Recovery after a stroke

Acute cerebrovascular accident or, in other words, stroke, is one of the most common and dangerous diseases in the neurological practice of doctors. According to statistics, 450 thousand people die from this pathology every year, and even if a person managed to survive, 70% of patients face disability.

Despite the horrifying statistics, practice shows that after suffering an attack, it is quite possible to regain lost mental and physiological abilities, and rehabilitation after a stroke, as well as the attention and care of loved ones, can help in this. It is rather difficult to predict the prognosis for recovery in advance, since everything depends on the degree of brain damage, the individual characteristics of the organism. A patient after a stroke cannot do without an active rehabilitation course, so you need to be patient, believe in your own strength and strictly follow all medical prescriptions.

The main goal of rehabilitation after a stroke

During the development of a stroke, there is a pronounced oxygen starvation of brain cells, which leads to their death, rupture of capillaries and blood vessels, followed by hemorrhage of the cerebral hemispheres. The consequences of such pathological changes are quite severe and often lead to the death of a person. In neurology, there are two main types of stroke - ischemic and hemorrhagic. In the first case, blood does not enter the brain, and with a hemorrhagic stroke, on the contrary, a hemorrhage occurs in the brain.

The danger after a stroke is that a person loses physical abilities, there are speech and mental deviations, memory loss, problems with vision and coordination of movements. In order to return a person to his former life, or at least improve his condition, after providing medical care in a hospital, the patient needs competent and complete rehabilitation.

In modern neuroscience, stroke recovery consists of a range of physiotherapy, drug therapy, diet, and psychological support. All these activities allow you to fully or partially return the lost functions. The beginning of rehabilitation measures should be carried out from the first days after the relief of an acute condition and systematically continued for a long time. Many doctors believe that the sooner stroke rehabilitation is carried out, the greater the chance of a successful recovery.

Principles of Effective Recovery

After an attack of a stroke, a person stays in a hospital under the supervision of doctors for at least 3 weeks. During this period, doctors monitor the patient's condition, conduct diagnostics, and prescribe medications. With a stable condition of the patient, rehabilitation measures begin within 3 days after the attack, this will help to exclude a second attack, the development of convulsions, paresis and other life-threatening conditions. In the conditions of the clinic, specialists in physiotherapy exercises, massage, as well as a doctor-psychologist work with the patient.

Rehabilitation measures directly depend on the degree of damage to brain structures:

1. Mild degree - there are weak neurological disorders, coordination of movements is slightly impaired, paralysis of only one side may be present, memory is not impaired. Recovery usually takes 2-3 months.
2. Medium degree - characterized by serious problems with coordination and speech, one or two parts of the body are paralyzed, a person is not able to eat independently. It will take at least 6 months to recover from a moderate stroke.
3. Severe degree - the clinic is quite pronounced, the patient's condition is severe and complete restoration of all functions is impossible. But high-quality rehabilitation at this stage is very important for the patient, since it gives chances for a partial improvement in well-being.

The rehabilitation program after a stroke makes it possible to independently restore a person's ability to self-service, if possible, to conduct normal social and labor activities. After working with professionals in a hospital, rehabilitation is carried out at home, and it must be of high quality, systematic and correct. It is important to note that patients after a stroke need the help of loved ones who can devote maximum time to the recovery period.

For the correct recovery period, you need to follow some rules:

• Early start - rehabilitation should begin from the first days of hospital stay and continue at home until the lost functions are restored.
• Systematic - all procedures must be performed regularly, it is not allowed to skip medication, massage or exercise, it is also important to maintain the mental state of the patient, not to allow him to "lose spirit".
• Sequence - there are several stages of the recovery period, which depend on the condition of the patient. They need to be performed step by step, while depending on the opportunities achieved, move on to new stages - more complex ones.
• Multidirectionality - the lost functions of the patient must be restored in parallel.
• Supervision of a specialist - a person after a stroke should be regularly observed by a neuropathologist, also visit a rehabilitator who will be able to assess the condition, choose the right complexes of rehabilitation measures, and give useful advice on nutrition and lifestyle.

Rehabilitation of ischemic stroke has a more successful prognosis than with a hemorrhagic attack, but still partial restoration of lost functions is quite possible. The main thing is the good mood of the patient himself! It is important to understand and accept that it will take a lot of time for a normal life after a stroke, so you need to be patient and believe in yourself.

Stages of rehabilitation

Rehabilitation of patients after a stroke in terms of neurology is divided into 4 main periods:

• Acute - is 3 - 4 weeks after the attack. Recovery activities are carried out in the neurological department under the supervision of doctors and rehabilitation specialists. This period is considered very important for the patient, since there is a high risk of recurrent stroke, which in 85% of cases leads to death. Monitoring of the patient's vital signs is carried out daily.
• Early recovery - takes up to 6 months after the attack. At this time, a person is on outpatient treatment or in specialized centers, sanatoriums, where he daily performs a set of procedures prescribed by a doctor.
• Late recovery - from 6 months to 1 year. At this stage, a person is mainly at home, while there are already pronounced achievements in physical and psychological terms. However, all rehabilitation measures continue, and the patient regularly visits the attending physician.
• Remote - after 1 year the patient is at home or in a medical facility. With successful rehabilitation, the patient already has the ability to independently perform some movements, walk with canes, eat independently, mental abilities return.

Each patient goes through all these stages of the recovery period individually. Sometimes, already after 1-3 months, a person is able to get out of bed, move around the room, speech and visual functions return to him. But sometimes even after a long rehabilitation it is not possible to return the minimum abilities, the person remains paralyzed, requires constant care.

How is rehabilitation at home

If, after discharge from the hospital, a decision is made to conduct rehabilitation at home, the patient should first be visited by a rehabilitation doctor, a psychotherapist. In the process of their work, close people who will continue to care for the patient should listen to all the recommendations of specialists and in the future perform restorative procedures on their own.

Recovery after an ischemic or hemorrhagic stroke always requires an integrated approach and regularity, as well as patience and calmness, since any nervous shocks can provoke a second attack.

Medical therapy

Treatment after a stroke necessarily consists of long-term medication that will help restore brain function, improve the general condition of the patient, and reduce the risk of possible complications.

Medication allows you to:

• speed up metabolic processes;
• activate brain cells;
• improve blood circulation in brain structures;
• normalize blood sugar;
• reduce the level of cholesterol in the blood plasma;
• keep your blood pressure in the normal range.

In the post-stroke period, the following groups of drugs can be prescribed to the patient:

• nootropics;
• alpha blockers;
• tranquilizers;
• blockers;
• antidepressants.

The choice of any drug, dose, duration of administration remains with the attending physician and directly depends on the patient's condition.

Some drugs that are recommended for ischemic stroke are strictly prohibited for hemorrhagic, as they can provoke re-hemorrhage.

exercise therapy at home

The most important stage in the recovery period is physiotherapy, which begins with minimal exercises, which are increased each time. Exercise therapy after a stroke will increase muscle tone, restore lost strength in a paralyzed body, restore balance, perform standard household tasks and take care of yourself.

There are a lot of devices, simulators and exercises to restore the physical activity of patients, but in the early stages it is enough to perform simple exercises:

• Flexion, extension of the fingers, elbows, knees, hands.
• Using splints to stretch the limbs. To do this, the arm or leg is fixed with a bandage to a plank or other solid object for 30 minutes.
• The towel is hung over the patient, after which he grabs it with his hand, performs the available movements (raising, lowering, bending, unbending). As you improve, the towel is hung higher each time, which makes the exercise more difficult.
• To eliminate muscle spasm, it is recommended to put a roller under the knee area.
• Sitting or lying on the bed, as far as possible, raise the right and then the left leg up. Such an exercise is suitable for patients who have already been able to partially restore motor activity.

Before performing any exercise, you need to consult a doctor. In the early period of rehabilitation, the time for exercises is limited - 1 - 3 minutes, but as the patient improves, both the time and the load increase. If it is difficult for the patient to perform the given exercises, shortness of breath, palpitations appear, you need to stop exercising, put the patient to bed, measure blood pressure, and, if necessary, call a doctor.

In the early and late recovery period, various exercise machines, treadmills and other devices can be used for exercise therapy, which will speed up recovery.

Massage

An integral part of early and late rehabilitation is massage, which allows you to restore movement, reduce the risk of some complications. Massage is shown already in the first two days after a stroke with the patient feeling well. Particularly effective is segmental and acupressure massage. At the initial stages, the massage lasts 5-7 minutes, and in the future up to 20-30 minutes.

The course of treatment consists of 20-30 procedures, while they need to be carried out daily. After the completed course, take a break for 2 months and repeat the treatment. Massage procedures should be carried out by a specialist, since any wrong movements can be harmful to health.

Nutrition

A prerequisite for successful rehabilitation is the observance of dietary nutrition. Considering that with a stroke there are often violations of the swallowing and chewing function, so the diet should be sparing. In a serious condition of the patient or in the first weeks after the attack, nutrition can be carried out using a nasogastric tube.

Diet therapy during the recovery period includes table number 10, which consists of eating only high-quality foods with a minimum amount of fat and salt. The attending physician or nutritionist must familiarize the patient's relatives with permitted and prohibited foods, give recommendations on the frequency of meals and their preparation.

Diet principles:

• limit the intake of fats, fatty acids;
• exclude foods rich in cholesterol;
• daily salt intake should not exceed 3-5 g;
• increase your intake of fiber and complex carbohydrates;
• complete rejection of fatty, spicy and fried foods;
• portions are not large;
• all products should be served boiled, baked or steamed;
• food intake up to 5 - 6 times a day.

The patient's diet should contain liquid food, as well as a sufficient amount of fish, vegetables and fruits. Dairy and sour-milk products, lean meats will bring benefits. As the patient recovers, the diet can be expanded with other foods, but fatty and spicy foods, alcohol should be abandoned almost forever.

Psychological help

A stroke has a bad effect on the psychological state of the patient, since it is difficult for them to adapt to new living conditions. Patients are often in a deep depressive state, they can be overly aggressive, so the professional help of a psychotherapist is very important.

Those affected by the disease need moral support, it is extremely important for them to hear that everything will be fine and that he will recover soon. The patient should not feel like a burden, should strive for recovery. If the relatives are unable to cope with the patient's emotions, you will need the help of a psychologist, as well as taking antidepressants.

It is very important that a person who has experienced a stroke strive for recovery, otherwise there will be no effect from the treatment, and constant nervous strains may well provoke a second attack.

Recovery of speech and memory

After a stroke, many people have problems with speech and memory. Patients sometimes do not remember their loved ones, they cannot answer a simple question. Taking medications helps improve brain function and slowly restore speech and memory. However, in addition to taking medications, communication is important. The patient needs to read books, magazines, it is also recommended to show family photos, tell stories from life that will evoke positive emotions. In some cases, the help of a speech therapist is required. The doctor will show several exercises that allow the patient to pronounce sounds and first words.

Almost half of the patients present with memory problems. Depending on the extent of the brain damage, the patient may not remember certain moments in life or completely lose his memory. A huge role during this period is given to taking drugs from the group of nootropics, which normalize metabolic processes in the structures of the central nervous system, activate the brain.

During the rehabilitation period, to restore memory and speech, it is recommended to conduct special training:

• untie easy crossword puzzles;
• memorize and repeat numbers;
• memorize poetry;
• play educational board games.

Training to restore speech and memory should be carried out systematically, this will allow the patient to quickly activate the brain, learn to think and understand all the circumstances of the situation.

Home care for bedridden patients

A person who has had a stroke is not able to move independently, so he needs constant care. At home, you will definitely need the following items:

• vessel;
• diapers for adults;
• absorbent diapers;
• anti-decubitus circles,
• pole by the bed;
• soft carpet next to the bed.

It is very important to monitor hygiene, this will help to eliminate the appearance of bedsores. For proper care you need:

• 2 times a day to wash the patient;
• brush your teeth;
• wash mucous membranes;
• 1 - 2 times a week to clean the ears;
• every 2 to 3 hours the patient should be turned on its side;
• wipe food in the absence of a chewing and swallowing reflex;
• it is forbidden to feed on force, it can cause vomiting;
• with urinary incontinence, there is a need for catheterization.

After some time, with proper rehabilitation, it is partially or completely possible to restore some functions, which will allow the patient to take care of himself on his own. But until that moment, all responsibility lies with the relatives, who must be patient and not lose hope for the recovery of their loved one.

Life after a stroke

Many are concerned about the question - is it possible to recover from a stroke? It is difficult to predict the prognosis for recovery, since everything depends on the degree of brain damage, the age of the patient, concomitant diseases, and the quality of rehabilitation measures.

A person who has had a stroke attack, even with a successful outcome from treatment, will have to monitor his health for the rest of his life, stop smoking, drinking alcohol, follow a diet and a healthy lifestyle. According to statistics and medical observations, about 30% of patients return to partial restoration of vital functions.

Particular attention after a stroke is given in the first year of life, since there is a high risk of a second attack, after which a person dies or remains disabled for life.

Full recovery after a stroke is possible only with a mild attack, but the rehabilitation period is still very important, because it gives a chance for life expectancy.