The Physical & Mental Stages in Massive Stroke Recovery
Stroke affects each of us differently and so do the recovery process. Internally, it depends on where in the brain the stroke occurred and how bad is the damage. While externally, it can depend on our motivation to recover, the caregiver support, rehabilitation, and past health history.
We shall never compare each one of us as our cases are unique on our own. While generally, the first three to four month is where the rapid massive stroke recovery takes place, some of us even have it extended to the first one to the second year after stroke.
As stroke has stolen our independency and ability, rehabilitation exists to help us reclaim back both that we lost.
During rehabilitation, we are trained to function effectively according to our bodily limitations. Most rehabilitation starts soon after the stroke and done at the hospital and subsequently at home or community.
Physical Therapy For Stroke Patients
Stroke damages our brain cells and they cannot grow again. So the undamaged cells have to make new connections in the brain to make up for the lost function. This is called neuroplasticity. Physiotherapy helps to improve this process and speed the recovery process.
Early Stage of Physical Therapy
In order to prevent joint stiffness and muscle tightness, physiotherapist first assesses your disability and then instructs you to change the posture and position to prevent complications. Being more active speeds this process.
Once you are fit enough you can start with moving around the bed, sitting to stand, moving with support and then finally trying to climb stairs. It is important to do this step by step and not jumping straight into doing something more complex.
You should start by setting small realistic goals with time limits. These can be something minor like reaching for an object etc. But achieving it would prove to be a major success in the road to recovery. You can involve your family or caregiver into helping you achieve these goals.
While in the hospital, your improvement is measured every week by Functional Independence Measure Score (FIMS). It includes activities of daily living skills, mobility skills and communication skills. You are expected to improve by 1 to 2 FIM points each day.
For effective recovery, exercise and practising specific tasks in which you are not doing so well can be used.
If you are not able to stand without support, you should do it more often until you can. If you are unable to lift your hand, you should do activities that involve lifting that arm.
Constraint induced movement therapy is something which enhances this process. It restricts the movement from your “good” arm and allows you to work more with your “affected” arm so that your affected arm gets more strength.
Leg weakness can also be improved by doing strengthening exercises with the help of a physiotherapist initially and later at your home at leisure.
Orthotics which includes splinting and casting helps your motor control and reduce the tone of muscles. These can be made to fit you individually like ankle-foot orthoses which helps improve foot drop and walking ability.
Serial casting also helps in preventing and reversing contractures and reducing muscle spasticity. Spasticity causes contractures in muscles and thereby reduces joint movement. Antispastic medications like Botox (botulinum toxin) may help in this regard in addition to physiotherapy.
After Discharge From Hospital
Once you get home, be as active as you can while avoiding falls. Maintaining your general health is also equally important. Recovery from stroke is usually complete within 3 months and thereafter gaining new skills is unlikely.
But you should not abandon exercise because there are certain other benefits. It can make you better at something you are already doing clumsily and you never know you can maybe gain new skills if you are so determined.
Mental Recovery After A Stroke
Stroke comes suddenly putting your whole life to a halt. It is certainly a difficult time for you and your loved ones.
Feeling depressed, angry, emotional, anxious and change in personality can occur to any of us in that situation. But to some, these mental changes can be devastating and if not treated can result in loss of life.
Therefore, it is equally important to give attention to mental health as well as to physical health.
You and your caretaker must be aware of symptoms of depression like crying, feeling miserable, lack of motivation, loss of appetite, lack of sleep, palpitations and trembling.
Looking out for these and seeking immediate help is very important. You may need advice and therapy on how to cope with the situation, how to improve relationship with family members and sexual relationship.
You might be prescribed antidepressants if your symptoms are severe. You should continue the medication exactly as the doctor advised.
You need to be informed about your condition and treatment options in order to be less anxious.
Relaxing methods like hot baths, meditation, listening to your favourite music also might help.
If anxiety severely bothers you, visiting a psychiatrist may be helpful. They will direct you to Cognitive Behavioural Therapy which will change the way you think, feel and behave so that you are more positive regarding life. Sometimes you may need medication in addition.
You can talk openly how you feel to your friends and family. They will help you get through this whole ordeal.
Communication is important so that you can tell how you want to be treated.
This usually fades away with time. Finding something that can keep occupied and satisfied is crucial in maintaining mental well being. You can seek help from your friends and family in order to keep your spirits high and live a quality life.
Although recovering physically and mentally after a stroke is a lengthy and tiresome process, being informed and realising that there is a life beyond stroke, may lead you to live a long and happy life.