Stroke rehabilitation does not reverse the post-stroke brain damage, but can substantially help stroke survivors become as independent as possible and attain the best possible quality of life.
Once the stroke survivor is out of immediate danger, the next focus should be on his rehabilitation program. The duration of stroke rehabilitation depends on the stroke severity, the level of tissue damage in the brain and how soon the survivor was given treatment. People who had experienced minor strokes are able to reduce post-stroke complications during their hospital stay only. Children tend to recover more quickly from stroke compared to adults. Since children’s brains are in the development stage, they have a better chance of returning to a full functional life faster against adults.
Different therapies could be involved in the survivor’s rehabilitation plan, including physical therapy, occupational therapy, Yoga or speech therapy. Since high blood pressure can be a risk factor for stroke, regular exercise that focuses on regulating blood pressure is the best way to avoid any future risk.
Physical Therapy (PT) is the most common method to resolve problems with movement, paralysis or loss of muscle function after Stroke. PT, primarily focusing on motor control relearning, may help the patient overcome postural instability and regain strength.
A physical therapist evaluates the stroke survivor’s posture, strength, flexibility, walking endurance, balance and coordination competency. Based on the results, an individualized exercise program is created, considering the stroke severity and the patient’s age, gender, history of illness and prior activity level.
The prescribed exercise program activates the affected part of the patient’s body and realigns muscles or joints. If a physical therapist is having a tough time to re-educate the patient’s brain and body through actual movement, certain rehabilitation equipment could be recommended to achieve speedy stroke recovery. Common PT interventions for stroke include proper positioning and careful handling of the hemiplegic shoulder or arm, Limb Physical Therapy, gait re-education, posture correction and Functional Training.
Occupational Therapy (OT) works on improving the patient’s motor and sensory abilities, promoting safety after stroke. However, OT principally helps survivors relearn skills needed for performing self-directed activities (also known as occupations), including personal grooming, preparing meals and performing other daily jobs.
Through OT, the stroke survivor is taught to divide a complex activity into its component parts and then practice each part to perform the whole sequence of actions. This strategy improves coordination and may help patients with Apraxia relearn how to carry out planned actions. The ultimate OT goal is to teach survivors driving and providing on-road training.
Occupational therapists also aim to change elements of stroke survivors’ environment that limit their activities of daily living. They also help patients make changes in their homes to increase safety such as installing grab bars in bathrooms to facilitate physical functioning.
Speech Therapy (ST) helps stroke survivors with Aphasia relearn language or develop alternative means of communication. Intensive exercises such as repeating the therapist’s words and certain reading or writing exercises can assist people with Aphasia. Conversational rehearsal, the development of prompts or cues help the patient remember specific words.
ST also aims at helping people improve their ability to swallow after stroke. Difficulties with swallowing can be caused by an inability to manipulate food with the tongue, a delayed swallowing reflex or an inability to detect food that is stuck in the cheeks after swallowing. Speech-language experts help the individual simply improve posture during eating.
Yoga can primarily focus on two impairments caused after stroke – difficulty with balance, and one-sided weakness. Modifying standing poses, such as Virabhadrasana (Warrior Pose) and Utthita Parsvakonasana (Extended Side Angle Pose), can help stroke patients in speedy stroke recovery.
The patients can practice Ardha Adho Mukha Svanasana (Half Downward-Facing Dog Pose) at the wall initially. As strength and balance develop, he may go for standing poses against a wall or try poses such as Utthita Trikonasana (Extended Triangle) and Utthita Parsvakonasana (Extended Side Angle).
As per many studies, music may stimulate multiple brain functions including motor function and attention among certain stroke patients. It can trigger the production of neurotransmitters in certain stroke survivors, enhancing connections between the auditory and motor systems. This, subsequently, can help the stroke survivor improve walking and speech.
Virtual Reality (VR) is a relatively new approach that is gaining popularity in stroke rehabilitation. Through the Computer Assisted Rehabilitation Environment, VR has been helpful in addressing motor deficits and shorten the recovery process in some patients. Through VR, the stroke victim experiences stimulation of neurons in the brain. By performing virtual activities that do not actually put strain on his body or cause any pain, the patient’s cognitive functioning is developed and perception is improved. The process, in turn, improves brain functioning.
However, a number of research studies on the effectiveness of VR in stroke rehabilitation are still underway.