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
- 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.
- Spasticity, stiffness in muscles, painful muscle spasms
- Problems with balance and/or coordination
- Problems using language, including having difficulty understanding speech or writing (aphasia); and knowing the right words but having trouble saying them clearly (dysarthria)
- Being unaware of or ignoring sensations on one side of the body (bodily neglect or inattention)
- Pain, numbness or odd sensations
- Problems with memory, thinking, attention or learning
- Being unaware of the effects of a stroke
- Trouble swallowing (dysphagia)
- Problems with bowel or bladder control
- Difficulty controlling emotions (emotional lability)
- 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
- 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
- Having had a TIA (transient ischemic attack)
- Heart disease
- Older age
- High cholesterol
- 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.