Rehabilitation and recovery after stroke
Neurology / / April 30, 2016
Most people who survive a stroke, have some form of disability.But many people are able to make significant steps to improve the condition and rehabilitation.According to the statistics:
- 10% of stroke survivors recover almost completely;
- 25% recover with minor impairments;
- 40% have moderate to severe disorders that require special care from relatives and doctors;
- 10% require care in a nursing home, etc.
For better recovery capabilities after a stroke it is important to start rehabilitation as soon as possible.
Rehabilitative therapy begins in the hospital as soon as the patient's condition stabilizes.The initial range of movements and exercises include moving the nurse or physiotherapist affected limb patient (passive exercise) and move the limbs in an outpatient practice (active exercise).Patients are encouraged to gradually sit, stand and walk, and then to perform the tasks of daily living (eg, bathing, dressing and using the toilet).
Some patients will recov
Nursing after stroke
Once the patient is discharged from hospital, he continues rehabilitation at home or on an outpatient program.Some patients can be transferred to a rehabilitation hospital.Others may require a long-term skilled care for the elderly and disabled.In addition to the current care physician or neurologist, rehabilitation team may include:
- physiotherapists, which focused on restoring physical function and helping patients to pick them strength, balance, coordination, etc .;
- occupational therapists - to help patients regain the ability to perform activities of daily living;
- reche-language therapists - to help improve speech and language skills;
- psychologists - to help mental and emotional condition of the patient;
- social workers - to help patients and their families with financial mechanisms and coordination of home care services.
- Stroke: Causes, Symptoms and Diagnosis
- treatment and stroke prevention
- Atherosclerosis and its causes
- Age-related changes in the heart and blood vessels
consequences of stroke
stroke can cause various possible limitation.Types of disability depends on what part of the brain has been damaged.
Five main types of disability for stroke:
- paralysis or problems with movement control . paralysis usually occurs on the opposite side with respect to the brain side of the body.If someone has a brain damage on the left side of the brain will be affected by the right side of the body, and vice versa.Unilateral paralysis called palsy, and one-sided weakness is called hemiparesis.Hemiplegia or hemiparesis may affect a person's ability to walk or grasp objects.Loss of muscle control may also cause problems in swallowing (dysphagia) or speech (dysarthria).Patients may also have difficulty in coordination and balance (ataxia);
- Sensory disturbances, including pain. Stroke can affect a person's ability to feel touch, pain, temperature or body position.Pain, numbness or tingling sensation may occur in paralyzed or weakened limbs (paresthesia).Sometimes patients have difficulty recognizing their damaged arms or legs.Some people who have had a stroke, suffer chronic pain.Muscle spasms or stiffness are common for such patients.sensitivity disorders can also affect the ability to urinate, or to control the bowel;
- problems speaking or understanding (aphasia). Many stroke survivors have language disorders that affect the ability to speak, write, and understand spoken or written language.This state of aphasia.Sometimes patients may know the right words, but they have problems with their pronunciation (dysarthria);
- Violations of thinking and memory. Stroke can affect concentration and short-term memory.This may affect the ability to make plans, learn new tasks, follow instructions or understand the meaning.Some stroke survivors unable to recognize or understand their disabilities or do not know what sensations affect the course of violations on one side of their body;
- Emotional disturbances. Some emotional and personality changes that follow a stroke, caused by the effects of brain damage.Clinical depression is a very common and not just the psychological response to the stroke but also a symptom of physical changes in the brain.Patients may have difficulty with emotional control, they may be inappropriate emotional reactions (crying, laughing, smiling, etc.) for no apparent reason.
Due to the fact that stroke affects different parts of the brain for different patients vary widely, specific approaches to rehabilitation:
- exercise program. recommended to patients as soon as possible to get to his feet to prevent deep vein thrombosis.Patients should try to walk more every day.You can thus take advantage of special devices, appliances, fixtures, to support the legs.Exercise on a treadmill can be very useful for patients with mild to moderate dysfunction.Exercise should be adapted to the physical condition of the patient and may include aerobic and neuromuscular (coordination and balance) types.
- muscle recovery. Stretching exercises used to treat spastic muscle.They can also help patients recover function of paralyzed hands.Developed and studied various methods.
- Speech therapy and sign language. intensive speech therapy is critical to recovery after a stroke.Doctors recommend 9 hours per week of therapy for 3 months.It improves faster when family and friends are helping to consolidate the speech therapy lessons.
- Education swallowing. Education of patients and their caregivers swallowing techniques, as well as secure and safe products and fluids are important to prevent aspiration (suction accidental food or liquid in the airways), it helps those who have suffered a stroke.
- Education attention. problems with attention are very common after a stroke.Direct re-training teaches patients with specific tasks, using repetitive responses to certain stimuli.This approach helps patients relearn the real skills and perform daily tasks.
- Vocational training. Occupational therapy is important in everyday life, improves performance and participation in society.
Drug therapy during rehabilitation
Medicines can sometimes ease the specific effects of stroke:
- dantrolene (Dantrium), tizanidine (Zanafleks) and baclofen (Lioresel, Gablofen) used for the treatment of spasticity.
- Botox injections are approved for the treatment of spasticity of the upper limb (eg, elbows, wrists, fingers).
- Heparin, a blood thinner medication used to prevent blood clots in leg veins (thrombosis).
- Some patients experience constant hiccups, which can be very serious.Chlorpromazine and baclofen are the drugs used in this problem.Antidepressants may be prescribed for the treatment of depression.
Emotional consequences of stroke
Stroke is emotionally difficult for patients and their families.Emotions Guardian in response to the patient's emotions are critical.The patient becomes worse when the caregiver is depressed or not aware of stroke.Guardians and the family need to be supportive and encouraging support for the patient, while he will not be able to do everything himself, to the best of their abilities and opportunities.