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Stroke Rehabilitation Information

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Introduction

Stroke is the third leading cause of death and the leading cause of long-term disability in the U.S. There are approximately 4 million Americans living with the effects of stroke. In addition, there are millions of husbands, wives, children and friends who care for stroke survivors and whose own lives are personally affected.

According to the National Stroke Association:

  • 10% of stroke survivors recover almost completely
  • 25% recover with minor impairments
  • 40% experience moderate to severe impairments that require special care
  • 10% require care in a nursing home or other long-term facility
  • 15% die shortly after the stroke
  • Approximately 14% of stroke survivors experience a second stroke in the first year following a stroke.

Successful rehabilitation depends on:

  • Amount of damage to the brain
  • Skill on the part of the rehabilitation team
  • Cooperation of family and friends. Caring family/friends can be one of the most important factors in rehabilitation
  • Timing of rehabilitation – the earlier it begins the more likely survivors are to regain lost abilities and skills

The goal of rehabilitation is to enable an individual who has experienced a stroke to reach the highest possible level of independence and be as productive as possible. Because stroke survivors often have complex rehabilitation needs, progress and recovery are unique for each person. Although a majority of functional abilities may be restored soon after a stroke, recovery is an ongoing process.

 

Effects of a Stroke

  1. Weakness (hemiparesis) or paralysis (hemiplegia) on one side of the body that may affect the whole side or just the arm or leg. The weakness or paralysis is on the side of the body opposite the side of the brain affected by the stroke.
  2. Spasticity, stiffness in muscles, painful muscle spasms
  3. Problems with balance and/or coordination
  4. Problems using language, including having difficulty understanding speech or writing (aphasia); and knowing the right words but having trouble saying them clearly (dysarthria)
  5. Being unaware of or ignoring sensations on one side of the body (bodily neglect or inattention)
  6. Pain, numbness or odd sensations
  7. Problems with memory, thinking, attention or learning
  8. Being unaware of the effects of a stroke
  9. Trouble swallowing (dysphagia)
  10. Problems with bowel or bladder control
  11. Fatigue
  12. Difficulty controlling emotions (emotional lability)
  13. Depression
  14. Difficulties with daily tasks

Types of Rehabilitation Programs

  • Hospital programs: in an acute care facility or a rehabilitation hospital
  • Long-term care facility with therapy and skilled nursing care
  • Outpatient programs
  • Home-based programs

Rehabilitation Specialists

  • Physicians: physiatrists (specialists in physical medicine and rehabilitation), neurologists, internists, geriatricians (specialists in the elderly), family practice
  • Rehabilitation nurses: specialize in nursing care for people with disabilities
  • Physical therapists: help to restore physical functioning by evaluating and treating problems with movement, balance, and coordination
  • Occupational therapists: provide exercises and practice to help patient perform activities of daily living.
  • Speech-language pathologists: to help improve language skills
  • Social workers: assist with financial decisions and plan the return to the home or a new living place
  • Psychologists: concerned with the mental and emotional health of patients
  • Therapeutic recreation specialists: help patients return to activities they enjoyed before the stroke.

Preventing Another Stroke

  • People who have had a stroke are at an increased risk of having another one, especially during the first year following the original stroke.
  • The following factors increase the risk of having another stroke:
  • High blood pressure (hypertension)
  • Cigarette smoking
  • Diabetes
  • Having had a TIA (transient ischemic attack)
  • Heart disease
  • Older age
  • High cholesterol
  • Obesity
  • Sedentary lifestyle

Although some risk factors for stroke cannot be changed (e.g. age) others such as high blood pressure and smoking can be altered. Patients and families should seek guidance from their physician about lifestyle changes to help prevent another stroke.

Resources

Agency for Healthcare Research and Quality
AHRQ Publications Clearinghouse
PO Box 8547
Silver Spring, MD 20907
1-800-358-9295
Web address: http://www.ahrq.gov/
AHRQ's free booklet, entitled "Recovering After a Stroke," is designed to help stroke survivors and their families get the most out of post-stroke rehabilitation. It provides information about the possible effects of stroke as well as types of rehabilitation programs and how to get the most out of the program you choose. It includes resources for help and information.
(Available in English and Spanish)

AHA Stroke Connection
1-800-553-6321
Web address: http://www.americanheart.org
A service coordinated by the American Heart Association. Provides information regarding stroke, how it affects the lives of stroke survivors and their families, how to find a support group and how to subscribe to the Stroke Connection Magazine.

Community Resources

  • Home health services, available from the Visiting Nurses Association, public health departments, hospital home care departments and private home health agencies.
  • Meals on Wheels: hot meals are delivered to the homes of people who cannot easily shop and cook.
  • Friendly Visitor (or other companion services): a paid or volunteer companion makes regular visits or phone calls to a person with disabilities.

Eldercare Locator
National Association of Area Agencies on Aging
927 15th Street NW, 6th Floor
Washington, D.C. 20005
1-800-677-1116
Web address: http://www.eldercare.gov

National Aphasia Association
29 John Street, Suite 1103
New York, NY 10038
212-267-2814
Web address: http://www.aphasia.org

Provides an educational packet of information about coping with aphasia which includes a listing of support groups.

National Easter Seal Society
230 West Monroe St., Suite 1800
Chicago, IL 60606-4802
1-800-221-6827
Web address: http://www.easter-seals.org

Easter Seals offers high quality programs for children, vocational training and employment, and medical rehabilitation services to children and adults with disabilities.

National Family Caregivers Association
10400 Connecticut Ave. Suite 500
Kensington, MD 20895-3944
1-800-896-3650
Web address: http://www.nfcacares.org
Maintains an information clearinghouse for family caregivers; directs people to appropriate resources.

National Rehabilitation Information Center
4200 Forbes Boulevard, Suite 202
Lanham, MD 20706-4829
1-800-346-2742
Email: naricinfo@heitechservices.com
Web address: http://www.naric.com
Provides information about rehabilitation facilities, support groups, and disability organizations. Can conduct specialized literature searches.

National Stroke Association
9707 East Easter Lane
Englewood, CO 80112-3747
1-800-STROKES
Web address: http://www.stroke.org

Provides educational materials on all aspects of stroke, including stroke screenings. Offers programs and support activities for stroke survivors and their caregivers.

Back to Stroke Information Page.

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

Last updated June 22, 2007