In order to understand the recovery and rehabilitation after a stroke, it is important to understand what has happened to the body when someone has a stroke.
A stroke or “brain attack” occurs when a blood clot blocks an artery or when a blood vessel breaks, interrupting blood flow to an area of the brain. When either of these events happen, brain cells begin to die and brain damage occurs. This includes muscle and nerve damage. Depending on which area of the brain is affected and how much of the brain is affected, a person may lose their ability to speak, move certain body parts and process information. For example, when someone has a minor stroke, they may experience minor problems such as weakness in an arm or leg; however, if someone suffers a massive stroke, they may be paralyzed on one side of their body or lose their ability to speak.
Because the stroke damages neuromuscular system, a very effective way to regain function is physical therapy. Physical therapists specialize in neuromuscular problems and how to solve them in a natural way. So whether the stroke was minor or massive, physical therapy can help the patient recover and provide education to help in the future.
How much you can recover following a stroke depends on the size and location of the stroke, how quickly you receive care, and, in some cases, other pre-existing health conditions. Rehabilitation should begin very soon after your stroke. The therapist’s main goal will be to help the patient return to independent normal activities at home, in the community and at work. The physical therapist will conduct an examination, evaluate the patient’s condition and develop a customized plan focusing on improving the patients functional abilities.
Depending on the results of the severity of the stroke, other pre-existing conditions and the time lapse since the stroke, treatment will vary. For example, if a patient had a massive stroke, their initial goals are likely to include being able to move around in bed, sit up, transfer to a chair or wheelchair and walk with an assistive device such as a walker or cane.(Complete tyranny of low expectations displayed here. You can't accept your stroke providers being so accepting of their failure to get you 100% recovered. It is their failure, NOT YOURS, to not get to 100%)
Stroke recovery continues throughout life. It may be years before a person’s maximum potential is reached if the damage is severe. For example, if the patient had a massive stroke and experienced paralysis on the left side, has been to therapy but is still experiencing difficulty performing daily activities, the patient needs additional therapy. No one should settle for less than they can achieve, so continue to look for an experienced physical therapist. Often due to insurance issues patients are discharged from inpatient physical therapy or home health physical therapy but can still receive physical therapy on an outpatient basis. It is essential that the patient resolve any lingering weakness, balance, and/or pain issues to improve their quality of life and help prevent accidents or falls in the future.
On a general note, some people recover completely from a stroke(10%, bet you won't be one of the lucky ones). Unfortunately more than two-thirds of stroke survivors live with some type of disability despite diligent medical and rehabilitation efforts. So it is best to prevent strokes before they happen and thankfully up to 80 percent of strokes are preventable. Some risk factors for stroke cannot be changed, such as age, gender, family history, race (e.g., stroke death rates are higher for African Americans even at younger ages) and previous heart attack or stroke. But there are many other stroke risk factors that you can be changed with the following actions:
  • Control high blood pressure (take medication as prescribed)
  • Stop smoking
  • Reduce high cholesterol/increase HDL
  • Reduce risk of diabetes and/or tightly control diabetes
  • Reduce risk of carotid artery disease
  • Lose weight (try moderation, eliminating processed foods, eating fresh/healthy/whole)
  • Increase physical activity (walk, hire a trainer, join a class, stretch)
  • Reduce how you perceive/react to stress (deep breathing, cognitive therapy, quiet time)
  • Consider yoga (restorative yoga is improves blood/oxygen flow)
  • Change your diet (avoid excess sugar, processed foods, eat organic/local)
  • Stay hydrated (most people are dehydrated, drink clean water – avoid plastic containers)
As you can see, all of these risks can be reduced through lifestyle changes, such as improving your diet, reducing how you perceive and react to stress and regular exercise. Whether you have had a stroke or not, a physical therapist can help design an exercise program that will help strengthen your muscles, improve your balance, and improve your overall cardiovascular health. This is particularly important for those who have suffered a stroke and fear or hopelessness is preventing their movement toward better health.
Strokes are the fourth leading cause of death in America and a leading cause of adult disability. The sooner a stroke is identified and a person seeks medical attention, the better the outcome. The following mnemonic, taken from Dr. Jill Bolte Taylor’s book, My Stroke of Insight, is useful in helping to identify symptoms related to stroke:
S = Speech, or problems with language
T = Tingling, or numbness in your body
R = Remember, or problems with thinking
O = Off-balance, or problems with coordination
K = Killer headache
E = Eyes, or problems with vision
A stroke is a medical emergency. Call 911.
Dr. Leon Bradway PT MS OMPT is owner of the Sports, Back & Pain Management Clinic in Bryan. He has developed conditioning programs and rehabilitated division one college athletes, high school and middle school athletes and elite military forces. He believes that most injuries can be prevented and that no one should have to live in pain as there are natural solutions that work.