Medical stroke rehabilitation is considered to be the process of regaining lost abilities and motions or relearning them anew. A stroke survivor may experience paralysis or problems controlling movement (also called motor control), sensory disturbances, speech and language ability (also called aphasia), cognitive function, vision as well as emotional well being.
Stroke rehabilitation oversees multidisciplinary medical professional involvement. Those include a rehabilitation doctor, physiotherapist, occupational therapist, psychologist and others. Before a stroke survivor is discarded from acute treatment, they are evaluated by a physical and rehabilitation medical doctor. They are given a rehabilitation plan, recovery options and motivation incentives. The medical specialist together with the patient sets the main recovery goals and therapy is prescribed for the patient’s individual situation. The patient after seeing a medical specialist may not be given an obligatory palliative care. Then, it is possible to seek rehabilitation options that are covered by the state, insurance or paid out of pocket.
Why stroke rehabilitation is important?
The rehabilitation and support a stroke patient receives can greatly influence their recovery levels and health outcome. Quality, timely rehabilitation that is suitable for the patient will be their best chance to achieve a most successful recovery. After stroke, the first three months the brain is much like a new brain. It can learn and adjust immensely (ability called neuroplasticity), thus it is crucial to start rehabilitation right after acute treatment. After three months, neuroplasticity returns back to a more normal state. However, the stroke patient can continue to regain lost functions, now at a slower pace.
Depending on the country, the types of stroke rehabilitation available are:
- Acute care and rehabilitation hospitals
- Outpatient rehabilitation
- Nursing facilities
- At home
Acute care and rehabilitation hospitals
Inpatient medical rehabilitation is the most common immediate type of rehabilitation to prevent consequences that stroke brings about. Before a stroke patient is discarded from acute treatment, the attending physician or rehabilitation medical doctor provides a referral and signs them up for rehabilitation in a nearby rehabilitation center. Even though it is possible to access rehabilitation a few weeks after discharge from inpatient treatment, there are cases when waiting to start rehabilitation can take up to 6 months.
If inpatient doctor hasn’t provided a referral, you should see a family doctor who can refer to an inpatient rehabilitation. Or they may refer to a physical and rehabilitation medical doctor for assessment of functional abilities. When evaluating a patient for potential rehabilitation services, the physical and rehabilitation medical doctor will assess:
- the patient’s health condition and related functional limitations
- potential for medical rehabilitation
- motivation of the patient and their loved ones
- health stability in order to receive rehabilitation services
Inpatient facilities may be freestanding or part of larger hospital complexes. Patients stay in the facility, usually for 2 to 3 weeks, and engage in a coordinated, intensive program of rehabilitation. Such programs often involve at least 3 hours of active therapy a day, 5 or 6 days a week. Inpatient facilities offer a comprehensive range of medical services. These include full-time physician supervision and access to the full range of therapists specializing in post-stroke rehabilitation.
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Outpatient stroke rehabilitation
Outpatient rehabilitation occurs right after the physical and rehabilitation medical doctor or rehabilitologist creates a plan for the patient. It is usually a monoprofessional type of rehabilitation service. Every medical practitioner works according to a plan, collaborating with the patient. It is possible to receive it in polyclinics, day hospitals and inpatient rehabilitation facilities. Rehabilitation services will be paid for either by the state or out of pocket, depending on your case. There are various possible options for receiving outpatient rehabilitation:
- In case the patient is in a relatively good physical condition and doesn’t need to go to a rehabilitation facility. The patient can return home to continue their rehabilitation routines with the help of nearby practitioners (physiotherapist, occupational therapist, speech-language pathologist, psychologist, etc) in inpatient or outpatient facility.
- The patient has already completed a rehabilitation course paid by the state or out of pocket in one of the rehabilitation centers and already returns home to complete their recovery. Or the patient has signed up for a following course and is waiting in line to receive the service.
- The patient has received a disability status and can sign up for an evaluation with the physical and rehabilitation medical doctor or rehabilitologist, who will come up with a rehabilitation plan and who refers to a rehabilitation service.
Outpatient facilities are often part of a larger hospital complex and provide access to a full range of doctors and physicians that specialize in stroke rehabilitation. Patients typically spend many hours, often 3 days a week, in outpatient rehabilitation facility getting therapy. These facilities may offer flexible treatment programs – as intense as in inpatient rehabilitation facilities, as well as less demanding regimens, depending on the stroke patient’s health state and condition.
Rehabilitation services available at nursing facilities are vary more than those available at inpatient and outpatient rehabilitation facilities. Skilled nursing facilities usually emphasize rehabilitation in particular, whereas traditional nursing homes emphasize residential care. Also, the regimens are not as demanding compared to inpatient and outpatient treatment programs, and fewer hours of therapy are offered.
The rehabilitation services available in skilled nursing facilities are for patients no longer needing hospital care but who still need nursing services, a less demanding rehabilitation program and 24-hour access to nursing support. You can find out more about the particular prerequisites whether you qualify for rehabilitation services in nursing facilities, depending on your country and particular case.
Stroke rehabilitation at home
If the patient has a severe or a moderately severe case, they have the option to receive rehabilitation or palliative care services at home from physicians, rehabilitation nurses, occupational therapists, recreational therapists, speech-language pathologists, vocational therapists and mental health professionals. This type of rehabilitation is prescribed by a physical and rehabilitation medical doctor or a rehabilitologist who accordingly create the rehabilitation plan. Medical rehabilitation at home can also be received through a referral from a family doctor which involves a rehabilitation plan, if the family doctor has learned to evaluate functional limitations and according improvement or preventative measures.
Home rehabilitation allows for greater flexibility so that patients can tailor their program of rehabilitation and follow individual schedules. Stroke survivors may participate in an intensive level of therapy several hours per week or follow a less demanding regimen. These arrangements are often best suited for people who require treatment by only one type of rehabilitation therapist.
For rehabilitation at home, the digital therapy tool Vigo is a great assistant which helps to create a stable daily regimen for a more successful recovery. It is accessible via software, at your home and anywhere with internet access. Vigo offers content to improve physical and emotional health, new and useful information about stroke, physiotherapy and breathing exercises every day as well as conversations based on effective psychological techniques. To register, write to firstname.lastname@example.org or fill out the registration form in the website.
Rehabilitation is a defining part of stroke recovery. Even though it doesn’t reverse the effects of a stroke, it makes you stronger, more capable and confident to help you return to a more independent life.