During a stroke, whether ischemic or haemorrhagic, nerve cells in the brain are damaged or deprived of oxygen causing them to diet. This leads to disability, but the severity of disability varies depending on the extent of damage to brain cells, which in turn depends on the speed with which emergency stroke treatment is provided. Stroke rehabilitation programmes will also therefore vary as they are based on the extent of brain injury and the brain circuits that have been damaged. Although rehabilitation cannot reverse brain damage, it can help restore some degree of independence to improve stroke outcomes over the long term.
An effective neurorehabilitation plan must be carefully directed, involving well-focused and repetitive practice. This is similar to the kind of training that is provided to students who must learn a new skill or sport, whether playing the piano or cricket. The rehabilitation plan will always be personalized as it must meet the requirements of each individual patient, focusing on skills and functions that have been impaired as a result of the stroke.
Some of the most common impairments that need to be addressed include weakness, impaired motor skills, poor coordination, trouble walking, loss of sensation, visual impairment, speech impediments, and difficulty communicating. We know from research using brain imaging technology that the human brain has what is defined as neuroplasticity. This refers to the ability of the brain to rewire brain circuits. Through this process, functions that are impaired because of damage to specific brain areas shift to other regions of the brain.
This process of the formation of new brain circuits or connections is driven by the rehabilitative process. A rehabilitation plan is designed specifically to impart or teach skills that were lost as result of brain cell damage from a stroke. Rehabilitation also helps stroke survivors to develop strategies that can compensate for any remaining disabilities. This helps to restore a greater degree of independence and a higher quality of life.
Another important goal of rehabilitation is to lower the risk of other complications after a stroke, such as injuries from falls, pneumonia, and clot formation, among others.
A stroke rehabilitation programme will generally commence as soon as the patient’s condition has stabilized, sometimes within just two days of suffering a stroke.
The first phase of rehabilitation is simply aimed at facilitating independent movement and strengthening of muscles to overcome weakness or paralysis. Therapists provide guidance with a variety of range-of-motion exercises, including assisted or self-performed exercises, aimed at increasing strength and mobility in weakened limbs, including the legs and hands.
Depending on the severity of the stroke, a patient may need assistance and training with basic activities such as learning to sit up or move around. Once a patient has acquired the ability to perform basic activities that are essential for everyday life, such as dressing, bathing, and using the toilet, the first phase of therapy is complete, providing a significant degree of independence.
The process of rehabilitation will continue after this phase with various goals of relearning skills, through a range of exercises and activities. The stroke recovery timeline can vary greatly among patients as every patient has a different experience. At a bare minimum modest stroke recovery can take days or weeks after initial treatment, but in most cases, recovery and rehabilitation will continue for months or even years after the stroke.
Stroke rehabilitation can be physically and mentally exhausting for patients, requiring hard work and determination, but it is potentially life-changing. This is why it’s important for family members and other loved ones to be involved in the rehabilitation process, providing support and encouragement, so that patients are more inclined to adhere to rehabilitation programmes and make a fuller recovery.
