Recovering from a stroke

Rehabilitation after a stroke begins as soon as the person is medically stable. Stroke rehabilitation is tailored to the person concerned but will usually include physiotherapy, speech therapy, and occupational therapy. Other health issues that may have contributed to the stroke are also targeted to help prevent further strokes from occurring.

Goal of rehabilitation

The aim of treatment after the initial stage of a stroke is rehabilitation - that is restoring the person with a stroke to their greatest potential and maximum independence.

• Because every stroke is different there is no single or main treatment.
• If a person is medically stable they will be able to start rehabilitation 24 hours after a stroke (the sooner the better). Some people will need more rest and medical treatment before they begin specific treatment such as exercises.
• Each person will progress at a different rate, and faster at some times than others.

The rehabilitation programme

Members of the rehabilitation team work together to provide care and therapy for the person with a stroke, in a programme especially for their particular stroke.

Rehabilitation starts immediately, but its extent will depend on what the person can manage.

The programme will be:

• designed in consultation with the person with a stroke and their family
• adjusted over time to meet changing needs
• aimed at helping the person with stroke to overcome the problems associated with their particular stroke.

Physiotherapy

The aim of physiotherapy is to assess and treat problems to do with movement and balance.

This includes:

• explaining what is involved in physical rehabilitation
• preventing physical problems that may occur later because of immobility, too-tight muscles or the over use of the good side
• designing a programme of exercise to help the particular physical difficulties resulting from the person's stroke and giving ongoing instruction and help with exercises
• deciding whether aids (eg. a walking frame) will be helpful and arranging for these to be provided
• re-evaluating the exercises over time in light of the progress being made
• advising caregivers how to physically help the person (eg. how to lift them safely or get them comfortable when lying or sitting).

Occupational therapy

The aim of occupational therapy is to help the person to regain competence in the activities of daily living.

This includes:

• self care (eg. washing, dressing, toileting, feeding)
• household tasks (eg. cooking, cleaning, looking after children)
• interests (eg. playing a musical instrument, using a computer)
• vocation competency (eg. writing, driving, using specific tools).

Speech therapy

Speech therapy aims to manage swallowing and /or communication difficulties.

This includes:

• assessing and advising on the management of a swallowing disorder
• assessment of altered communication to determine whether it is a language difficulty or confusion
• finding out the type and extent of any communication problem
• advising the family/whanau how to communicate in the best way possible for the person
• preparing and carrying out a programme of management or therapy to encourage the return of communication
• recommending the use of alternative methods of communication where appropriate.

Further information

Stroke Foundation field officers are available to provide information and support to families/whanau and caregivers. (Stroke Foundation contact details under 'Further information and support' below).

Original material provided by the Stroke Foundation of New Zealand. Edited by everybody, March 2011.