Rehabilitation after a stroke is vital to recovery

July 19, 2021

Providence Heart & Vascular Team

In this article:

Stroke is often referred to as a singular event, however, 40 percent of stroke survivors have moderate to severe impairments afterward.
Recovery from stroke depends on the size of the stroke and the location in the brain.
Starting rehab immediately after stroke is vital to regaining function and recovery.

[3 MIN READ]

Stroke is a life-altering event. And while its immediate impact can be catastrophic, what we don’t often hear about is how lasting the effects are and the hard work that stroke patients (and their rehab teams) put in after the event to get back to independent living. While some stroke survivors may have minor impairments, others can lose significant movement on one side of the body, including the ability to walk, speak or even swallow. Routine daily activities we often take for granted, such as dressing, bathing and eating, may become frustrating and challenging or nearly impossible.

Approximately 10% of stroke survivors recover completely, according to the National Stroke Association, while 40% have moderate to severe impairments that require special care.

No matter the extent of the stroke’s effects, rehabilitation, is a vital part of regaining function and a sense of independence. It’s also an important step in supporting the overall well-being of a person who may have lost the ability to communicate or do the things they love. A team of specialists provides expertise and encouragement to overcome challenges, celebrating every victory – big or small – along the stroke recovery journey.

How a stroke affects the body

Arteries in the brain are designed to provide a constant flow of nutrient- and oxygen-rich blood. If one of these arteries is blocked or bursts, blood stops flowing into a part of the brain. This is a stroke. Every second that passes while the brain goes without blood and oxygen destroys precious brain tissue.

If a stroke happens on the left side of the brain, the right side of the body will be affected. A person may also experience:

Difficulty with speech and language
Inability to read, write and learn new information
Inability to do math or to organize, reason and analyze things

A stroke on the right side of the brain affects the left side of the body, and a person may also experience:

Difficulty with depth perception or directions
Inability to create, such as painting a picture, or appreciate art and music
Inability to recognize the emotion in someone’s voice

How long is stroke recovery?

Recovery time, hospital stay and rehab needed following a stroke is as unique as the individual. The size and location of the stroke in the brain play a major role, but there are other factors that affect recovery, such as:

Age
Overall health prior to the stroke
Speed of intervention during stroke
Level of support by of family and friends

Most rehab teams meet with patients within 24-hours after having a stroke, while they remain in the hospital. Early intervention can greatly improve the recovery process and help support the emotional well-being of patients as they transition from hospital care to home, and eventually to independence if that’s possible.

A rehab team helps meet recovery goals

A well-rounded stroke rehab team will look for the effects of the stroke on physical and cognitive function and then design a plan to help the patient meet both small and large milestones on the path to recovery.

The goal of the rehab team is to help patients regain function and recover as much independence as possible. Physical, occupational and speech therapists are key team members during treatment and may provide a range of therapies to address issues related to stroke, such as:

Mobility
Locomotion (walking, using a wheelchair, climbing stairs)
Self-care (dressing, cooking, brushing teeth)
Communication (speech problems, recalling appropriate words)
Swallowing problems
Cognition (organization and memory problems)
Control of bowel and bladder function

A stroke team may also include a mental health provider that can help the patient and their loved ones deal with the emotional weight of loss of function and the rehab journey in general.

Physical therapy

Physical therapists are uniquely trained to help stroke patients with strength and mobility, using a range of methods. “Physical therapy serves to enhance neuroplasticity, the brain's ability to adapt or make new connections, with task-specific therapy that engages the patient's body and attention,” says Lauren Wagner, physical therapist at Providence St. Vincent Outpatient Rehabilitation Services in Portland, Oregon.

Physical therapists help patients with walking aids, such as crutches, or fit patients for manual or power wheelchairs if necessary. “We also help patients who have had a milder stroke and are making larger gains to return to sports or running,” Wagner explains.

“We work closely with occupational therapy and speech-language pathology to ensure the patient has a cohesive experience and to understand factors that affect physical therapy goals such as cognition and attention,” she says.

Speech-language pathology

For stroke patients who struggle with expression, speech, language or even swallowing, speech-language pathologists, also known as speech therapists, are an essential part of recovery and can serve as a bridge to communicating with their loved ones.

“We work with patients to identify potential deficits or changes in these areas, set appropriate and functional goals for therapy, and provide treatment,” explains Wes Smith, speech-language pathologist at Providence St. Vincent Medical Center Outpatient Rehabilitation in Portland, Oregon.

“Specific treatment approaches can vary widely but are tailored to meet each patient's needs. Treatment may involve exercises to improve oral-motor control for speech or swallowing, word-finding or comprehension activities to support expressive/receptive language ability, and strategies to support memory, attention and problem-solving for daily tasks,” says Smith.

Occupational therapy

Often after stroke, patients have difficulty or are unable to carry out daily activities and personal care. Where physical therapists and speech pathologists help patients relearn or regain function, occupational therapists help patients navigate more safely and independently in the home or workplace. An occupational therapist may also play a role in recommending walking aids, or other assistive devices to help patients bathe, dress, drive or cook.

Rehab occurs in different settings

How, when and where a patient receives post-stroke care can vary. It can also evolve as certain milestones are met throughout the process, allowing for more independence and movement. Through constant assessment, the rehab team will determine the best situation, which might include one or a combination of the following:

Inpatient rehab: This may be a part of the hospital or a free-standing facility designed to provide intensive rehab for stroke survivors.
Skilled nursing facility: This type of facility cares for patients who are not ready to be discharged directly home but aren’t able to tolerate intensive rehab.
Home or outpatient rehab: Patients receive rehab services at an outpatient office or in some cases, in their home.

A stroke is a significant event that can profoundly change a person’s life in the blink of an eye. After a stroke, a supportive and robust recovery program with a well-rounded rehab team can help patients overcome their challenges, restore a sense of well-being and prevent another stroke.

Read about two Providence patients who recovered, aided by their rehab team:

If you or a loved one has questions about stroke recovery or stroke prevention, talk to a provider.---

Find a doctor

The heart and vascular specialists at Providence can help you recognize the signs of stroke and provide a robust post-stroke recovery program. Through Providence Express Care Virtual, you can access a full range of healthcare services. If you need to find a doctor, you can use our provider directory.