Stroke rehabilitation begins once the patient’s condition has stabilized, which can be as soon as 24 to 48 hours after the incident. Early, individualized therapy helps improve chances of recovery. After leaving the hospital, the patient continues rehabilitation at a skilled nursing facility, inpatient or outpatient clinic, or at home. While some stroke survivors recover fully, others may always have some disability.
Stroke is one of the leading causes of long-term adult disability, affecting approximately 795,000 people each year in the United States. Rehabilitation can improve functions and sometimes effect remarkable recoveries.
Stretching exercises promote blood flow and make it easier to move your limbs. The therapist starts by gently stretching hands, arms, and shoulders in a full range of motion. They can also show how to use an unaffected hand, for example, to gently stretch the wrist, fingers, and thumb on your opposite hand.
Stroke: Rebuild Strength
Strengthening the muscles in hand and arm will help improve grip and the ability to use the limb. An early arm exercise involves holding the weak arm with the strong arm and rocking it back and forth like a baby. As it gains strength and mobility, the patient can use squeeze balls, wrist weights, or hand weights to tone and build muscle.
Stroke: Electrical Stimulation Therapy
A stroke interferes with the brain’s ability to send messages to the nerves in the muscles. This can make it difficult to move and control the arm and hand. Electrical stimulation (ES) therapy is a safe way to stimulate the nerves that make the muscles contract. ES may also help to regain control over the limb, improve muscle tone, and reduce pain and spasticity.
Stroke: Constraint-Induced Movement Therapy
At some point in the recovery process, the therapist may have the patient wear a restraining device on the functioning arm. Then the patient tries to move the affected hand and arm as much as possible to do repetitive tasks. This type of therapy is thought to increase brain plasticity and the ability to repair itself. The goal is to regain function of the affected limb.
Stroke: Practicing Fine Motor Skills
Fine motor skills are small, precise movements you make with the hand and fingers. For example, tracing a design with a pen, shuffling cards, using a pegboard, or picking up small beans and putting them in a cup. As with all rehabilitation exercises, repetition is important to help retrain the brain. Daily practice is necessary.
Drug therapy for spasticity is often used in addition to physical exercises and stretching. Oral muscle relaxant medications help reduce large areas of spasticity by interfering with the nerve signals that cause muscles to contract. However, these medications may also cause side effects such as drowsiness and weakness. The stroke rehab team keeps a close watch on these drug side effects.
Stroke: Spasticity Injections
For spasticity in a few select areas, targeted therapy is an option. A doctor injects the patient with botulinum toxin, phenol, or both. Botulinum treatments block the release of nerve chemicals involved in muscle contraction. Phenol injections serve as nerve blocks in affected muscles, which reverses spasticity. Effects of both treatments usually last about three to six months. Depending on the medication, side effects can include pain, swelling, soreness, fatigue, and muscle weakness.
Stroke: Intrathecal Baclofen Therapy for Spasticity
When a patient has severe spasticity or hasn’t done well on oral medications, intrathecal baclofen therapy may be an option. A small pump is surgically implanted to administer muscle relaxant medicine directly to the spinal fluid. The pump uses a smaller amount of baclofen medication than when it’s taken by pill, so it can cut down on some side effects and act faster.
Stroke: Occupational Therapy
One of the most important parts of recovery is relearning daily living skills so that the patient can be mobile and independent. An occupational therapist (OT) shows how to work around disabilities so that the patient can change clothes, take a shower on their own, cook, clean, and if possible, drive a car. The OT also helps to set up the home to make it safer and easier to move around in.
Stroke: Continue The Rehab, Never Give Up
The first three months after a stroke are when most people make the biggest gains in their recovery. But by continuing to set new goals and exercising every day, one can see continue progress even years later. Practicing new skills helps the undamaged part of the brain take over new functions.