The effects of a stroke are greatest immediately after the stroke occurs. From that point on, you may start to improve. However, the speed with which you improve, as well as how well you improve, depends on the extent of your brain injury and your response to rehabilitation.
Key points to keep in mind about improvement and recovery after a stroke:
- Recovering your abilities begins after the stroke is over and you’re medically stable.
- Some improvement occurs spontaneously and relates to how the brain works again after it’s been injured.
- Stroke rehabilitation programs help you improve your abilities and learn new skills or coping techniques.
- Depression after stroke can interfere with rehabilitation and is important to treat just as the stroke itself.
- Improvement often occurs quickly in the first months after a stroke. It continues with your ongoing efforts.
What is Involved in Rehabilitation?
Rehabilitation actually starts in the hospital as soon as possible. Once patients are stable, rehabilitation may begin within 24 to 48 hours after a stroke occurs. During this acute phase, clinical rehabilitation priorities of the Stroke Unit Rehabilitation Team (SURT) include:
- Prevention of complications
- Initiation of early interventions, applying standard evaluation
- Clinical analysis of functional abilities
Some of the first steps of rehabilitation involve promoting independent movement, because many patients are paralyzed or seriously weakened. For example, you’ll be asked to change positions frequently while lying in bed and engage in passive or active range-of-motion exercises to strengthen stroke-impaired limbs. (Passive range-of-motion exercises involve a therapist helping a patient move limbs repeatedly. Active exercises can be performed by a patient with no physical assistance from the therapist.) Generally, you will progress from sitting up and transferring between the bed and a chair to standing, bearing your own weight and walking—with or without assistance.
Rehabilitation continues to evolve as new techniques become available. Depending on the severity of a stroke, rehabilitation options may include:
- A rehabilitation unit in the hospital or at a rehabilitation hospital
- Home therapy
- Home with outpatient therapy
- A long-term care facility that provides sub-acute therapy and skilled nursing care
The Goal of Rehabilitation
The goal in rehabilitation is to improve function so you can become as independent as possible. This should be accomplished while preserving dignity and motivating you to relearn old skills that the stroke may have taken away which may include eating, dressing and walking. Rehabilitation also teaches new ways of performing tasks to compensate for any residual disabilities. Some patients need to learn to bathe and dress using only one hand, or how to communicate effectively when their language ability has been compromised. There is a strong consensus among rehabilitation experts that the most important element in any rehabilitation program is carefully directed, well-focused, repetitive practice.
Even though rehabilitation cannot reverse the damage caused to the brain by stroke, it can substantially help you achieve the best possible long-term outcome.