WHO defined stroke as ‘rapidly developed clinical signs of focal disturbance of cerebral (brain) function, lasting more than 24 hrs or leading to death, with no apparent cause other than vascular origin.
Stroke is one among the top five causes of death in the Indian region. Although the prevalence of stroke appears to be comparatively less in India than in developed countries, it is likely to increase proportionally with the increase in life expectancy.
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.
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
- Fatigue
- Difficulty controlling emotions (emotional lability)
- Depression
- Difficulties with daily tasks
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
- Diabetes
- Having had a TIA (transient ischemic attack)
- Heart disease
- Older age
- High cholesterol
- Obesity
- 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.
What is stroke rehabilitation?
Stroke rehabilitation is the process by which a stroke survivor works with a team of health care providers with the aim of regaining as much of the function lost after a stroke as possible. By joining a comprehensive rehabilitation program immediately after leaving the hospital, stroke survivors can maximize their chances of recovery, and in most cases they can regain a substantial portion of the functions they lost as a result of their 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.
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
Occupational Therapy for Stroke Rehabilitation
Occupational Therapy is an integral part of almost every stroke rehabilitation program. A recent study concluded that patients who had received occupational therapy after a stroke were more independent in performing their personal activities of daily living and were more likely to maintain these abilities.
The primary role of the Occupational Therapist (OT) is to assist their patients to have the maximum independence in as many areas of their life as possible.
Why is stroke rehabilitation important?
The importance rehabilitation after stroke cannot be overemphasized. Studies have shown that rehabilitation is responsible for most of the recovery experienced by patients after a stroke, and that without it, little or no improvement can be accomplished. Stroke rehabilitation provides a targeted and organized plan to re-learn functions lost in the shortest period of time possible.
How long does stroke rehabilitation last?
The duration of the patient’s rehabilitation needs will depend on the type of stroke. The brief period of in-hospital therapy is followed by further rehabilitation in an outside facility for the following several weeks.
Although most of the patient’s improvement will take place within this time, his brain can continue to learn and re-learn new and old tasks for life long. This is why it is so important to continue with the rehabilitation at home after the patient has completed the visits to the rehabilitation center.
Although most of the patient’s improvement will take place within this time, his brain can continue to learn and re-learn new and old tasks for life long. This is why it is so important to continue with the rehabilitation at home after the patient has completed the visits to the rehabilitation center.
A successful outcome will require dedication, perseverance, and a positive attitude. In fact, some studies suggest that successful and meaningful recovery is more likely to be accomplished if the patients are dedicated and keep a high level of motivation during their rehabilitation process.
Acknowledgement:
National Institute of Neurological Disorders & Stroke (www.ninds.nih.gov)
stroke.about.com (www.about.com)
Article provided by:
DR. ALOK S. PATIL
OCCUPATIONAL THERAPIST &
PHYSICAL REHAB CONSULTANT.
Seeta Sadan, Near Ashray Hotel,
Bal govindas Road, Off L.J Road,
Mahim, Mumbai 400016.
Phone: 022-2430 3633.
Mobile:: 99 202 111 32
Email: patilalok@gmail.com
Web: dralokpatil.com 
