Rehabilitation for stroke: What to know

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Stroke rehabilitation is therapy that helps people recover from the aftereffects of a stroke.

A stroke occurs when the blood supply to part of the brain is cut off. It can occur when a blood vessel becomes blocked or bursts. When this happens, brain cells are starved of oxygen and begin to die. A stroke is a medical emergency, and prompt treatment is essential.

If treatment does not occur to restore the blood supply, damage to the brain can be permanent.

The type of rehabilitation someone requires depends on the severity of the stroke and the affected areas of the brain. In general, however, the aim of rehabilitation is to help the person relearn skills that may have been lost, learn compensatory techniques where relevant, and make any necessary lifestyle changes.

Strokes can cause a range of disabilities, depending on the area of the brain affected. Some common problems include:

• pain
• difficulty reading and writing
• memory problems
• mood swings and emotional changes
• paralysis or hemiparesis, which is weakness on one side of the body
• trouble speaking or understanding language

The rehabilitation process aims to help an individual regain as much function and independence as possible.

It involves a team of healthcare professionals, including:

• doctors
• nurses
• therapists
• counselors

The team develops a customized treatment plan based on the person’s individual needs.

The plan may include:

• physical therapy to help the person relearn simple motor activities, such as walking, sitting, and lying down
• occupational therapy to help with everyday activities through exercise and training
• speech-language therapy to help relearn language and speaking skills
• cognitive rehabilitation to help with thinking and memory problems
• counseling to help the person and their family cope with the emotional impact of a stroke
• medications to help with a range of symptoms that occur as a result of a stroke

Learn more about working speech therapy.

Most people who have had a stroke need physical activities to help them relearn movement skills and coordination they might have lost.

If the stroke affected their upper extremities more than the lower extremities, the person may require occupational therapy to help with fine motor skills. They may require physical therapy to help with gross motor skills.

For most stroke survivors, rehabilitation focuses on physical therapy.

The therapist starts by helping the person perform safe exercises, such as range-of-motion exercises and stretching. As the person gets stronger, they progress to more challenging activities, such as walking and climbing stairs.

The therapist may help the person safely use tools such as:

• canes
• walkers
• wheelchairs

They may also use electrical stimulation and massage to help reduce pain and improve muscle function.

A person who has had a stroke may experience cognitive impairment, such as forgetfulness, disorientation, and confusion. These can negatively impact their quality of life.

Following a stroke, people may experience emotional distress, such as mood swings, anxiety, and depression.

Cognitive rehabilitation helps the person identify and compensate for cognitive deficits. The therapist may teach the person strategies to help with:

• memory
• attention
• problem-solving
• concentration
• daily functions, such as handling finances or medications
• processing the impact the stroke has had on their life

Technology-assisted activities may include:

• computer programs
• virtual reality
• robotic devices

These activities can help the person practice new skills and improve their function.

For example, computer programs can help a person with memory problems learn how to organize information. Virtual reality can help people practice grocery shopping or cooking tasks. They may use robotic devices to help regain movement in their arms or legs.

Researchers are looking into several newer therapies for their potential in stroke recovery, including:

• Constraint-induced movement therapy: This involves restraining the use of the unaffected arm or leg while working the affected limb. The aim is to help the person relearn how to use the affected limb.
• Functional electrical stimulation: This therapy uses electrical stimulation to help the person regain movement in their limbs.
• Transcranial magnetic stimulation: This therapy uses magnetic fields to stimulate nerve cells in the brain and improve function.

Using these alongside physical therapies or other therapy types may be beneficial.

A team of professionals will help people during their recovery program and may comprise the following:

• Physical therapist: Helps a person regain strength, range of motion, coordination, and balance.
• Neurologist: Specializes in stroke and other conditions affecting the brain and spinal cord.
• Rehabilitation nurse: Helps a person manage any health problems and adjust to life after a stroke.
• Occupational therapist: Provides strategies that help someone manage personal care or daily activities such as cooking and eating.
• Speech-language pathologist: Helps a person with speech and language difficulties, problems reading and writing, and eating and swallowing issues.
• Dietician: Provides information about healthy eating and special dietary needs.
• Social worker: Assists people with rehabilitation programs, living arrangements, insurance, and support at home.
• Neuropsychologist: Treats issues with changes in thinking, memory, and behavior.
• Physiatrist: Assists with physical medicine and rehabilitation.

Stroke rehabilitation can take place in various settings, including:

• inpatient rehabilitation centers
• outpatient rehabilitation centers
• specialty stroke units
• nursing homes
• assisted living facilities
• at home, through home health agencies

A person may receive therapy in more than one setting. For example, they may start with inpatient rehabilitation in the hospital and then continue with outpatient therapy at home.

If a person has a stroke, they are at increased risk of having another stroke. It is important to address the causes of the stroke to reduce this risk. Causes include:

• heart disease
• high blood pressure
• atrial fibrillation
• high cholesterol
• diabetes

A doctor may prescribe medications to help these conditions. They may also recommend dietary changes, increased physical activity, and other lifestyle changes.

Learn more about stroke prevention.

Below are some of the most frequently asked questions and answers about rehabilitation from stroke.

What factors might affect the outcome of rehabilitation?

The chances of a successful recovery following a stroke depend on many factors, including:

• the severity of the stroke
• the person’s age and overall health
• how soon treatment starts
• the type and intensity of rehabilitation
• the person’s support system

When can rehabilitation begin?

Rehabilitation should begin as soon as possible after a stroke, within 1 or 2 days. The sooner treatment starts, the better the chances of recovery.

In some cases, rehabilitation may begin while the person is still in the hospital. In others, it may start after being discharged.

How long does stroke rehabilitation take?

The amount of time it takes to recover from a stroke varies for each individual and ranges from weeks to years. Some people may recover fully, while others face lifelong changes and disabilities.

However, with proper rehabilitation and support, many people can lead fulfilling, independent lives.

Stroke rehabilitation is an important part of the recovery process following a stroke. It can help people regain strength, coordination, and independence.

A team of medical professionals works with people who have had strokes to create a treatment plan that meets their needs. The sooner rehabilitation begins, the better the chances for a successful recovery.