Advice for Stroke Patients

[ahuramazda]

Hi, I know this is perhaps not the most pertinent board to post this on but was hoping to hear what the kind folks here would have to say.

A relative has recently had a stroke which has partly paralysed his left side. He has mobility problems and his vision has been affected. Slowly he's gaining more mobility but it's a long haul (7 weeks since the stroke). Whilst vision is currently poor, we're hoping this will improve in time.

I'm trying to educate myself on the best approaches to rehabilitation. Obviously, the NHS here in the UK has a program for rehabilitation but there's always other ways of viewing a problem.

Look forward to hearing from you.

[old goat]

Recovery from stroke can be very lengthy--months, even over a year. The brain heals on it's own--rehab doesn't help that. The important goals of rehab are to maintain muscle strength in the unaffected parts of the body, to maintain flexibility of the joints, and to a limited extent to reprogram healthy parts of the brain to take over the work of the damaged parts--this is highly age-dependent. I can't discuss specific rehab regimens, but frequency is important. Daily if possible or even twice daily. However, much of this can be done by family and friends after instruction and with ongoing supervision by the therapists. The psychological benefits of rehab are as important as the physical benefits, and the great majority of physical therapists I have worked with are very positive, inspiring, motivating people.

[skinipenem]

google "brain plasticity" and stroke

dead brain is dead brain. nearly dead brain can be recoverable brain. the rest of it ya gotta relearn.

good luck.

[kingdom-tele]

there is much more to post CVA rehab than maintaining the unaffected body, there are a variety of neurological levels PT can work at, including spinal loops that help with tone reduction, body recognition/perception training, eye mobility recovery, etc.

Here is a concept worth looking into amongst many...

http://www.citherapy.net/

Our plasticity is unfathomable.

All the best and good luck to your relative.

[old goat]

there is much more to post CVA rehab than maintaining the unaffected body, there are a variety of neurological levels PT can work at, including spinal loops that help with tone reduction, body recognition/perception training, eye mobility recovery, etc.

Here is a concept worth looking into amongst many...

http://www.citherapy.net/

Our plasticity is unfathomable.

All the best and good luck to your relative.

I have no personal experience with CI but it sounds like a reasonable approach for the young, very motivated patient with the resources to pay for it and who has enough function on the affected side to be able to live with the good limb restrained 90% of the time (the studies of this approach appear to have excluded severe strokes.) The CI regimen involves 6 hours a day of supervised exercise--compared with the 30-60 minutes once or twice daily or a few days per week most stroke patients get. The intensity of the regimen alone may explain much or all of the benefit, and may make it hard to reproduce the results outside the research setting. OTOH building one less F 35 would pay for CI for a lot of patients.

Re: plasticity--I saw a film of a patient who had an entire cerebral cortex on one side removed for a tumor. He was able to control both sides of his body with the remaining lobe, although he was more clumsy on the "wrong" side. The catch--he was an infant when he had the surgery. The ability of the brain to rewire is highly age dependent.

[kingdom-tele]

I here ya OG, definitely a demanding application, but it is more the notion that we have to avoid how to rehab people around their deficit vs working directly with their deficits. The time frames and intensities for anything should be individually applied as they can take it IMO.

the only difference in young vs older brain is synaptic strength, being older doesn't negate the physiology, it's resistance to change is compounded by having to overcome the structural issues associated with aging, but the brains ability is no different at 1 than at 81. we are designed for efficiency, often at the expense of attaining our potential.

it is merely one style. the best thing we can do is merely be involved and make movement as enjoyable and variable as can be.

[mtaylor]

I had a brain injury a couple years back, one thing I would highly recommend is a support group, just to meet other people who have gone through the same thing, and see recovery in action.