Rehabilitation after a Stroke: What is Important to Know?

A stroke is a life-changing event that can leave individuals and their families facing numerous challenges. As the third leading cause of death worldwide and a major cause of disability, understanding the rehabilitation process is crucial to recovery. In this comprehensive guide, we will discuss essential information about stroke, its types and symptoms, consequences, and the different stages of recovery. We will also explore how to restore movement and cognitive functions, tips for home rehabilitation, emotional support, and ways to prevent complications and relapse.

Types of Stroke and Symptoms

There are three main types of stroke:

1. Ischemic Stroke: Caused by a blood clot that blocks blood flow to the brain. It accounts for approximately 80% of all strokes.
2. Hemorrhagic Stroke: Occurs when a blood vessel in the brain ruptures, causing bleeding in the brain. It accounts for about 15-20% of strokes.
3. Transient Ischemic Attack (TIA): Also known as a “mini-stroke,” it is a temporary disruption of blood flow to the brain.

Common symptoms of a stroke include:

• Sudden weakness or numbness in the face, arm, or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding speech
• Sudden difficulty seeing in one or both eyes
• Sudden trouble walking, dizziness, or loss of balance and coordination
• Sudden severe headache with no known cause

Consequences after Stroke

The effects of a stroke vary depending on the severity and location of the brain injury. Common consequences include:

• Physical impairments: Weakness or paralysis on one side of the body, difficulty walking or swallowing, and impaired fine motor skills.
• Cognitive impairments: Memory loss, difficulty with attention and problem-solving, or trouble understanding language.
• Emotional changes: Depression, anxiety, irritability, or emotional lability (sudden and uncontrollable emotional changes).

Stages of Recovery

The stages of stroke recovery include:

1. Acute Care: This stage occurs immediately after the stroke, focusing on stabilizing the patient and preventing further complications.
2. Inpatient Rehabilitation: Typically lasting 2-3 weeks, this stage focuses on intensive therapy to restore physical and cognitive functions.
3. Outpatient Rehabilitation: After discharge, the patient continues therapy on a less intensive basis to regain independence in daily activities.
4. Community Reintegration: The patient gradually returns to their normal life, participating in social, vocational, and recreational activities.

Restoring Movement Functions

Hand Recovery

To restore hand function, occupational therapists use various techniques, such as:

• Range of motion exercises: Maintain joint flexibility and prevent stiffness.
• Strength training: Improve grip and pinch strength through resistance exercises.

• Fine motor skills practice: Engage in activities like buttoning shirts, picking up small objects, or using utensils.
• Constraint-induced movement therapy (CIMT): Encourage use of the affected hand by restricting the unaffected one during specific tasks.

Speech Function

Speech-language pathologists help patients regain speech and language abilities through:

• Speech therapy: Exercises to improve articulation, fluency, and voice quality.
• Language therapy: Focuses on comprehension and expression of spoken and written language.
• Augmentative and alternative communication (AAC): Use of communication devices or techniques to assist those with severe speech impairments.

Restoring Cognitive Processes

Cognitive rehabilitation involves working with a neuropsychologist or occupational therapist to address cognitive impairments, such as:

• Memory: Using strategies like mnemonics, visual imagery, and repetition to enhance recall.
• Attention: Practicing focused and divided attention tasks to improve concentration.
• Problem-solving: Engaging in structured problem-solving exercises to develop reasoning skills.
• Language: Participating in language therapy to address difficulties with comprehension and expression.

Home Rehabilitation

Prevention of Bedsores

To prevent bedsores, consider the following:

• Repositioning: Change the patient’s position every two hours to relieve pressure.
• Cushioning: Use specialized cushions or mattresses to distribute pressure evenly.
• Skin care: Keep skin clean and dry, and use moisturizers to maintain skin integrity.

Hygiene

Promote good hygiene practices by:

• Bathing: Assist with daily bathing or use no-rinse body wipes for those with limited mobility.
• Oral care: Encourage regular teeth brushing and provide assistance if needed.
• Incontinence care: Use disposable incontinence pads or briefs and change them frequently to maintain cleanliness.

Diet: What to Eat, What to Avoid

A healthy diet after a stroke should include:

• Fruits and vegetables: Aim for at least five servings per day.
• Whole grains: Choose whole wheat bread, brown rice, and whole grain pasta.
• Lean proteins: Opt for poultry, fish, beans, and low-fat dairy products.
• Healthy fats: Incorporate sources of omega-3 fatty acids, such as salmon, nuts, and seeds.

Avoid excessive salt, saturated fats, and added sugars.

Emotional Support

Providing emotional support is crucial for stroke recovery. Consider the following:

• Active listening: Encourage open communication and listen attentively to the patient’s concerns.
• Empathy: Show understanding and validate the patient’s emotions.
• Support groups: Connect with others who have experienced a stroke to share experiences and coping strategies.
• Professional help: Seek the assistance of a mental health professional if needed.

Prevention of Complications: How to Avoid Relapse

To prevent complications and reduce the risk of another stroke:

• Control risk factors: Manage high blood pressure, high cholesterol, and diabetes through medication and lifestyle changes.
• Quit smoking: Smoking increases the risk of stroke; quitting can significantly reduce this risk. Don’t replace smoking with vaping which also has several health risks.
• Exercise: Engage in regular physical activity to improve overall health and reduce stroke risk.
• Limit alcohol: Moderate alcohol consumption (one drink per day for women, two for men) is recommended.

In conclusion, stroke rehabilitation is a critical part of recovery, involving physical, cognitive, and emotional aspects. Understanding the types of stroke, symptoms, consequences

Article verified by Theresa Piekarski, RN MSN BSBA
Director of Clinical Services