More than 700,000 people suffer strokes each year in the United States, and that number is expected to surpass 1 million by 2050. Approximately two-thirds of these individuals are stroke survivors who require rehabilitation to become independent.
For the best results from stroke rehabilitation, it should begin as early as possible. Although rehabilitation can't cure the effect of stroke, it can make a considerable difference in helping survivors attain the highest possible quality of life.
Paralysis is one of the most common disabilities to result from stroke. Up to 9 out of 10 stroke survivors suffer some amount of paralysis, usually on the side of the body opposite the side of the brain damaged by stroke. Paralysis is caused by messaging problems between the brain and muscles, making it impossible for muscles in the face, arms or legs to move voluntarily. Related conditions include:
- Hemiplegia: Paralysis on one side of the body
- Hemiparesis: Weakness on one side
- Dysphagia: Problems swallowing
- Ataxia: Difficulty with walking and balance
There are a variety of sensory issues related to stroke. Visual problems can include the inability to recognize objects or even one's own limb. Pain is a common issue and often involves tingling or prickling in stroke-affected limbs. Chronic pain can result from damage to the nervous system or mechanical problems caused by weakness after stroke. Stroke survivors may be unable to feel temperature, touch, or position. In many cases, there is loss of urinary continence because of the difficulty controlling bladder muscles, although permanent incontinence is uncommon.
Language impairments impact at least one-fourth of all stroke survivors. Expressive aphasia occurs when there is damage to the dominant side of the brain - or Broca's area - and makes it difficult to convey thoughts through spoken words or writing. Receptive aphasia involves the rear portion of the brain - or Wernicke's area - and makes it difficult to understand spoken or written language. Global aphasia, the most severe form of aphasia, causes stroke survivors to be unable to speak or understand language.
Thinking and Memory Deficits
Stroke survivors with damage to the parts of the brain responsible for awareness, learning and memory may have very short attention spans or difficulty with short-term memory recall. Learning new tasks or making plans may also be impossible. Related thinking and memory deficits for stroke survivors include:
- Anosognosia: Cannot comprehend the reality of physical impairments
- Neglect: Cannot respond to sensory stimuli on the side of the body impaired by stroke
- Apraxia: Cannot carry out a learned purposeful movement
Stroke survivors must deal with a wide range of emotional symptoms due to the psychological trauma of stroke and physical effects of brain damage. Depression is the most common emotional issue. Signs of clinical depression (which get treated with antidepressant medications and counseling) include the following:
- sleep disturbances
- weight loss/weight gain
- social withdrawal
- suicidal thoughts
Treatment begins with acute care immediately after a stroke. Next, patients receive care during spontaneous recovery that occurs during the several weeks after a stroke. Rehabilitation programs are a critical component of stroke care. Through rehabilitation, stroke survivors learn to become as independent as possible so that they can achieve the best possible quality of life. It requires a coordinated effort of care from a team that includes physical and occupational therapists, speech-language therapists, rehab nurses, mental health professionals, neurologists and other specialists. Stroke rehabilitation involves the following training:
- Personal Care: Stroke survivors relearn personal care skills such as bathing, getting dressed and eating through occupational therapy. They also learn strategies to control continence such as exercises to strengthen pelvic muscles.
- Safety Skills: Family members and caregivers receive training in how to help loved ones once they return home. They also develop a safety plan for installing equipment such as grab bars.
- Physical Therapy: Stroke survivors learn how to use affected limbs through physical exercises and sensory stimulation exercises. They also work on goal-directed activities to promote coordination.
- Speech Therapy: Patients with aphasia relearn speech and language skills through conversational coaching and rehearsal. In some cases, stroke survivors need other means of communication like symbol boards, sign language, or other technologies. Speech therapy also involves learning strategies to improve swallowing and practicing social skills.
Stroke survivors benefit from advanced treatments in a warm and caring environment. The Brian Center of Durham is a full-service rehabilitation facility that provides state-of-the-art physical therapy, occupational therapy, and speech therapy from an experienced staff. Our therapists work with patients to regain:
- motor control
- speech clarity
- communication or language
- facial expression