After a stroke, the primary approach to healing and recovery involves an active rehabilitation plan to improve physical ability and cognitive function. There are a number of different types of post-stroke rehabilitation, and if you are recovering from a stroke, you will likely need to participate in one or more of these.
Physical therapy includes a variety of muscle maneuvers and exercises. Post-stroke physical therapy activities are designed to train the brain and the muscles to work together using an approach that builds muscle strength and maintains healthy muscle tone.
A study from the United Kingdom used data from the Cochrane database, one of the largest stroke survivor databanks, to evaluate the effectiveness of physical therapy after a stroke. The study concluded that there is a wide range of physical therapy techniques and methods used around the world for recovering stroke survivors.
While the researchers did not find that one kind of physical therapy was better than the others, they did conclude that physical therapy is effective for helping stroke survivors improve mobility (the ability to get around), walk at a faster pace, function more independently, and have better balance.
Researchers estimated the ideal dose of physical therapy to be approximately 30-60 minutes five to seven days per week. Physical therapy was also found to be more effective when the sessions were initiated shortly after the stroke.
Unlike physical therapy, occupational therapy is a more task-focused type of training. Occupational therapists work with stroke survivors on practical, real-world, day-to-day tasks such as climbing stairs, getting in and out of bed and getting dressed.
Of course, there is an overlap between physical therapy and occupational therapy, and the two are both key components of stroke recovery. But physical therapy is more focused on strengthening and maintaining the tone of target muscle groups, while occupational therapy is more focused on coordinating and using muscles for certain directed goals.
Speech and Swallow Therapy
Speech and swallowing are skills that require thinking about the action while coordinating muscles. Both skills use muscles of the face, mouth, tongue, and throat. Speech problems are often expected after a stroke, while swallowing problems are usually more of an unpleasant surprise for stroke survivors and their loved ones.
A speech and swallow evaluation is typically done in the hospital within days after a stroke. As you recover from your stroke, your speech and swallowing abilities might begin to get better on their own.
Speech is important for communication. Speech requires the use of language to understand what people are saying. Speech also requires the use of language to communicate with others. Speech therapy is focused on understanding words as well as on producing words that others can clearly understand. Sometimes, speech therapy involves flashcards, pictures, and, of course, practice and repetition with speaking.
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Swallowing is important for a number of reasons. Nutrition is a vital part of life, and that doesn't change after a stroke. Swallowing ability is necessary for maintaining good nutrition. However, properly coordinated swallowing is important for other health issues in addition to nutrition. When swallowing muscles do not move as they should, choking on food is one of the dangerous consequences.
Choking can cause an infection called aspiration pneumonia, which is a bigger problem among stroke survivors than most people realize. Choking on food can also result in a dangerous lack of oxygen, which can cause brain damage and even brain death. The consequences of a swallowing disability are not something to be ignored. Fortunately, there is a whole system in place for swallow therapy to help stroke survivors avoid these serious and scary complications of a stroke.
Visual therapy and balance therapy are often scheduled in combined rehabilitation sessions for stroke survivors. That is because vision partially relies on good balance and balance partially relies on good vision. The areas of the brain that control these two functions are separate, but they depend on each other as they interact. This is why it makes sense that post-stroke balance exercises incorporate visual skills.
A research study that involved a collaboration between researchers from Memphis, Tennessee and from Denmark concluded that 60% of the stroke survivors who participated in combination vision therapy and balance therapy were employed, compared with only 23% of stroke survivors who did not participate in the therapy.
Cognitive therapy is still a fairly new concept in stroke rehabilitation. Cognitive therapy involves interventions that are designed to improve thinking skills and problem-solving abilities.
There is a range of cognitive disability after a stroke. Stroke survivors who are recovering from a large cortical stroke often have more cognitive issues than stroke survivors recovering from a small vessel subcortical stroke. Left-sided cortical strokes cause somewhat different cognitive deficits than right-sided cortical strokes, and this can impact your road to recovery as a stroke survivor.
Cognitive therapy approaches, such as using video games, virtual reality techniques, and computer-generated rehabilitation therapy, are currently being studied as ways to improve cognitive function after a stroke. Among the various interventions for post-stroke cognitive deficit, the best type of cognitive therapy has not yet been established. However, so far, the conclusion is that stroke survivors who participate in cognitive therapy recover better than stroke survivors who do not participate in cognitive therapy.
Innovative Physical Therapy
New types of therapy include mirror therapy, electrical therapy, and music therapy. Stroke survivors who participate in research studies that use new and innovative rehabilitative therapies tend to test better on measures of stroke outcomes and usually do not experience negative effects caused by experimental rehabilitation.
The preliminary data on recovery after a stroke are promising, but research scientists always consider the possibility of a 'placebo effect.' A placebo effect is the likelihood that a person who is having an intervention will improve due to the preconceived belief that the intervention will help. A placebo effect can make an intervention appear to be beneficial even if the intervention is useless. There is probably a degree of the placebo effect and a degree of usefulness when it comes to most of the innovative rehabilitation techniques that are currently under research.
Read more What Is a Small Vessel Stroke?
— Update: 16-01-2023 — cohaitungchi.com found an additional article How to recover from a stroke with 4 types of therapy from the website www.insider.com for the keyword different types of therapy for stroke patients.
- To recover from a stroke, you may need a combination of physical, occupational, emotional, and speech therapy.
- While not everyone can fully recover from a stroke, these therapies can help you regain physical functions and relearn daily activites.
- This article was medically reviewed by Steven Reisman, MD, a cardiologist and the director of New York Cardiac Diagnostic Center.
- Visit Insider’s homepage for more stories.
In the US, more than 795,000 people have a stroke every year, according to the Centers for Disease Control and Prevention (CDC).
While annually, 140,000 people die from strokes, the majority survive. However, strokes often result in a range of physical, cognitive, and emotional disabilities, and recovery can be a challenging process. Here’s what you need to know to better navigate it.
How to recover from a stroke
Up to 50% of stroke survivors will have a persistent or long-term disability. For example, paralysis or weakness on one side of the body is a common result of stroke, affecting upwards of 72% of patients, according to the Stroke Association UK.
The recovery time and severity of the stroke will depend on the area of the brain and the location of the blood vessel affected, as well as the type of stroke: ischemic or hemorrhagic.
According to the National Institute of Neurological Disorders and Stroke (NINDS), rehabilitation begins 24 to 48 hours after a stroke. A variety of medical staff and therapists may be involved to help rehabilitate different parts of the patient’s health: physical movement, occupational skills, speech pathology, and emotional changes.
Physical therapy aims to help stroke survivors regain the use of weakened or paralyzed limbs. Ross Berlin, MD, at AtlantiCare Neurosciences Institute, says paralysis impacts a variety of daily activities, like feeding oneself, bathing, dressing, or getting out of bed.
“Physical therapy includes the reproduction of these functions,” Berlin says, “as well as the use of therapeutic methods, such as robotic therapy, bracing, and medications to control some of the undesirable after-effects of a stroke.” Braces help support patients as they regain movement, and robotic braces both support and stimulate the limb to aid recovery and avoid long-term loss of movement and function.
It’s estimated around 14% of patients recover full physical function with the help of physical and occupational therapy — unfortunately, many will need partial or full-time care after a stroke. Most recovery takes place within the first few weeks, though improvements will often continue for up to four months.
Occupational therapists work alongside physical therapists to help stroke survivors regain independence as much as possible. While physical therapy focuses on regaining movement, occupational therapy is tailored to the patient’s specific difficulties.
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A 2015 review of occupational therapy studies found occupational therapy was most effective when given to patients at home: one study used educational sessions based around self-care at home, like bathing, grooming, dressing, and nutrition, while another focused on assistive devices for ADL (activities of daily living) which helped stroke survivors with bathing and hygiene.
Occupational therapists will also work with survivors on healthy lifestyle habits to reduce the chance of a repeat stroke, as around 25% of people will have another stroke within five years. The American Stroke Association suggests up to 80% of second strokes and heart attacks can be prevented with lifestyle changes, like lowering blood pressure and cholesterol, increasing physical activity, quitting smoking, and improving diet.
Another common side-effect of a stroke is difficulty with speech, known as aphasia, which affects up to 33% of survivors.
“Speech and language therapists focus on a variety of functions including general thinking, processing and cognitive skills, understanding spoken language, the ability to express oneself in a variety of methods either verbally or using adaptive devices such as sign language, language boards, symbol boards or other methods,” says Berlin.
As with physical recovery, recovery of speech and language mostly happens within two to three months, and a full recovery is unlikely after this point. However, patients can still continue to make improvements years following their stroke.
“Unfortunately, speech and language skills are one of the more sensitive areas of the brain impacted by stroke, and while they can improve over time they may leave the individual with significant deficits for a prolonged period of time,” Berlin says.
Many stroke survivors experience emotional or personality changes, like forgetfulness, irritability, confusion, anxiety and anger. Lack of confidence, fear, and the impact of their physical and cognitive abilities are a source of stress for many stroke victims, and this often leads to family and relationship difficulties.
Extreme fatigue affects 25% of stroke victims, while a further 33% experience moderate fatigue, according to Stroke Association UK. Over a third of stroke patients experience post-stroke depression, according to the American Stroke Association, although Berlin says most patients experience depressive symptoms to some degree.
“Like other effects of stroke, it can be mild, moderate or severe,” says Berlin. “Support groups after a stroke can be extremely helpful when one shares one’s difficulties with others having the same or similar experiences.”
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