After you are stabilized, rehabilitation becomes an important part of the recovery process. It may begin in the acute setting, then continue for months to years after the stroke. You may need to learn new ways to do activities of daily living. Many assistive technologies and adaptive tools are available to assist you in gaining self-sufficiency. The best outcomes are achieved by participating in focused programs that use repetition to rebuild skills and abilities.
Rehabilitation may include management of:
Your ability to speak or understand the spoken word may be affected by the stroke. You may also have gaps in memory, find it hard to put words together, or think through complete sentences. Speech therapy will assist you in regaining this important ability. It may take considerable time and effort.
After a stroke, it is common to have trouble with swallowing, which can affect your ability to get proper nutrition and hydration. Swallowing difficulties may involve choking or coughing while eating, or coughing up food after eating. Aspiration of food and liquid into the lungs increases your risk of developing aspiration pneumonia .
Speech therapists can also help with these problems. Depending on the results of your swallowing evaluation, you may need to make temporary or permanent changes to the kinds of foods you eat or how you consume them.
You may have trouble with walking. Even just sitting up may require extensive retraining of major muscle groups and coordination. You may need to use walking aids, such as a cane or braces, to compensate for weakened muscles. Physical therapy will be a very important part of maximizing your recovery. During regular therapy sessions, a physical therapist can teach you how to move about after a stroke that has caused leg or body weakness.
Studies have found that occupational therapy can improve the types of activities that you do every day (like feeding, dressing, bathing, and going to the toilet). Your doctor can refer you to physical and occupational therapists.
Hands and arms may also suffer from a stroke. You may have to relearn how to do things that you once felt were simple, such as writing or feeding yourself. Occupational therapists have a number of assistive devices to improve these functions when damaged by a stroke.
Symptoms of spacial neglect include difficulty processing stimuli from the environment. Cognitive behavioral therapy may help treat these symptoms.
For the first time in your adult life, you may have to depend on others to feed you, move you, dress you, get you to the bathroom, even just to stay alive. This is the most difficult aspect of stroke for most people.
In addition to family and friends, there are many professional caregivers with the skills to help you with your daily living activities. Your doctor and other members of your health care team will connect you with the help you will need.
Recovery may happen within days or it may take months. Along with your treatment team, set reasonable goals and put your best effort to achieve them.
Symptoms of depression often involve feeling profoundly sad and losing interest in activities that you once enjoyed. Depression is common after a stroke. This condition can be treated by working with a mental health therapist and taking medications. Antidepressants may assist the brain in recovery after a stroke, helping to restore mental and motor functioning.
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Chollet F, Acket B, Raposo N, et al. Use of antidepressant medications to improve outcomes after stroke. 2013;13(1):318.
Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011;42(1):227-276. Available at: http://stroke.ahajournals.org/content/early/2010/10/21/STR.0b013e3181f7d043.full.pdf. Accessed June 16, 2014.
Life after a stroke. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/lifeafter. Updated March 26, 2014. Accessed June 16, 2014.
Long-term management of stroke. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900125/Long-term-management-of-stroke. Updated February 16, 2016. Accessed October 5, 2016.
Post-stroke rehabilitation fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://stroke.nih.gov/materials/rehabilitation.htm. Updated March 6, 2014. Accessed June 16, 2014.
Stroke rehabilitation. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T580145/Stroke-rehabilitation. Updated September 9, 2016. Accessed October 5, 2016.
Swallowing dysfunction after stroke. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T474355/Swallowing-dysfunction-after-stroke. Updated September 29, 2016. Accessed October 5, 2016.
10/22/2007 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Legg L, Drummond A, Leonardi-Bee J, et al. Occupational therapy for patients with problems in personal activities of daily living after stroke: systematic review of randomised trials. BMJ. 2007;335(7626):922.
10/9/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Mitchell PH, Veith RC, Becker KJ, et al. Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant: living well with stroke: randomized, controlled trial. Stroke. 2009;40(9):3073-3078.
1/14/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Chollet F, Tardy J, Albucher JF, et al. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo-controlled trial. Lancet Neurol. 2011;10(2):123-130.
10/1/2013 DynaMed PlusSystematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Bowen A, Hazelton C, Pollock A. Cognitive rehabilitation for spatial neglect following stroke. Cochrane Database Syst Rev. 2013;7:CD003586.
Last reviewed December 2015 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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