Stroke Rehabilitation

What is stroke rehabilitation?

Stroke rehabilitation helps you learn how to do things that you did before you had a stroke. When a stroke occurs, parts of the brain are damaged permanently. Other parts of the brain around the stroke area may be damaged temporarily and may start working normally again after the stroke. Sometimes, a different part of the brain "takes over" for a part damaged by the stroke.

A stroke can affect your senses, movement of your muscles, and speech. Often it causes paralysis or weakness on one side of the face or body. A stroke can also change behavior, thoughts, and memory. Familiar objects from the past may not be familiar anymore. The mental problems caused by a stroke can be very serious. Stroke survivors may cry easily or laugh uncontrollably. Depression is common. It is important for the family of a stroke survivor to understand that many mental problems, even personality changes, may be caused by a stroke. People who have had a stroke need support as they recover.

Your healthcare provider will be able to tell what kind of rehabilitation (rehab) will help. Rehab can start after the stroke is over and the person's condition is stable. This is usually within days after the stroke.

Most people who have had a stroke do get better. How fast and how much they get better depends on how bad the stroke was. Most of the recovery that is possible will occur within 6 to 12 months after the stroke.

Rehabilitation helps you get maximum recovery. Rehab teams also help you adapt if your recovery is not great. The team helps you manage new disabilities so you can be as independent as possible.

There are 3 main kinds of stroke rehab:

• Physical therapy (PT) helps restore physical abilities and skills like walking and range of movement. PT works on problems such as partial or one-sided paralysis, balance problems, weakness, and foot drop.
• Occupational therapy (OT) involves relearning the skills needed for everyday living such as eating, using the toilet, dressing, and taking care of yourself.
• Speech therapy is another major part of stroke rehab. It may also be called speech and language therapy. Some stroke survivors can think as well as they could before the stroke, but they cannot get the right words out or process words coming in. This is usually caused by a stroke on the left side of the brain. Speech language therapists can also help with memory loss and other thought problems caused by the stroke.

Most insurance covers the cost of stroke rehab programs. Primary care doctors can supervise simple rehab programs. Specialists ("rehab doctors" who are board certified in physical medicine and rehabilitation) direct more complex rehab problems.

What will I do in rehab?

What you do in rehab depends on what you need to relearn. You may work to become more independent in many areas. These include:

• self-care skills such as feeding, grooming, bathing, and dressing
• skills for getting around, such as walking or propelling a wheelchair
• communication skills in speech
• thinking skills such as memory or problem solving
• skills for interacting with other people.

Depending on how bad the stroke was, you may have rehab treatments in:

• a rehab unit in the hospital
• a rehab clinic
• your home
• a long-term care facility that provides therapy and skilled nursing care.

What are the benefits?

The most valuable benefits of stroke rehab are independence and improved quality of life. Stroke rehab can help you and your family during a difficult time. Between 10% and 20% of stroke survivors recover almost completely. About half of the rest recover with minor impairments. The other half will have moderate to severe impairments requiring special care.

For more information see Resource List: Stroke.

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