Rehabilitation Therapy After Stroke

April 06, 2018
Rehabilitation Therapy After Stroke

Stroke is one of the leading causes of long-term adult disability.  It affects approximately 795,000 people each year in the U.S.  Even the very word "stroke" indicates that no one is ever prepared for this sudden, often catastrophic event. But stroke survivors and their families can find workable solutions to most difficult situations with rehabilitation therapy after a stroke.  Working with a knowledgeable team of rehabilitation therapists helps you approach every problem with patience, perseverance and creativity.  Early rehabilitation gives you the knowledge and tools you need to improve functions and re-gain independence.  Sometimes remarkable recoveries for someone who suffered a stroke

What Is a Stroke?

A stroke occurs when blood cannot get to the brain.  This deprives the brain of oxygen and brain cells die.  Interruption of blood flow occurs in two ways:  An ischemic stroke  occurs  when a clot obstructs the flow of blood to the brain.  A TIA (transient ischemic attack), or "mini stroke", is caused by a temporary clot.  A hemorrhagic stroke. occurs when a ruptured blood vessel that prevents blood flow to the brain. When brain cells die, the area of the body that is controlled by those brain cells is affected.

Who Gets a Stroke?

Some risk factors are out of your control, such as your gender, age and race. But many risk factors can be influenced by diet and exercise. People who are at risk for a stroke have:

People with Heart and Blood Pressure Issues:

High blood pressure:  

Blood pressure is the force of blood pushing against the walls of your arteries as the heart pumps blood. An optimal blood pressure reading is under 120/80 mmHg and blood pressure readings up to 139/89 are in the normal to high range. Your ideal blood pressure is based on your circumstances and your doctor can advise you on what your ideal blood pressure is.


Atherosclerosis develops when plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can stop the blood flow. This can cause a heart attack or stroke.  Carotid Artery Disease occurs when atherosclerosis affects the carotid arteries in your neck that supply blood to your brain.  Peripheral Artery Disease or PAD, occurs when atherosclerosis effects the blood vessels carrying blood to leg and arm muscles.

Heart Failure or Congestive Heart Failure:

With this condition, the heart is still working, but it isn't pumping blood as well as it should.  Therefore, the brain and other organs do not get enough oxygen.

Arrhythmia, Atrial Fibrillation, or an Abnormal Rhythm of the Heart:

With these conditions, the heart is either beating too fast, too slow or irregularly. This affects whether or not the heart is able to pump enough blood to meet the body's needs. It can result in the blood pooling and develop a clot. Additionally, sleep apnea can be linked to atrial fibrillation and is associated with increased stroke risks.

Heart Valve Problems:

If the heart valves don't open enough, blood flow is hampered. On the other hand, if heart valves don't close tight enough, blood can leak through, causing blood to flow backward through them.

High Cholesterol:

Large amounts of LDL or "bad" cholesterol in the blood can build up and cause blood clots, therefore leading to a stroke.  In addition, it appears that too little HDL or "good" cholesterol can put men at risk for stroke. But more data is needed to verify if this is true for women as well.

People with Metabolic Issues:


If you have Type 1 or 2 diabetes, make sure to control your blood sugar. Diabetes mellitus is a risk factor for stroke. In addition, many people with diabetes have high blood pressure as well as high cholesterol and are overweight. This increases their risk even more. While diabetes is treatable, the presence of the disease still increases your risk of stroke.

People with an Unhealthy Lifestyle:


The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system and pave the way for a stroke. But even worse, the use of birth control pills combined with cigarette smoking can greatly increase the risk of stroke. So quit smoking now and lower risks. 

Poor Diet, Physical Inactivity, and Obesity:  

Physical inactivity can result in becoming overweight or obese. It can also increase your blood pressure and cholesterol as well as contribute to diabetes. Furthermore, excess body weight and obesity are linked with an increased risk of high blood pressure, diabetes, heart disease and stroke. In addition, diets high in cholesterol can raise blood cholesterol levels and diets high in sodium (salt) can increase blood pressure.  But a diet containing five or more servings of fruits and vegetables per day may reduce the risk of stroke. In addition, losing as little as 5 to 10 pounds can make a significant difference in your risks. Aim for being active at least 150 minutes a week. But if tracking the numbers is too much, just move more and sit less. Even if weight control has been a lifelong challenge, start by taking small steps today.  Lower your risk by managing your weight, increasing your activity level, and improving your diet.

What Are the Effects of Stroke?

In light of all the factors that can increase risk of stroke, it's no wonder stroke is one of the leading causes of long-term disability in adults.  It affects approximately 795,000 people each year in the U.S.   The after effects and severity of a stroke depend primarily on two factors:  first, where in the brain damage occurred and second, the extent of the damage.  Consequently, effects can range from mild to devastating.  After effects can include:

Weakness or Paralysis:   

A stroke often damages areas of the brain that control movement.  This can result in weakness or paralysis of the face, arm, or leg.  Typically, one side of the body is affected, but sometimes both sides are.  Weakness or paralysis can result in difficulty with using your arm and hand, walk, talking and swallowing, and completing activities of daily living such as taking a shower and getting dressed.  Or it can result in the inability to do them at all.

Sensory Impairment or Numbness: 

Just like a stroke can affect strength and movement, it can also affect the sensation or ability to feel the face, arm or leg.  Sensory impairment or numbness can result in difficulty with coordination and put you at risk for injuring yourself without even knowing it.

Cognitive Impairment:  

Cognitive impairment can include confusion, difficulty remembering, or trouble with organizing your thoughts and planning ahead.  It can cause difficulty with problem solving, thinking logically, and trouble following through with what you want to do.

Speech and Swallowing Impairment:  

Because a stroke can cause weakness and sensory impairment to the muscles in the mouth and throat, it can result in trouble speaking, chewing or swallowing.  In addition, understanding speech and communicating with others can be difficult when a stroke causes cognitive impairment.

Visual Impairment:  

A stroke can result in trouble seeing in one or both eyes.  It can cause blurry vision, double vision or a visual field cut

How Do You Recover From Stroke? 

Rehabilitation for Stroke

Although the consequences of stroke can be devastating, comprehensive rehabilitation can help you put the pieces back together again.  You will need a team of medical professionals who are experienced with the after effects of stroke to help you recover.  Your rehabilitation team may include your neurologist along with physical, occupational and speech therapists. Your rehab team will guide you through the course of your recovery to help you get back to the job of living.

Physical Therapy for Stroke

Your physical therapist will evaluate your flexibility, range of motion, strength, endurance, muscle tone, and balance.  She will look for impairment that might cause pain or interfere with your ability to move, walk, and maintain balance.  An individualized treatment plan will be developed and may include:

Manual Therapy

Techniques such as myofascial release, massage, tissue mobilization or other methods can help to increase tissue flexibility, range of motion and decrease pain.

Stretches and Exercises

Targeted stretches and exercises can help increase muscle strength and flexibility, increase muscle coordination and decrease pain.

Balance and Gait Training

Exercises and activities targeted at improving balance can improve walking, decrease loss of balance and reduce falls.


Modalities such as Neuromuscular E-Stim, TENS, Low Level Laser, Negative Pressure, Ultrasound help to increase tissues flexibility, decrease swelling, decrease pain and prepare tissues for movement.

Occupational Therapy for Stroke

Your occupational therapist will evaluate your arm and hand function, your visual function and your ability to complete activities of daily living such as dressing, bathing, cooking, shopping, driving or other functional living skills.  She will work with you to develop an individualized treatment plan.  Your plan may include:

ADL Training & Adaptive Equipment

Training in how to complete activities of daily living and identification of adaptive equipment such as reachers, dressing sticks, sock donners or other that can help compensate for changes resultant from the brain injury.

Exercise for Strength and Coordination

Stretches and exercises to decrease pain, increase muscle strength and flexibility, and increase muscle coordination.


Modalities such as Neuromuscular E-Stim, TENS, Low Level Laser, Negative Pressure, Ultrasound to increase tissues flexibility, decrease swelling, decrease pain and prepare tissues for movement.

Visual Re-Training

Eye coordination exercise and training in compensatory scanning to increase visual function for reading, driving and other functional activities.

Driving Rehab

Evaluation of safety to resume driving, identification of adaptive driving equipment needs, and training in risk reduction strategies.

Speech Therapy for Stroke

Your speech therapist will evaluate your cognitive function for memory, organization and problem solving.  She will assess your ability to communicate effectively with others.  She will also evaluate your ability to safely chew and swallow.  An individualized treatment plan will be developed and may include:

Cognitive Re-Training

Cognitive re-training includes brain exercises and activities to increase memory, organization and problem solving and training in strategies to compensate for impairments.

Speech and Language Training

Speech and language training includes exercises and activities to increase word finding, articulation, voice volume, breath support and comprehension to better understand what others are saying and express thoughts and ideas to others.

Swallowing and Eating

Swallow therapy includes exercises to increase lip, tongue, and throat muscles strength and coordination to enable chewing and swallowing in a strong and well coordinated manner.

What To Do Now?

Having a stroke can be very overwhelming.  It hits most people out of the blue leaving them unprepared to deal with the life-changing consequences that follow.  To compound matters, powerful emotions often follow.  Fear, frustration, guilt, anger, and depression can divert your focus away from rehabilitation therapy after stroke.   Fatigue can feel insurmountable.  But by partnering with a comprehensive rehabilitation team that you trust, you can navigate the rehab process to re-gain your function.  And Therapy Achievements wants to partner with you.  Together we can bridge the gap between where you are and where you want to be so you can reach your potential.