Stroke Rehabilitation: What are three types of post stroke rehabilitation therapies?

stroke patient

“A stroke can occur at any age, but is most prevalent in those over 65 –  in fact, one in six Americans in this age group will experience a stroke.”

National Institutes of Health

In a moment, a stroke can change your life. Where you once were able to talk a mile a minute, ride your bike, run, jump and play with your kids or grandkids, you now may have trouble speaking or even taking a few steps. Unfortunately this is the experience of more than 795,000 people in the U.S. each year. [1]

Every stroke is unique. Some are mild (called TIAs), some barely register at all, and some are quite severe, causing extensive damage to the brain and leaving lifelong impairments. Regardless of a stroke’s severity, stroke rehabilitation can help you regain as much function as possible.

Post-stroke rehabilitation should start as soon as possible

Areas of the brain damaged by a stroke are altered forever and can no longer function like they did pre-stroke. But through rehabilitation therapy, other areas of the brain are trained to take over those functions. Time is of the essence, because the sooner your body and brain begin training to regain lost function, the more complete your recovery can be. That’s why your medical team will begin therapeutic rehabilitation 24-48 hours after your stroke.

The level of rehabilitation and types of therapies you need depend on the effects of your stroke and its severity. Your healthcare team will recommend therapies to help restore optimal health and well-being. In most cases the three therapies described below are fundamental to any stroke survivor’s recovery.

Here are the 3 most common types of post-stroke rehabilitation therapies:

Physical Therapy

Paralysis or weakness on one side of the body is a common condition in stroke patients.  Physical therapy helps a patient regain the use of their affected limbs and lost motor skills. Some patients make a full recovery quickly, while others will need continuing therapy for months or years.

Physical therapy strives to teach the brain and muscles to work together while building strength, range of motion, and healthy muscle tone. It is an essential post-stroke therapy, as it helps patients improve their mobility and balance, walk faster, and function more independently.

“All stroke patients at the Penn Medicine Rehabilitation receive physical therapy and occupational therapy, and some also receive speech language therapy”, says Shannon K. Richardson, PT, DPT, NCS at Penn Medicine Rehabilitation. “Most patients tell us their primary goal is to walk again. We make every attempt to help them achieve that goal, starting with neuromuscular reeducation to promote and maximize active use of their affected trunk and limbs. Some of our treatments include the Bioness systems, body weight support systems and a 100-foot dynamic track system for balance and ambulation interventions.”

Shannon K. Richardson, PT, DPT, NCS

Occupational Therapy

Following a stroke, patients may have difficulty bathing, showering, dressing, grooming, going to the bathroom, and participating in their every day, functional activities. Occupational therapy helps patients regain their independence with these every day, meaningful activities and roles. Occupational therapists incorporate leisure pursuits, social interaction, and meaningful activities into treatment plans designed to regain motor skills in their affected limb.

Occupational therapists also work with the patient to educate and assist with healthy lifestyle habit formation to avoid further health complications and to manage current health conditions. These may include lowering blood pressure, controlling diabetes, adopting a healthy diet, lowering cholesterol, quitting smoking, and participating in meaningful exercise.

“As an occupational therapist, I use a holistic approach to healing after stroke”, says Natalia Stroutinsky Sobotka, MS OTR/L. “I take into account a person’s emotional, physical, and spiritual wellbeing when designing goals to help them participate in the everyday life tasks they value.”

Speech and Swallow therapy

The brain controls swallowing, speaking, understanding, memory, and problem solving. One or more of these skills can be affected based on the location of the stroke. A speech-language pathologist, also known as a speech therapist, works with the patient to address these changes so that the person can communicate effectively, eat and drink safely, and perform everyday tasks.

SWALLOW: More than half of stroke patients have difficulty swallowing; a condition known as dysphagia. Many people with dysphagia resume normal swallowing within a week after their stroke, but up to 13% continue to have difficulties. [1] A speech therapist performs an assessment on the person’s swallow function and determines the foods and liquids that will be safest to reduce the risk of choking and/or a lung infection. Speech therapy focuses on improving swallow safety and function by training in strategies to compensate for difficulties seen on the test. It can also include exercises to strengthen weakened musculature.

SPEECH/LANGUAGE: Aphasia is difficulty with expressing and/or comprehending language. It affects nearly one-third of stroke survivors. After evaluation, a speech therapist targets language strengths to enhance language weaknesses within structured and unstructured tasks. Communication strategies are established to maximize understanding and the expression of wants, needs and ideas between the person with aphasia and their communication partner. Although sixty-one percent of these people continue to struggle with aphasia one year after their stroke, [2] they typically improve their communication and/or quality of life with time and therapy.

COGNITION: Cognitive difficulties in memory, planning, and problem solving can also occur. This can make it difficult to successfully complete tasks such as finance management, medication management, scheduling and time management tasks, or driving. A speech therapist assesses the person’s current level of function after a stroke to deem if any assistance will be needed in these areas temporarily during the recovery process or whether certain assistance will be needed long-term.

As with physical therapy, speech therapy should begin as soon as possible post-stroke since people make the most and quickest gains within the first three months. However, people can still make progress in their rehabilitation even years following the stroke.

If you would like to learn more about the stroke rehabilitation program at Good Shepherd Penn Partners, please call 877-969-7342 or see our stroke rehabilitation program page here.

[1] Stroke Facts, Centers for Disease Contro and Prevention

[2] Dysphagia After Stroke: An Overview, National LIbrary of Medicine

[3] Stroke Statistics, Stroke Association