In-Patient Stroke Rehab: A Complete Care and Recovery
[ ReLiva understands the recovery of Stroke & Paralysis and that is why, it has established a full-fledged in-patient stroke Rehab center at Sapphire Hospital, Kalwa in Thane. It caters to Stroke / Paralysis patients from across Mumbai, Thane and Navi Mumbai.]
Understanding Stroke Rehabilitation
There are many steps to understand during stroke rehabilitation and it can feel overwhelming sometimes, especially if you're a new stroke survivor or caregiver. To help simplify the stroke rehabilitation process, we've outlined everything we think you should know about this journey.
Rehabilitation is the most important factor in recovery post stroke. It should be followed religiously daily and practiced throughout the day. No two stroke survivor’s prognosis is the same. The nature of symptoms can be different for similar cases of stroke. We never know how a brain responds post stroke. In some cases, the brain cells may be temporarily damaged and may resume functioning over time. In other cases, brain may re-organize its own functioning. In stroke, the other part of the brain usually takes over for a damaged region. In Stroke rehabilitation, it’s not only exercises that help, but a holistic approach is needed for recovery which should also include Occupational Therapy, Physical Therapy, Speech Therapist, Dietician etc. Along with proper prescription of exercises, the patient needs to get proper diet too, as it plays an important role and helps in modification of their lifestyle and also helps in prevention of another stroke. Post Stroke, the patient initially requires to undergo vigorous therapy to restore muscle function and for early ambulation (movement) and to attain independence. Researchers have found that people who participate in Stroke Rehabilitation Program perform better than most people who don’t participate.
What does Stroke Rehabilitation Include?
There are many protocols that can be followed in Stroke rehabilitation. Stroke protocol depends on part of the body affected or deficit demonstrated by the patient.
- Motor Relearning: These categories concentrate on your muscle strengthening and improving muscle coordination.
- Flexibility: These exercises help to improve muscle flexibility and prevent contractures and spasticity.
- Constraint-Induced Therapy: In this, your unaffected limb is constraint and you are made to practice by doing activity with your affected limbs. Due to this therapy, your brain recognizes functions of your affected limbs.
- Mobility Training: In this the patient is able to use mobility aids like walker, Hemi walker, cane etc. Patients are advised to use ankle brace to prevent ankle rotation and be able to bear weight on the affected limb.
- Transfer Training: This helps patient to relearn transfer techniques using the unaffected side in different settings.
Occupational therapy is also important at the same time.
- Fine/Gross Motor-Training: This includes improving fine motor and gross motor function of the patient. This includes holding a glass; picking a pin from the table etc. This helps patient to train his fingers and wrists.
- Dressing: This helps the patient to learn how to dress clothes using the unaffected side. Patient dressing could be modified by replacing buttons and zippers by Velcro, and Pants can be like just pull over’s.
- Toileting: This is the biggest issue faced by almost all patients and caregivers are very concerned. Patient is trained to access toilet with some modification in the toilet like side handle near the commode. Reacher are comfortable for regions where patients finds difficulty cleaning.
- Speech Therapy: This improves patient’s ability to speak and understands speech. It improves patient’s intellectual capabilities. It also helps in with lost cognitive abilities like memory, processing, problem-solving skills, social skills, and judgment and safety awareness.
- Psychological: Emotional adjustment will be tested. The patient may have to participate in counseling or support groups.
When Should Stroke Rehabilitation Begin?
The sooner rehabilitation begins; the earlier patient will be able to regain lost functions. But the priority should be that patient needs to be medically stable. It’s common to begin stroke rehabilitation within 24-48hrs of stroke. This could be done while in hospital.
Once the patient is discharged from critical care of the hospital, you can chose to take the patient home and manage the rehab care at home or opt for IPD rehab and attain faster comprehensive recovery in the initial few days. Once basic movements like shifting positions, toileting are attained, transferring the patient to home becomes much smoother for both patient and the care-giver.
How long does the rehabilitation last?
There is no appropriate time that can be predicted for the patient to recover. Some patient recovers in no time while some patients require longer time depending upon the severity of the stroke and demonstration of symptoms. Patient rehabilitation protocol may keep on changing depending upon the movement relearned and capability of mastering the new learning. With continuing practice, the patient can gain progression over time. After an initial burst of recovery in IPD rehab, patient can continue the rehab at home.
Who is Involved in Rehabilitation?
There is a large team that works together for the betterment of patient’s recovery. This includes:
- Physician: He monitors patient’s health and prescribes changes in medication depending on progress of the patient.
- Rehabilitation Nurse: She/he works in delivering medication on-time and incorporates learned skills in daily routines.
- Physical Therapist: They help the patient to relearn lost skills and improve muscle strength and coordination. Assist patient in ambulation and control balance.
- Occupational Therapist: These therapists help you to relearn arm and hand skill. They also assist in regaining eating skills.
- Speech Therapist: They help you in improving cognitive skills and also in speech and swallowing abilities of the patient.
- Dietician: They alter your diet according to the needs to your body. Usually diet consists of low fat and low protein and includes more green leafy vegetables and lot of fruits throughout the day.
What Factors affect Rehabilitation?
Stroke recovery varies from patient to patient. It is difficult to predict the rate of recovery in a patient. But it also depends on
- Physical Factor: Severity of stroke in term of physical and cognitive effect.
- Emotional And Psychological Factor: Rehabilitation depends on how patient accepts their defect and is motivated to work towards recovery. Practice outside the rehabilitation sessions helps better as it does not give time for the brain to forget the moment.
According to the research, the rate of recovery is greatest in the weeks and months after stroke. However, there are evidences that show progress even after 12 to 18 months. Yes, stroke rehabilitation is a long process, but there is tons of hope for recovery.