In the US, more than 795,000 people have a stroke every year, according to the Centers for Disease Control and Prevention (CDC).
While annually, 140,000 people die from strokes, the majority survive. However, strokes often result in a range of physical, cognitive, and emotional disabilities, and recovery can be a challenging process. Here’s what you need to know to better navigate it.
How to recover from a stroke
Up to 50% of stroke survivors will have a persistent or long-term disability. For example, paralysis or weakness on one side of the body is a common result of stroke, affecting upwards of 72% of patients, according to the Stroke Association UK.
The recovery time and severity of the stroke will depend on the area of the brain and the location of the blood vessel affected, as well as the type of stroke: ischemic or hemorrhagic.
According to the National Institute of Neurological Disorders and Stroke (NINDS), rehabilitation begins 24 to 48 hours after a stroke. A variety of medical staff and therapists may be involved to help rehabilitate different parts of the patient’s health: physical movement, occupational skills, speech pathology, and emotional changes.
Physical therapy aims to help stroke survivors regain the use of weakened or paralyzed limbs. Ross Berlin, MD, at AtlantiCare Neurosciences Institute, says paralysis impacts a variety of daily activities, like feeding oneself, bathing, dressing, or getting out of bed.
“Physical therapy includes the reproduction of these functions,” Berlin says, “as well as the use of therapeutic methods, such as robotic therapy, bracing, and medications to control some of the undesirable after-effects of a stroke.” Braces help support patients as they regain movement, and robotic braces both support and stimulate the limb to aid recovery and avoid long-term loss of movement and function.
It’s estimated around 14% of patients recover full physical function with the help of physical and occupational therapy — unfortunately, many will need partial or full-time care after a stroke. Most recovery takes place within the first few weeks, though improvements will often continue for up to four months.
Occupational therapists work alongside physical therapists to help stroke survivors regain independence as much as possible. While physical therapy focuses on regaining movement, occupational therapy is tailored to the patient’s specific difficulties.
A 2015 review of occupational therapy studies found occupational therapy was most effective when given to patients at home: one study used educational sessions based around self-care at home, like bathing, grooming, dressing, and nutrition, while another focused on assistive devices for ADL (activities of daily living) which helped stroke survivors with bathing and hygiene.
Occupational therapists will also work with survivors on healthy lifestyle habits to reduce the chance of a repeat stroke, as around 25% of people will have another stroke within five years. The American Stroke Association suggests up to 80% of second strokes and heart attacks can be prevented with lifestyle changes, like lowering blood pressure and cholesterol, increasing physical activity, quitting smoking, and improving diet.
Another common side-effect of a stroke is difficulty with speech, known as aphasia, which affects up to 33% of survivors.
“Speech and language therapists focus on a variety of functions including general thinking, processing and cognitive skills, understanding spoken language, the ability to express oneself in a variety of methods either verbally or using adaptive devices such as sign language, language boards, symbol boards or other methods,” says Berlin.
As with physical recovery, recovery of speech and language mostly happens within two to three months, and a full recovery is unlikely after this point. However, patients can still continue to make improvements years following their stroke.
“Unfortunately, speech and language skills are one of the more sensitive areas of the brain impacted by stroke, and while they can improve over time they may leave the individual with significant deficits for a prolonged period of time,” Berlin says.
Many stroke survivors experience emotional or personality changes, like forgetfulness, irritability, confusion, anxiety and anger. Lack of confidence, fear, and the impact of their physical and cognitive abilities are a source of stress for many stroke victims, and this often leads to family and relationship difficulties.
Extreme fatigue affects 25% of stroke victims, while a further 33% experience moderate fatigue, according to Stroke Association UK. Over a third of stroke patients experience post-stroke depression, according to the American Stroke Association, although Berlin says most patients experience depressive symptoms to some degree.
“Like other effects of stroke, it can be mild, moderate or severe,” says Berlin. “Support groups after a stroke can be extremely helpful when one shares one’s difficulties with others having the same or similar experiences.”
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