What to Expect After a Stroke: On the Path To Recovery

Did you know stroke is the leading cause of serious, long-term disability in the U.S.? Each year, close to 800,000 people suffer a stroke. More than seven million Americans are stroke survivors.

Surviving a stroke is the first step, but rehabilitation is important for relearning skills you may have lost. Stroke rehabilitation can help patients improve their quality of life and regain their independence.

Early intervention by rehabilitation professionals can help with recovery in physical, cognitive, psychological and speech deficits and can help patients regain their maximum abilities in those areas. The severity of a stroke affects a person’s ability to recover, but research has found that people who undergo consistent stroke rehabilitation perform better than those who do not.

Stroke Rehabilitation at INTEGRIS Health

INTEGRIS Jim Thorpe Rehabilitation in Oklahoma City offers both inpatient and outpatient stroke rehabilitation, physical therapy and recovery programs for patients of all ages who have disabilities that vary in severity. INTEGRIS Health also has stroke and brain injury resources with outpatient physical and occupational therapy available at facilities across the state.

“Our goal is to bring the next level of care,” says Jocelyn Woodard, who is an occupational therapist at INTEGRIS Health. “One of the things we really focus on is early mobilization. The sooner a person can move around after a stroke and start doing tasks themselves, the better. The more you get up and engage with others, the better your recovery.”

Stroke rehabilitation comes in different forms, depending on the part of the body or type of ability affected by your stroke. Physical activities might include motor-skill exercises, mobility training, constraint-induced therapy and range-of-motion therapy. Different technology can be used in treatment, such as robotic devices that assist impaired limbs, virtual reality and electrical stimulation.

Cognitive and emotional rehabilitation might include speech therapy, occupational therapy to help with loss of memory or problem-solving skills, antidepressants and psychological evaluation and support groups.

Getting the Most Out of Rehab

Planning should start as soon as possible during your hospital stay to allow for options and planning. Rehab stays can be for a limited time, and every day is important. Some different types of rehabilitation options include the following.

• Inpatient rehabilitation at INTEGRIS Jim Thorpe Rehabilitation or another rehabilitation facility. You must qualify and be able to tolerate three hours of therapy daily to be admitted.
• Outpatient rehabilitation, which requires patients go to an outpatient rehab clinic several times a week for therapy.
• Skilled nursing facilities where patients are still considered inpatient, but the therapy is less intense.
• Home-based therapy provided through home health agencies.

Technology in Stroke Rehabilitation

The INTEGRIS Jim Thorpe Rehabilitation stroke program uses technology to enhance traditional therapies and can include:

Lokomat – Robotic-assisted walking therapy using computerized legs, a harness and a treadmill. It promotes a natural walking pattern with multiple adjustments for pace and assistance level.

Ekso Skeleton with Variable Assistance – Robot-assisted walking therapy that allows wheelchair users to stand up and walk. The exoskeleton is a wearable bionic suit. You can walk with it on land (as opposed to Lokomat, which is attached to a treadmill).

Aquatics – The aquatic center uses the properties of water to enhance physical therapy treatments to help with walking and balance.

Bioness – A system that delivers low-level electrical stimulation to activate the nerves that control the muscles in the ankle or hand and forearm. The foot system helps someone who has “foot drop” to walk while the hand system helps someone with hand weakness to reach, grasp, open and close the hand.

Vital Stim – A system that delivers external electrical stimulation therapy to the throat muscles to help with swallowing.

Galileo Vibration System – An alternating vibration system used in conjunction with other therapies to facilitate and enhance functional movement.

Depression After a Stroke

Depression is an expected response after a stroke. First, because a stroke can cause changes in chemicals that regulate mood in the brain. In addition, the loss of motor and cognitive skills and the frustration that brings can be upsetting.

“Their lives have changed, and there is a grieving process,” Woodard says. “We encourage patients to engage with other people because it can help to know they are not alone. We also have stroke support groups that meet once a month for patients and their families.”

Woodward continues, “It’s important to get professional help right away and to keep moving, mentally and physically. We also encourage patients to engage in hobbies and activities they enjoyed prior to the stroke and learn how to do them in new ways.”

For instance, if a patient enjoyed golf pre-stroke, Jim Thorpe has a putt-putt golf course at the rehab center. If a patient once enjoyed cooking, a therapist will work with the person to learn how to do that again.

Ideas for patients to combat post-stroke depression include:

• Setting goals and finding ways to measure accomplishments, no matter how small.
• Getting out and enjoying some social activity, which will stimulate language recovery along with other health benefits.
• Consider joining stroke support groups. Survivors and family members share practical experiences, strengths and lessons learned.

When Should Stroke Rehab Begin?

The sooner you start rehabilitation, the better the likelihood you regain lost skills and abilities, Woodard says. Once your medical condition is stabilized, it’s common for rehabilitation to begin as soon as 24 hours after a stroke, while you’re still in the hospital. The duration of rehabilitation depends on the severity of the stroke and its complications and the plan will change as your needs change and skills are relearned.

“Another thing a patient may face is fatigue,” Woodard says. “The brain has just suffered an injury and is exhausted trying to recover. The body may be weaker, which can lead to soreness. But the longer you lie there, the harder it will be to regain skills.”

Regulating blood pressure – the number one culprit in strokes – is also vital, so your recovery team may work or prescribe medications to control blood pressure.

Handling Medications

Woodard says patients and families should be aware of what kinds of medications they are taking and how to take medications correctly.

“Can you open the pill bottle? Can you comprehend when and how to take the medication? Can you communicate how the medication affects your function? These are all important questions,” she says.

Recovering stroke survivors can use a pill planner to organize medications for the coming week, making it easier to remember if you have taken your medication. Keeping a notebook to write down questions that come up can help with doctor visits. Home remedies, vitamin supplements and other medications should not be taken without checking with your doctor first.

Some helpful resources for getting assistance with the cost of medicines include:

• www.okcommerce.gov/assistance/rx/ (or 1-877-RX4-OKLA or 1-877-794-6552)
• www.needymeds.org
• www.pparx.org
• www.patientadvocate.org

Never Lose Hope

Stroke recovery varies by person and recovering from a stroke can be a long and frustrating experience. Never lose hope. People can improve for many years after a stroke and the brain can create new pathways, but much repetition is required to heal your brain.

Improvement comes from motivation. Therapists can help patients progress, but only if the patient is motivated to do so, and support from family or friends can also make a big difference.

For more information about stroke recovery and rehabilitation, contact INTEGRIS Jim Thorpe Rehabilitation.