The symptoms described by Peter are typical for the sudden onset of a stroke. Common first symptoms of a stroke are a flaccid paralysis of one half of the body and loss of the ability to speak. In addition to paralysis, patients may experience so-called neuropsychological disorders as a result of the stroke. This may include, for example, being able to only perceive one half of a room or being unable to plan sequential actions correctly.

To ensure a good prognosis for the condition, immediate attention is paramount.

Peter’s family did exactly what they were supposed to do. They administered first aid by bringing him into a safe position and calling an ambulance. Twenty minutes later, he was at the hospital and received emergency care.

The chances of surviving a stroke are much higher if the patient receives medical attention within one hour of the stroke happening.

The most common cause of a stroke is impaired circulation in the brain, which causes a localized deficit of oxygen and nutrients. In turn, this deficit leads to damage and death of brain tissue.

Another cause of strokes is cerebral haemorrhage. If a vessel bursts, blood seeps into the adjacent brain tissue, causing the death of nerve cells.

The good news is that the brain begins to heal itself as early as two days after the stroke. The dead tissue is removed. The brain starts to regenerate.

In time, other areas of the brain can take over the functions of damaged areas. When spontaneous healing is complete, typically after a few months, much of the remaining recovery depends on type and intensity of rehabilitation.

Our brain is a mysterious and wonderful organ. Neuroscientists have already succeeded in revealing many of its secrets but some things are still a mystery. One important feature of the brain is well known: its plasticity.

Plasticity is the brain’s ability to modify its structure and function. Studies have shown that this ability is not lost even after a stroke. 

Every therapist is aware of neuroplasticity and uses it as the driving force of therapy work with patients. Regular practice of functional tasks and the resulting repeated brain stimulation allow the patient to re-learn abilities such as speech, movement and cognition.

Often, before a stroke survivor can perform independent exercises, help and support from trained caregivers and therapists are needed. Optimal care is ensured in specialized facilities for physical, occupational, and speech rehabilitation.

Peter remembers how difficult it was for him and his caregivers when he attempted to sit on the edge of the bed in the intensive care unit for the first time. Various tubes and cables were still attached to many parts of his body. He continuously felt like his strength could fail him at any time. The support of his therapists and the encouragement of his wife motivated him to keep going.

If a patient can sit in a wheelchair for three hours a day and is able to concentrate during therapy sessions, it is time to begin a rehabilitation program. Then the search for the right rehabilitation facility starts, often with the help of a social worker or a case manager. Contact your insurance provider to obtain a list of facilities that are covered.

Following a stroke, a rehabilitation center offers the chance to regain mobility and cognitive function in a protected environment. Doctors and therapists work with stroke patients to achieve their goals. They identify the main symptoms that are causing the limitations and prepare a therapy plan consisting of coordinated rehabilitation measures.

A common symptom of stroke is paralysis. When beginning with rehabilitation, it might be that an arm and/or leg cannot be voluntarily moved. The muscles in an extremity may become tight after some weeks and months, making the joint stiff and difficult to move. This stiffness, or spasticity, can be mild to severe. Severe spasticity or immobility may result in joint contractures, or rigidity.  

There are several methods to treat a so-called hemiparesis, irrespective of whether the extremity is flaccid or spastic. Physicians and therapists work together with their patients to develop customized and individual treatment plans based on evidence-based practice and therapy techniques.

Rehabilitation following a stroke is a long process and many patients will still require care a year later.

Peter is still attending therapy sessions two years after his stroke. His next goal is being able to load and unload the washing machine and the dishwasher by himself. These accomplishments will help him relieve his wife´s workload at home and be more independent.

Like Peter, many stroke patients find new goals they strive to achieve. After a stay in a rehabilitation center, outpatient therapy helps to progress independence, reduce long-term impacts of the stroke, and teach patients to live with permanent limitation.

Today, after two years, Peter is looking forward to going to his favorite café by himself again. He has a trusted companion, a walking stick.

In the mornings and evenings, he needs his wife to help him with personal hygiene and dressing. Before she heads off for work, she also puts out some tools that help him with daily tasks. His favorite tool is a reacher which gives him greater independence and safety by decreasing the amount that he needs to bend down to reach objects from the floor.

Such tools can make everyday life a lot easier. Therapists and orthopedic technicians can provide advice regarding suitable aids and devices. Occupational therapists can also support independence in daily routines.

Peter’s story is a possible, but fictitious, example of stroke recovery. It is not a linear path to recovery and everyone’s journey is different.

Author: Hannes Aftenberger

Sources:

Neurorestoration after stroke. (2016)  

The relationship between Home-time, quality of life and costs after ischemic stroke: The impact of the need for mobility aids, home and car modifications on Home-time (2020)