Stroke Rehabilitation Facilitates Recovery Process

Jeffrey Cameron, M.D., Medical Director, Sacred Heart Rehabilitation Institute at Columbia St. Mary’s

Posted: Sept. 1, 2006

Having a stroke is devastating. However, through rehabilitation, patients can often regain the strength, skills and confidence necessary to resume their daily activities. The rehabilitation process begins as soon as possible. In fact, most patients begin rehabilitation in the hospital as soon as they are stabilized, usually three to five days after the stroke occurred.

The majority of people recovering from stroke need about two to four weeks of inpatient therapy. However, some patients may need up to six weeks of therapy, while others may do well with only one. Sometimes when a patient has had a mild stroke and is hospitalized only a few days, rehabilitation may begin on an outpatient basis.

Although programs are individualized for each patient, standard focus areas include physical strength, conditioning, self-care, memory and thinking skills, walking, overall movement and communication. During rehabilitation, patients and their families learn to adjust to the physical, cognitive and emotional effects of stroke.

Customized therapy plans take into consideration the patient’s goals, physical condition and living situation. For many stroke survivors, it is important that they regain the ability to walk and take care of themselves before returning home. However, the degree to which a patient must regain these skills depends on the individual’s living situation. For example, a patient who lives alone or on a second-floor walkup may need more therapy than a patient who has the help of a capable and supportive spouse or caregiver and no stairs.

After leaving the hospital, stroke patients generally continue therapy on an outpatient basis. However, some patients may leave the hospital for a long-term care facility and continue rehabilitation there. Others may receive in-home therapy, especially if they have transportation concerns.

Patients who continue outpatient rehabilitation at Sacred Heart Rehabilitation Institute at Columbia St. Mary’s have a choice of two programs: The Brain Injury Day Treatment Program is a comprehensive program that offers an interdisciplinary and coordinated team approach. In addition to speech therapy, physical therapy and occupational therapy, people in this program may receive services provided by a psychologist, social worker and a therapeutic or vocational rehabilitation specialist. They may also undergo animal assisted therapy. Professionals in each of these disciplines work together in developing a specific treatment plan for each individual patient.

The Outpatient Neuro Rehabilitation Program is designed for patients who need individualized physical therapy, occupational therapy, speech therapy and/or psychology services provided by individuals who specialize in the care of individuals with stroke and other neurological diagnoses. Patients come to this program two to three times a week to work on specific tasks, such as progressing from a walker to a cane.

In both outpatient programs, patients work not only on improving mobility and activities of daily living, but also on how to compensate for new disabilities. For example, if a patient’s field of vision is affected by the stroke, he/she must be taught to consciously turn his head from side to side, especially when walking or using a stove. The programs also provide stroke patients with driving evaluations to make sure they are able to drive safely again.

While a primary goal of therapy is to maximize a stroke victim’s functioning, most patients should be prepared to accept some long-term weakness or sensory loss. At the same time, they can be assured that their disabilities may improve slightly up to a year after the stroke occurred.

Another goal of therapy is to help the patient prevent future strokes. Patients are encouraged to avoid risky behaviors, such as smoking, and to closely adhere to doctors’ orders by taking prescribed medications and following recommended diets.

Sacred Heart Rehabilitation Institute was the first in Wisconsin to develop an intense and comprehensive rehab day treatment program for persons recovering from neurological disorders, including stroke.

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