What to expect during stroke recovery

Stroke recovery.
Therapy and rehabilitation after a stroke is designed to help patients regain as much functional and cognitive ability as possible.

Getting better after a stroke is a marathon, not a sprint. Thanks to years of research, we know some of the steps that can help stroke patients on the road to recovery.

As a specialist in neurological rehabilitation at UT Southwestern here in Dallas, I often share this reminder with stroke patients and their families. We offer many resources to help people understand a stroke. But the bottom line is, stroke recovery is going to take time.

What happens during a stroke

Strokes are caused by a sudden interruption in blood flow to the brain. There are two types:

  • Ischemic – Caused by a blocked blood vessel or clot.
  • Hemorrhagic – The result of a blood vessel rupturing in the brain.

When blood can’t get to a part of the brain, the oxygen and glucose in the blood cannot feed those neurons. These cells begin to starve and can die very quickly if no action is taken.

The impact of a stroke can range from mild to severe, depending on a number of factors such as the magnitude of the stroke and where the stroke occurs in the brain.

Stroke rehabilitation and therapy

The first step in stroke treatment happens when the patient has been admitted to a hospital. Immediate treatment can sometimes reverse at least some of the stroke’s effects. We often see patients for rehabilitation evaluation in the intensive care unit!

Once stroke patients are stabilized (usually within two to three days), they are transferred to a rehabilitation unit to begin therapy. At this point, patients still may have problems moving their arms or legs, speaking or understanding language (aphasia), swallowing (dysphagia), or even recognizing one side of their bodies. After a stroke, patients usually spend about two weeks in the rehabilitation unit.

At UT Southwestern, several specialists are involved in the care and rehabilitation of stroke patients, including:

  • Physiatrist – This doctor will act as the supervising physician, complete a full medical evaluation, and measure progress toward goals.
  • Rehab nurse – Evaluates the patient’s safety and provides information about the patient’s medications.
  • Physical therapist – Helps with patients’ movements, including walking and getting in and out of bed, and works toward improvement.
  • Occupational therapist – Evaluates how well patients can perform activities such as getting dressed or eating and teaches new skills.
  • Speech therapist – Evaluates patients’ communication abilities and helps with any difficulties in talking or swallowing food and water.
Kathleen Bell, M.D.
Kathleen Bell, M.D.

Every day, the rehab patient meets with these therapists. Goals are set to determine when it’s safe for the patient to return home.

Stroke events are very individual in how they affect each patient. As a result, rehabilitation needs to be tailored to each patient’s overall health and our ability to support recovery. For example, if there are steps leading into a patient’s home, therapists will work with the patient on stair climbing.

Some of the rehabilitation process depends on exercise. Through years of research, we know that enriching the environment around a stroke patient will help the patient’s brain regenerate faster. Specifically, exercise helps retrain brain cells as they are regenerating. When the patient exercises, lots of messages are sent to their brain to help it understand how to recover movement, communication skills, and other abilities. We can use advanced ways of helping this, such as electrical stimulation and specialized walking equipment.

How to help when stroke affects your family

Family support is very helpful during stroke recovery, and a few simple things can make the process smoother, including: 

  • Meeting the rehab team at the beginning of the rehabilitation process to go over the situation and what to expect going forward. Any changes that will need to be made at the patient’s home are discussed. If someone has trouble walking, for example, therapists might recommend removing throw rugs.
  • Keeping a journal in the patient’s room. This way anyone can write down observations, including staff and visitors. Doctors can leave a note for family members in case they don’t connect at the same time.
  • Attending a therapy session with the patient to learn about the recovery process. It’s important for family members to know what they can do to help.

Family members need to remember to take care of themselves, too. Patients will need their support when they return home to continue their recovery and therapy. It also may be helpful to educate yourself on how to prevent strokes in other family members.

Recovery from a stroke can be a lengthy, challenging process. Knowing what to expect and how to offer the best support can help everyone involved.