Stroke Rehabilitation | What's involved in stroke Rehabilitation?

The goal of stroke rehabilitation is to help you relearn skills you lost when a stroke affected part of your brain. Stroke rehabilitation can help you regain independence and improve your quality of life.

The severity of stroke complications and each person's ability to recover vary widely. Researchers have found that people who participate in a focused stroke rehabilitation program perform better than most people who don't have stroke rehabilitation.

What's involved in stroke rehabilitation?

There are many approaches to stroke rehabilitation. Your rehabilitation plan will depend on the part of the body or type of ability affected by your stroke.

Physical activities might include:

• Motor-skill exercises. These exercises can help improve your muscle strength and coordination. You might have therapy to strengthen your swallowing.
• Mobility training. You might learn to use mobility aids, such as a walker, canes, wheelchair or ankle brace. The ankle brace can stabilize and strengthen your ankle to help support your body's weight while you relearn to walk.
• Constraint-induced therapy. An unaffected limb is restrained while you practice moving the affected limb to help improve its function. This therapy is sometimes called forced-use therapy.
• Range-of-motion therapy. Certain exercises and treatments can ease muscle tension (spasticity) and help you regain range of motion.

Technology-assisted physical activities might include:

• Functional electrical stimulation. Electricity is applied to weakened muscles, causing them to contract. The electrical stimulation may help re-educate your muscles.
• Robotic technology. Robotic devices can assist impaired limbs with performing repetitive motions, helping the limbs to regain strength and function.
• Wireless technology. An activity monitor might help you increase post-stroke activity.
• Virtual reality. The use of video games and other computer-based therapies involves interacting with a simulated, real-time environment.

When should stroke rehabilitation begin?

The sooner you begin stroke rehabilitation, the more likely you are to regain lost abilities and skills.

However, your doctors' immediate priorities are to:

• Stabilize your medical condition
• Control life-threatening conditions
• Prevent another stroke
• Limit any stroke-related complications

It's common for stroke rehabilitation to start as soon as 24 to 48 hours after your stroke, while you're in the hospital.

Where does stroke rehabilitation take place?

You'll probably begin stroke rehabilitation while you're still in the hospital. Before you leave, you and your family will work with hospital social workers and your care team to determine the best rehabilitation setting. Factors to consider include your needs, what insurance will cover, and what is most convenient for you and your family.

The options include:

• Inpatient rehabilitation units. These facilities are either freestanding or part of a larger hospital or clinic. You may stay at the facility for up to two to three weeks as part of an intensive rehabilitation program.
• Outpatient units. These facilities are often part of a hospital or clinic. You may spend a few hours at the facility a couple of days a week.
• Skilled nursing facilities. The type of care available at a nursing facility varies. Some facilities specialize in rehabilitation, while others offer less-intense therapy options.
• Home-based programs. Having your therapy at home allows greater flexibility than other options. One drawback is you likely won't have access to specialized rehabilitation equipment. In addition, insurance strictly controls who qualifies for home-based therapy.

Talk to your doctor and family about the best option for you.

What factors affect the outcome of stroke rehabilitation?

Stroke recovery varies from person to person. It's hard to predict how many abilities you might recover and how soon. In general, successful stroke rehabilitation depends on:

• Physical factors, including the severity of your stroke in terms of both cognitive and physical effects
• Emotional factors, such as your motivation and mood, and your ability to stick with rehabilitation activities outside of therapy sessions
• Social factors, such as the support of friends and family
• Therapeutic factors, including an early start to your rehabilitation and the skill of your stroke rehabilitation team

The rate of recovery is generally greatest in the weeks and months after a stroke. However, there is evidence that performance can improve even 12 to 18 months after a stroke.