Stroke Rehabilitation

By: Hannah Speckhart
Director of Rehabilitation
Southern Hills Skilled Nursing & Rehab Center

A cerebrovascular event (CVA/stroke) is the number 5 killer of all Americans and the number 1 cause of long-term adult disability. The rehabilitation period after this major event can help to decrease the odds of long term placement due to the level of disability. Stoke patients can see progress up to 6 months after the initial event/incident with appropriate rehabilitation.

strokeThe cause of strokes can be both environmental/behavioral as well as genetic. Risk factors for stroke include: high blood pressure, diabetes, smoking, history of TIAs, and high blood cholesterol. These risk factors can be addressed in order to be proactive to prevent stroke by way of environmental changes or medication. The common symptoms of a stroke are paralysis of muscles, impaired vision, slurred speech, numbness throughout extremities, facial muscle weakness. It is important to seek medical help at the initial onset of these symptoms because new advances in medication can help to lessen the long term effects of the stroke. The most recent drug being used is called “Activase or TNKase (both are a recombinant tissue plasminogen activator’s). This injection is used to treat an ischemic stroke within the first 3 hours of onset. This drug restores blood flow by dissolving the blood clot in order to remove the cause of the stroke onset” (Mayo Clinic). This medication can only treat a stroke of a certain “kind”; strokes can be caused due to difference origins. An ischemic stroke is when the blood vessels experience a blockage; this blockage causes restriction of oxygen to the tissues that is needed for basic function. There are also two different types of clots (occlusions) during an ischemic stroke: thrombosis or an embolus. A thrombosis is a clot that develops at a plaque within a blood vessel. An embolus is a blood clot that forms somewhere else in the body where it ruptures and travels until it reaches the small vessels of the brain, causing a blockage. The second type of stroke is a hemorrhagic stroke; this occurs when the blood vessel ruptures and causes bleeding inside of the brain.

Rehabilitation can look different for each person based on the specified symptoms that they are left with to face once the acute symptoms resolve. Speech therapy is a big proponent of rehab by helping people to strengthen their swallow musculature in order to eat foods of “regular” consistency as well as drink liquids of “regular”/thin consistency. Physical and Occupational Therapy can address signs of hemiparesis and make modifications/adaptions to technique or environment in order to promote the highest level of independence. Occupational therapy also commonly teaches appropriate stroke patients how to get dressed while using only 1 upper extremity and a plethora of adaptive equipment.

At Southern Hills, a large amount of our population has a past medical history of stroke or TIA (transischemic attack) which can be a precursor to a larger cerebrovascular event. The interdisciplinary approach is vital in order to make the most of the 6 month recovery period after the initial incident as well as to educate and assist with med management to prevent another cerebrovascular event. Those with a history of stroke, unfortunately increased their odds of having another event that could lead to more devastating deficits.

The Cleveland Clinic provides a helpful calculator to help determine your risk of a stroke, you can find it at: https://my.clevelandclinic.org/departments/neurological/depts/cerebrovascular/stroke-risk-calculator

It is a quick questionnaire that takes only a few minutes to complete.