consultation with a healthcare professional.

Non-pharmacological treatments

• Cognitive-behavioural therapy (CBT): This can help manage depressive symptoms and improve anxiety, tiredness, memory, concentration, thinking, and mood.
• Interpersonal therapy: This focuses on improving interpersonal relationships and communication.
• Problem-solving therapy: This is a brief "talking therapy" that teaches structured approaches to solving problems.
• Other therapies: Music, mindfulness, and motivational interviewing are also emerging as potential treatments.

Benefits of psychotherapy for post-stroke depression

Psychotherapy can help stroke survivors:

• Improve their mental health and well-being
• Address the emotional impact of the stroke
• Develop coping strategies
• Improve their quality of life

Home adaptations: Prevent falls and improve independence with home modifications

After a stroke, it's important to make adaptations to your home environment to prevent falls and improve your independence. Here are some ways to achieve this:

• Install grab bars and handrails: Install grab bars in areas like the bathroom and handrails on staircases to provide support and stability when moving around.
• Add non-slip mats: Place non-slip mats in the bathroom, especially in the shower or bathtub, to prevent slipping and falling.
• Remove tripping hazards: Get rid of any loose rugs, clutter, or obstacles that could cause you to trip and fall. Ensure walkways are clear and well-lit.
• Modify the kitchen: If you have reduced mobility, consider modifying your kitchen to make food preparation easier. This could include adjusting countertop heights or installing special cabinets for easier access.
• Enhance lighting: Improve lighting throughout your home, especially in hallways and staircases, to reduce the risk of falls and improve visibility.
• Relocate essential items: Move frequently used items to easily accessible locations. For example, keep everyday dishes and cookware within reach to avoid the need for stepping stools or excessive reaching.
• Install a shower chair or bench: Consider using a shower chair or bench in the bathroom to reduce the risk of falling while bathing. This is especially helpful if you experience fatigue or balance issues.
• Use adaptive equipment: Work with your occupational therapist to identify adaptive equipment that can aid in daily activities. This could include specialized utensils for eating, dressing aids, or devices to assist with mobility.
• Review home safety with a therapist: Consult a physical or occupational therapist to conduct a home evaluation. They can provide expert recommendations tailored to your specific needs and suggest additional modifications to maximize your safety and independence.

By implementing these home adaptations, you can enhance your safety, prevent falls, and improve your ability to independently perform daily activities as you recover from a stroke.

Frequently asked questions