Health Take-Away: Therapy can maximize stroke recovery
Stroke can be a very complicated diagnosis. Some patients walk out of the hospital a few days after suffering a stroke without any obvious signs of disability. Others may be hospitalized for weeks or more and leave with very visible signs of a serious blow to their brain. But in every case, people who have had a stroke are never quite the same.
This doesn't mean that they can't get back to their lives, their families and friends. A stroke occurs when a blood vessel is blocked or ruptured, depriving a part of the brain with the blood and oxygen it needs and causing brain cells to die. Strokes come in all varieties, from minor to very severe. In almost every case, stroke patients need a period of rehabilitation to help them relearn skills that were lost when stroke affected part of their brain.
Their journey will begin as soon as they are able to participate in rehabilitation while still hospitalized in an acute care hospital bed. From there, they may be transferred to the rehabilitation unit of the hospital, where therapy will increase to several hours a day. Patients can next be transferred to a skilled nursing facility for more therapy, or to home — often with therapists visiting them daily. And many continue with therapy on an out-patient basis until they have regained as much function as possible.
In fact, therapy will become an integral part of the lives of stroke patients and their loved ones for weeks, months and maybe even years. People can and do continue recovering for a long time. In the best-case scenario, patients should be under the care of a multidisciplinary team that includes their primary care physician, a physician who specializes in rehabilitation, plus physical, occupational and speech therapists who each bring their own area of expertise to the patient, and who work creatively together so that the individual needs of each patient are met.
Rehabilitation that begins as soon as possible can make a world of difference in the outcome. Therapists meet each patient where they are in terms of their ability and create a rehab plan that will gradually bring the stroke survivor to the next step. Once there, they work toward new goals. The focus is on maximizing essential functions that will improve their quality of life and help patients be as independent as possible.
Physical therapists focus on improving movement and balance with exercises to strengthen muscles needed for standing, walking and other activities. Occupational therapists help stroke survivors better manage daily activities such as dressing, preparing meals and living safely at home. Speech and language pathologists work with stroke patients to re-learn language skills like talking, reading and writing. They also help with swallowing problems that can affect some stroke patients.
In the process, the rehab team works together to enhance the progress of each patient, creating unique strategies that can help them compensate for lost function, adapt to a new way of life, and maximize every possibility for improvement. Their collaboration means that they look at each patient from three potential angles, often embedding a physical, occupational and speech-related component into many of the patient's therapy sessions.
Stroke rehab therapists are highly skilled caregivers who have deep understanding of the complex function of the brain, and how to guide patients back to the best life possible after stroke. They also understand that this disease can impact an entire family. They help their patients' loved ones maintain realistic expectations and suggest ways to continue useful practices at home. And they encourage participation in stroke support groups where patients and families can voice their hopes and fears, while also finding strength and even great ideas from each other.
Jessica Dellaghelfa, DPT, is a physical therapist and Natacha Dockery-Livak, M.A.,M.S., CCC-SLP, is a speech and language pathologist at the BMC Center for Rehabilitation.
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