When Should We Start Stroke Rehabilitation and Other Common Questions |Stroke Rehabilitation and Complementary Therapy |PatientsEngage

Submitted by PhysioNicole on 22 February 2020

Rehabilitation is essential and critical to improved quality of life and recovery for a stroke patient. Experienced Physiotherapists Nicole D’souza and Kshitija Ghole from the Neurology Foundation address some of the common questions on stroke rehabilitation.

1. What is the aim of stroke rehabilitation?

The aim of Stroke rehabilitation is to help those affected to relearn essential skills lost due to damage to the brain. These could range from re-learning how to walk again, using your hand, speaking and performing daily activities. It aims to empower the person to live his/her life as independently as possible.

2. What is most recommended: rest or rehabilitation after in the initial days after a stroke?

After a stroke, once the patient is medically stable the doctor in-charge will recommend rehabilitation at the earliest. It is important for the patient to come to the upright position or start moving as early as possible to enable a better and quicker recovery.

3. What does rehabilitation involve?

A person with stroke may suffer from a number of difficulties ranging from difficulties with movement to difficulties with speech, cognition etc. Thus a multidisciplinary approach is important when managing a person with stroke. This may involve physiotherapy, speech therapy, cognitive therapy, counselling, diet and nutrition, dance therapy, music therapy, art therapy, yoga etc based on ones needs.

Physiotherapy rehabilitation involves stretching exercises, strengthening exercises, mobility exercises, balance training, co-ordination exercises, gait training. There are advanced therapies also such as aqua-therapy, treadmill training, virtual rehabilitation, robotics that are also being used in rehabilitation. These exercises help to reduce spasticity, improve mobility, improve walking pattern and increasing functional independence.

4. Rehabilitation at home vs hospital, what are pros and cons of each?

Rehabilitation plays a crucial role in improving a person's life after a stroke. The quality of rehabilitation is more important than the place where it is taking place. In a hospital a variety of equipments are available for rehabilitation which may not be available at the home. At the same time it is important to consider the home environment while rehabilitating a person in a hospital setup so that any barriers in the home environment can be modified.

5. What are some ways to motivate patients?

The motivation of the patient towards participating in rehabilitation is one of the most important factors for recovery. Talking to the patient, understanding their interests, likes and dislikes, including the patient and the family in decision making and setting goals are some of the ways in which to motivate the patient. During the course of rehabilitation showing them small improvements can also serve as motivation to continue with the rehab. For those who may be suffering from depression, group therapy or counselling will help them improve their mood and increase their motivation.

6. Have you found any complementary therapies to be helpful?

Following medications and physiotherapy exercises are important part of rehabilitation process. Along with that complementary therapies which are found to be helpful are Music therapy, Dance and Movement therapy, Virtual rehabilitation, Yoga, Art therapy, Graded Motor Imagery etc.

7. How long must rehabilitation be continued?

After a stroke, initially rehabilitation is required to relearn lost skills and get back to daily activities. However appropriate rehabilitation must continue lifelong to maintain the effects of the therapy and to prevent further strokes by keeping blood pressure, diabetes and cholesterol in check.

8. What specialists are required for rehabilitation? What is the role of each specialist?

Neurophysicians are usually the leaders of the rehabilitation team. They diagnose, monitor and prescribe medications. Other members of the rehabilitation team are Physiotherapists who deal with movement related concerns, Occupational therapists who help to reintegrate the person back in to the home and work environment, speech therapists who deal with speech, swallowing and communication issues. There may also be need for vision related exercises. Psychologists help in dealing with emotional and cognitive issues. Nutritionists and dieticians provide advice on diet and nutrition.

9. What factors are important for the patient's recovery?

A person's recovery is dependent on a number of factors such as:

area of the brain affected
type of stroke & severity
genetic factors.
socio-demographic factors like age, gender, socioeconomic status, and family support.

Nicole D'souza - Masters in Neurological Physiotherapy, Head of therapy & Research at Neurology Foundation

Kshitija Ghole - Masters in Physiotherapy, Therapist at Neurology Foundation

Community

Neurological Conditions

Stroke Rehab and Recovery

Condition

Stroke

Changed

Sun, 10/24/2021 - 19:27

Stories

Stroke Prevention and Management – What You Can Do

Stroke is the third leading cause of death in India and a leading cause of disability. Dr. Atulabh Vajpeyee, neurologist and founder of the Stroke Support Group Udaipur (SSGU), talks about the magnitude of the problem of stroke, how to rein in your risks and the importance of correct and timely management of the disease. Stroke is the second most common cause of death after coronary artery diseases. What are the different types of stroke? It is the second leading cause of death in the world,…
Physical Activity and Exercise Can Help Keep Mental Illness in Control

Exercise and yoga can improve quality of life for people with mental illness and reduce risks of strokes, diabetes, auditory hallucinations and other health problems, informs Dr R Padmavati, Additional Director, Schizophrenia Research Foundation. World Health Organisation defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity is not just "exercise". Exercise, is a subcategory of physical activity that is planned,…
White Meat vs Red Meat: Which is Healthier?

Is it true that red meat should be avoided, while white meat encouraged? Bonnie Lau, an Australian-trained dietitian, counselling patients on GlycoLeap, answers. Here, we compare the pros and cons of both and helps you decide which type of meat you should eat in the future. Meat is a great source of protein and lots of vitamins and minerals. But there are claims that red meat (mutton, lamb, beef, pork) should generally be avoided, while white meat (chicken, duck, fish) is encouraged. We look at…
Never Too Old to Sing

The Choir of the Loaves and Fish, a musical ensemble of senior citizens, started by Pervin Varma with Regina Thomas in Bengaluru has been immensely therapeutic for the elderly and has helped bring loads of warmth and sunshine into their lives. Picture above: Ammachy taking a bow with Pervin Varma Imagine a group of people – all senior citizens between 65 and 96 – people who have suffered strokes or are living with cancer, arthritis, heart disease, dementia, physical disabilities, people with…
Journey from Negative to Positive through Dance Movement Therapy

Restoring self-esteem and self-worth is what Dance Movement Therapy by Renelle Snelleksz has successfully achieved for a cross section of people like people with Parkinson’s Disease or those with a history of physical abuse and even children who have survived cancer but are deeply scarred. What is Dance Movement Therapy? How is it different from learning Dance? Dance Movement Therapy (DMT) is very different from technique-based dance in that it creates a safe and non-judgemental space for…
Speech and Hearing Disorders in an Aging Population

Dr S.P. Goswami, Professor of Speech Pathology at Mysore counsels that with the right kind of support, the load of the communication disorder can be shared equally by the aged individual as well as the family, the key to it being to meet them halfway. Aging is a phenomenon which starts from birth and brings about changes in the individual across the life span. However, beyond the yardstick of 60 years, anatomical and physiological changes become highly evident in the human body, thereby leading…
Post-Stroke Depression Is Common

But often overlooked, says Porrselvi A.P. a cognitive and psychosocial interventions specialist. Here, she offers a case study and practical strategies to guide you back to normal life. The patient: Mrs. K, a 67-year-old woman had a stroke in the left side of her brain in September last year. Her condition: Mrs K was referred for cognitive and psychological evaluation following complaints of social withdrawal, memory disturbances and increased irritability…
Stroke Management

In addition to Treatment and Rehabilitation, the following aspects are equally important Nutrition Eat like a Mediterranean (fresh fruits and vegetables, whole grain foods, lean meats and poultry, fatty fish once or twice a week) Cut fat intake Limit your alcohol consumption Limit salt intake. Exercise Make exercise a habit as soon as the doctor gives you the go-ahead. Exercise at least 30-40 minutes every day. Exercise will help you maintain an ideal weight and…
Stroke Treatment

The primary goal of treating stroke patients is to restore blood flow to the brain. The doctor will consider some of the following options: Medications that dissolve the blood clot. Surgical procedures that can open up or widen arteries - either in the carotid artery or in the brain, wherever the blockage is located. The carotid artery is located in the neck, supplying blood to the brain, neck and face. There are two carotid arteries, one on the right and one on the left. Once the…
Tests for Stroke

What tests do you need to have done? Stroke is a medical emergency, and anyone suspected of having a stroke should be taken to hospital immediately (delay affects rehab) so that tests can be done and the correct treatment provided as quickly as possible. Tests include: Physical examination and tests like a blood pressure test, blood tests to check cholesterol levels and blood sugar levels. Ultrasound - a wand waved over the neck can provide a picture that shows whether there is any…