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Life after a stroke - Stroke rehabilitation and recovery.

 7 minute read

After suffering from a stroke, most patients want to know if they will make a full recovery and how long it will take. After treatment, doctors make a recovery plan that their patients need to follow. The recovery plan prepared is determined by different factors, such as the type of stroke the patient is suffering from and the magnitude of the disease.

Types of stroke

Stroke is the number 1 cause of disability in America and the fifth leading cause of death among Americans. Here are different types of strokes.

Ischemic Stroke Infographic

 Ischemic Stroke: This type of stroke accounts for about 87% of all recorded stroke cases. Ischemic stroke occurs when there is a blood clot at the blood vessel supplying blood to the brain. Moreover, atherosclerosis can also result in cerebral embolism in that the blood stops flowing to the brain.

 

Hemorrhagic Stroke: This type of stroke occurs when the blood vessels in the brain rupture, thus spreading blood to the brain. The disease is usually caused by high blood pressure and arteriovenous malformations (AVM). Hemorrhagic stroke can either happen intracerebral or subarachnoid.

 

Transient Ischemic Attack (TIA): This type of stroke occurs when a temporary clot affects the blood vessels supplying blood to the brain. However, when diagnosed early, the clot can be removed to prevent permanent damage. Transient Ischemic Attacks are a sign of subsequent major strokes in the future.

 

Brain Stem Stroke: This type of stroke occurs when the brain stem is affected. This stroke affects both sides of the body. Patients suffering from this kind of stroke can't make any movements in any part of the body below the neck. Although brain stem stroke can be hard to diagnose, the patient's recovery process depends on how soon the blood starts flowing on the affected parts.

 

Cryptogenic Stroke: A patient is diagnosed with cryptogenic stroke if the doctors can't determine what caused the stroke.

 

The Brunnstrom Stages of Stroke Rehab


The Brunnstrom stages are determined by the motor development and reorganization of a patient's brain after stroke. The brain works by engaging all functioning reflexes to detect movement. Next, the brain sorts out the good reflexes and adopts them.

 

Stage 1: Flaccidity. The flaccidity stage is when the affected muscles can't move and mostly feel floppy and limp. At this stage, the brain doesn't send signals to the affected muscles to make them active. Doctors use passive range motions using special equipment to move the affected area like the leg, arm, or hands. Moving the affected parts send signals to the brain that the affected is ready to learn again.

 

Stage 2: Spasticity. At this stage, the muscles have started to respond. However, the affected area may find it hard to relax since the brain still finds it hard to send signals. While in this stage, the patient continues with active-assisted therapy plans like using ROM to make the muscles more active.

 

Stage 3: Increased Spasticity. While at this stage, the patient might experience rapid muscle tightening and multiple muscles firing while trying to move the affected part. Doctors encourage patients to use passive and active -assistive exercises like ROM to increase the number of signals sent to the brain.

 

Stage 4: Decreased Spasticity. The muscle tightening and spasming is minimal compared to stage 2 and 3. At this stage, the brain can now send signals at ease to the affected muscles. Doctors recommend their patients to focus on isolated movements and only use active range exercises. Although there are no chances of repairing the already damaged brain, the non-damaged parts can still learn to perform the same functions as the damaged part. The brain adapts to the new functions if the patient repeats specific exercises constantly.

 

Stage 5: Continued Decreased Spasticity. At this stage, the brain is more active in sending signals to the affected part. Moreover, the chances of muscle tightening and spasticity are very minimal. The affected part can also make complex movements. At this stage, the patient should start resisting active ROM therapy so that the muscles can gain weight. Patients are encouraged to use specific strengthening equipment, add in-weights and use resistance bands to help them gain better strength and control.

 

Stage 6: Coordination returns: The muscle spasticity disappears entirely at this stage. The patient's motor control is almost fully restored. Patients are required to do more coordination exercises that involve all parts of the body to optimize recovery. At this stage, patients are encouraged to start doing the activities they were doing before they suffered from a stroke.

Stroke Risk Factors


Different things trigger stroke, of which most of these factors can be controlled. Did you know that one in every four stroke survivors is at risk of suffering from another stroke? That's why it's important to know your risks of suffering a stroke so that you can work on preventing it from happening. Although there are some factors you can't control, you can at least focus on those that you can control.

 

Stroke Factors that you can't control

Under this category, you can't do anything to change the chances of getting a stroke. Here are different risk factors you can't control.


1. Age. As you get old, the chances of getting a stroke increase. However, that doesn't mean people under 65 do not suffer from stroke. On the contrary, even babies can suffer from stroke.

 

  1. Family history. If there is someone in your family who suffered from a stroke before reaching the age of 65 years, there are chances you might suffer from stroke. This is because you share the same genetics as them.

 

  1. Race. Hispanic, Latino, and African American people have increased chances of suffering from stroke compared to other people.

 

  1. Gender. Women are at a higher risk of suffering from stroke compared to men. The factor is triggered by pregnancy, post-menopausal hormone therapy, diabetes, and oral contraceptives.

 

  1. Prior Stroke, TIA, and Heart Attack cases: People who have suffered from transient ischemic attacks and heart attacks are at higher risks of suffering from stroke compared to people who haven't.

 

Stroke Risk factors that you can control


1. Hypertension. If you're suffering from high blood pressure, you can manage it through medications and diet to prevent it from causing a stroke.

 

  1. Diabetes. Controlling your blood sugars and keeping them within the normal range will significantly reduce the chances of you getting a stroke.

 

  1. High blood cholesterol. If you have high cholesterol in your body, it might build up in your blood and cause blood clots that lead to stroke. You can manage the amount of cholesterol by increasing HDL and reducing LDL to lower your risks of a stroke.

 

  1. Smoking. Nicotine and carbon monoxide present in cigarettes can damage your cardiovascular system. Smoking, when combined with oral contraceptives, increases the chances of you getting a stroke. To be on the safer side, consider quitting smoking.

 

  1. Physical Inactivity. Exercises make your body more active and reduce the chances of you getting diabetes and high blood pressure, obesity, and high blood cholesterol, the main culprits that cause a stroke.

 

6. Obesity. People with excess body weight are at a higher risk of getting a stroke. To lower the risks, you can consider losing excess weight through exercise or diet.

 

  1. Diet. Minimize the intake of saturated fats, cholesterol, and trans fats to manage the amount of cholesterol in your blood. Include plenty of vegetables and fruits in your diet to keep you healthy and minimize the chances of getting a stroke.

 

  1. Carotid Artery Disease. If you have atherosclerosis, consult your doctor as early as possible to manage the disease before it leads to stroke.

 

  1. Peripheral Artery Disease. The disease is caused by excessive build-up of fatty products in the arteries, thus leading to carotid artery disease. Managing the disease at an early stage will lower the risks of you suffering from a stroke.

 

  1. Atrial Fibrillation. Atrial fibrillation is linked to sleep apnea which is known to increase stroke risks. The disease affects the upper chamber heartbeats, leading to the formation of blood clots that may cause a stroke.

 

  1. Other Heart Diseases. People suffering from coronary heart disease and heart failure have higher chances of suffering from a stroke. However, you can reduce the chances of getting a stroke by managing the heart disease early.

 

  1. Sickle Cell Disease. Sickle cell anemia is common in Hispanic and African American children, thus limiting the amount of oxygen carried by the blood to all body organs. The infected blood cells might stick to the blood vessels, thus blocking the arteries taking blood to the brain. You can manage the disease through medication to lower the chances of suffering from a stroke.

 

Stroke Recovery Stages


The earlier you seek medical attention and get treated, the higher the chances of recovering well. After treatment, post-stroke patients will likely experience a slow recovery process in the subsequent month. Although different patients will have different recovery processes, it's crucial to have a general idea of what to expect.

 

  1. Initial Treatment. After you're diagnosed with a stroke, the doctors will first stabilize your condition and determine the type of stroke you are suffering from. Once they get the specific type, they will give you medications to reduce the adverse effects that stroke causes. If the stroke is severe, the patient might be required to spend some time in the intensive care unit.

 

  1. Start Rehab. After the cause of stroke is treated, it's advisable to start rehabilitation as earlier as possible. It's recommended to take the patient to a rehab to get assisted by the team there. The team includes physiatrists, neurologists, and physical and occupational therapists who will work for hand in hand to promote the recovery process from a stroke.

 

  1. Hospital Stay. Mostly, patients will spend 5-7 days in hospitals after they're treated. When in the hospital, the medical team will closely monitor the effects that the stroke has caused to determine the best recovery plan for the post-stroke patient.

 

If the patient has long-term effects such as swallowing difficulties, speech impairment, and cognitive problems, the medical team will manage them by conducting different therapies.

 

  1. Leaving the Hospital. The medical team will make a discharge plan according to how severe the stroke was. They can decide to send you to a rehab facility or recommend the patient be accompanied by a skilled nurse when sending the patient home. Even after being discharged, patients are advised to continue with the recommended therapies to recover quickly.

 

  1. The First 90 Days. The first 90 days are critical in the recovery process of the post-stroke patients. It's at this stage that some patients start gaining mobility. Some patients will also experience spontaneous recovery since their brain is learning new ways to complete different tasks.

 

Frequently Asked Questions about Stroke Recovery

 

How long do stroke patients take to recover?


How long a patient takes to recover depends on many factors. For example, a patient suffering from a mild stroke will take less time to recover than a patient suffering from a massive stroke. On the brighter side, more than 50% of stroke patients show improvement and can walk again. However, some patients will require a cane to assist them when walking. That's why post-stroke patients are required to adhere to all prescribed exercises to maintain consistency so that they can promote neuroplasticity.

 

What percentage of stroke patients make a full recovery?


Mostly, about 10% of all stroke patients recover completely, while 25% of those patients get minor impairments. However, about 40% of patients who suffered massive stroke experience impairment requiring specialized care. Unfortunately, around 15% of stroke patients die while undergoing treatment or shortly after they are discharged. Patients who regain most of the body functions are those that follow a well-organized approach to manage stroke.

 

Does massage help stroke recovery?


Massage helps in stroke recovery by reducing the muscle tension and tightness of the affected part. Massage also helps in reducing inflammation and pain as well as alleviating muscle spasms. Moreover, massage is known to relieve stress and anxiety, thus managing insomnia.

 

What do I do after stroke recovery?


Once the patient has successfully passed all the rehab recovery therapies and has recovered from a stroke, it's essential to manage the risk factors that could have triggered the stroke. You can prevent subsequent stroke attacks by managing risk factors within your control. You can do so by quitting smoking, managing diabetes and high blood pressure. Moreover, once you recover from a stroke, you need to incorporate exercises and movements to improve your general quality of life.

 

What factors determine the recovery of a patient after stroke?


Different determinants mark a successful recovery process. For example, neuroplasticity gained after repetitive and constant activities helps in making a successful stroke recovery. Patients who don't adhere to all instructions given by the doctor tend to have slower limited recovery.

 

Can acupuncture therapy help in stroke recovery?


Yes. Acupuncture promotes the stroke recovery process by helping with relaxation, digestion, and sleep. This therapy also helps in reducing inflammation, pain, and edema.

 

Can I make a full recovery from a stroke?


The magnitude of stroke and how well you adhere to the rehab sessions determines whether you will make a full recovery or not. Moreover, the recovery process is different for each patient. Some patients might take weeks to recover, while others might take years to recover. Some patients will have lifelong disabilities, and that's why it's essential to maintain constant repetitive movements to optimize the recovery process.

 

Does smoking affect stroke recovery?


Smoking is one of the factors that increase the chances of getting a stroke. Different studies suggest that smokers have higher chances of getting impaired after a stroke attack than those who never smoked.

 

What are the signs of stroke recovery?


At first, the recovery process might be slow, and you might not even notice it. However, if you stick to the recommended rehab plan, you may start noticing improvement. For example, you will know you're recovering well when you notice increased coordination and balance while doing certain things.

 

Stroke Recovery Rehab Equipment


Stroke patients are affected in different ways, and every patient is given specialized treatment that caters to their specific needs. However, there are other supportive rehab types of equipment that you can incorporate to speed up the recovery process. The products help in easing the pain, optimizing mobility, improving blood circulation, thus making the recovery process more manageable. Although most of these products are commonly used in rehabs and hospitals, patients can use them at home. Here are different stroke rehab products that you can use at home.

 

Hand Therapy and Dexterity


Nowadays, there are dexterity training boards that rehabs are using to train different hand movements. The boards are made of exoskeleton-like devices that are connected to the computer via Bluetooth. The dexterity training boards are interesting to use and encourage patients to play more, thus optimizing motor neuroplasticity.

 

Massage


A massage is a form of therapy known to speed up the recovery process for stroke patients. Massage not only reduces inflammation and pain but also encourages blood circulation and lymphatic flow. Most massage equipment can be used both at the hospital and at home. They are made in a way that caregivers can easily control by providing an intensive massage that alleviates muscles to start functioning correctly. The massage equipment also helps in managing insomnia.

 

Foot Orthosis


Once a person suffers from a stroke, they will likely experience lower-limb deformity. Most rehabs use ankle-foot orthosis equipment (AFO) to correct the problem. Most AFO equipment has different configurations to cater to specific needs for each patient. They control the inversion and aversion of the foot, thus providing the required support for both sides of the ankle

 

Balance and Gait equipment


A person recovering from a stroke needs to optimize coordination and balance when moving around. However, they need ambulation support when walking to maintain balance. The balance and gait equipment helps patients to have an upright truck and posture.

 

Pain and Spasticity


Transcutaneous electrical nerve stimulation (TENS) therapy helps control pain and muscle spasticity, thus encouraging the muscles and nerves to function correctly. To make the recovery process easier, you can incorporate the Interferential therapy equipment, TENS equipment, Digital electrical muscle stimulation equipment in the therapy sessions. Performing comprehensive therapy will reduce edema, inflammation, and muscle spasms and increase blood circulation in the affected parts.

 

Mobility products to help in stroke recovery


Patients suffering from massive stroke will likely experience paralysis of some parts of the body. Mainly paralysis affects movement and mobility parts. Different types of equipment aid the patients in performing their daily activities like walking, thus improving mobility. Such equipment is safe and durable and will make your recovery process easier

 

Bathing Mobility equipment


Bathrooms are known to be the most dangerous places in your house since most falls occur there. Using specialized equipment in the bathroom will prevent post-stroke patients from suffering such accidents. For example, a bathroom should have grab bars, shower benches, and safety mats to reduce slipping incidents.

 

Toileting mobility products


Most post-stroke patients experience mobility issues, and it can be challenging for them to use regular toilets because they need to keep on bending down and rising. To prevent falling risks, you can add a raised toilet seat and safety frames. There are also portable toilets that you can add to the patient's bedroom to minimize movements.

 

Dressing mobility equipment


Post-stroke patients need dressing aids that will provide support when they are getting dressed. For example, you need to add dressing sticks, long-handled shoehorns, and leg lifters to make their dressing and undressing tasks easier.

 

Bed mobility equipment


Most post-stroke patients have insomnia because they experience muscle tightness that makes it harder to relax. Since it can be challenging for post-stroke patients to move around, they need equipment to aid them in getting to bed and a comfortable bed. Get an adjustable, powered bed because it's safe and comfortable. Moreover, you can invest in bed wedges, bed assist rails, and handles to give the patient the necessary support.

 

Mobility Aids equipment


People recovering from stroke need to be as active as possible. That's why it's crucial to get assistive mobility devices such as transport chairs, rollators, and special wheelchairs. This equipment helps post-stroke patients to quickly move around while ensuring their safety. For example, rollators are lightweight and provide enough support in case of any uncertain ambulation. Nowadays, you can get wheelchairs that combine rollators to make the patient as comfortable as possible.