What is post-stroke rehabilitation?
The goal of stroke rehabilitation is to help a person relearn skills lost after a stroke affects part of the brain. Stroke rehabilitation can help a stroke survivor regain function, independence and improve his/her quality of life. Research has shown that stroke survivors who participate in a focused stroke rehabilitation program are more likely to regain function and perform better than most people who don't have stroke rehabilitation.
Post-stroke rrehabilitation also involves teaching the person new ways to adapt and compensate for any remaining disabilities. For example, one might need to learn how to dress using only one hand, or how to eat with an assistive device if the hand has been affected.
A stroke rehabilitation program must be individualised to address impairments after stroke, such as motor weakness, loss of sensation, lack of balance and coordination, problems walking, problems with hand grasp, visual loss, or difficulty speaking or understanding. Studies using advanced imaging have shown that through rehabilitation after stroke, it is possible to increase neuroplasticity- a process that involves rewiring of the brain, that helps brain recovery and recovery of skills and function.
What factors can affect the outcome of stroke rehabilitation?
After a stroke, the rehabilitation plan will change during the recovery process and will depend on which part(s) of the body or abilities were affected and the type and severity of deficits. Factors that affect the outcome of stroke rehabilitation include:
• The severity and extent of damage to the brain
• The intensity of the rehabilitation program. The dose (frequency, duration, number of repetitions) influences the intensity of the rehabilitation program and patient outcome
• Timing of the rehabilitation. Early rehabilitation leads to greater chances of recovery and regain lost skills and function.
• Age. Children and young adults tend to recovery to a greater extent than the elderly after stroke.
• Level of alertness. Stroke may affect a person’s ability to remain alert and follow instructions to engage in rehabilitation activities.
• Severity of concurrent medical problems.
• The home environment. Adaptation of the home environment such as stair rails and grab bars can increase independence and safety at home.
• The work environment. Modification to the physical work environment may improve physical safety as well as modifications of work tasks may make return to work possible.
• Family and friend support. Social support by family, friends and colleagues can be a very important factor in rehabilitation.
What medical and healthcare professionals specialize in post-stroke rehabilitation?
A stroke rehabilitation team includes a variety of healthcare professionals:
• Medical doctors are primarily responsible for managing the long-term care of stroke survivors, including recommending rehabilitation to address the needs of the stroke survivor.
• Nurses also provide information about routine health care, such as how to follow a medication schedule, how to care for the skin and manage bladder and bowel issues, how to move out of a bed and into a wheelchair, and special needs for people with diabetes.
• Physiotherapists specialize in treating disabilities related to movement and sensory impairments. They help restore physical functioning by evaluating and treating problems with movement, sensation, balance, coordination and walking.
• Occupational therapists help to improve motor and sensory abilities post-stroke. They help a person relearn skills needed for performing self-directed activities such as personal grooming, preparing meals, and housecleaning.
• Speech-language pathologists help a person relearn how to use language or develop alternative means of communication and improve the ability to swallow.
• Psychologists can help with the person’s mental and emotional health and assess cognitive skills and abilities.