Dr Bal Athwal, consultant neurologist at the Wellington Hospital, part of HCA Healthcare UK, provides an insight into the range of current stroke rehab interventions.
Stroke rehabilitation refers to the program of different therapies designed to help patients relearn skills lost after a stroke. Stroke rehabilitation depends on the parts of the brain that were affected by the stroke so the rehabilitation can involve helping you with movement, speech, strength, or daily living skills.
The aim of stroke rehabilitation is to help patients regain independence and improve quality of life. It is typically recommended for all people affected by stroke.
What methods are most effective in stroke rehabilitation?
There are wide range of different methods used in stroke rehabilitation. As mentioned previously, it depends upon the areas of the brain that were affected by the stroke which dictates the most effective form of rehabilitation.
Some effective rehabilitation methods include:
Speech-Language therapy – this method involves speech and language pathologists helping patients to recover their ability to communicate and swallow after a stroke. It usually involves body positioning, tongue strengthening exercises, and dietary modifications. In some cases where the patient is struggling with communication, this can involve breathing and cadence exercises to help improve sentence formation and speech coordination.
Physical therapy – this method aims to help stroke patients regain their physical function or compensate for physical deficits after a stroke. It often involves strength and mobility training by a range of motion exercises. This is a very effective form of stroke rehabilitation as it helps target the affected muscles and keeps the nerves stimulated to retrain your brain to regain control of your body.
Occupational therapy – this form of rehabilitation focuses on restoring your ability to perform routine daily activities such as cooking, driving, and doing household chores. Perceptual training is one technique often used in occupational therapy to help patients with sensory and perceptual deficits. This type of training helps stroke patients overcome visual impairments, perception problems, or one-sided paralysis.
Neurological therapy – this method aims to improve cognitive and motor impairments caused by brain and nerve damage from a stroke. Brain exercises for stroke recovery may also be included in your treatment plan. These can include brain teasers, puzzles, music, and creative projects.
Mirror therapy – this is a technique used for one-sided paralysis or weakness. Mirror therapy involves doing small hand and arm motor skill exercises in the mirror. It helps to improve strength and coordination in the unaffected limb and enhance motor skills on the affected side.
Recreational therapy – similar to occupational therapy, recreational therapy aims to help patients return to the activities they previously enjoyed, in particular, recreational activities. For example, if you enjoyed playing cards with friends your therapist would help you to rebuild the skills to shuffle and communicate in order to be able to play.
Which methods aren’t used as much as they maybe should?
The biggest shortfall for most patients is simply due to difficult in accessing rehabilitation treatment. Rehabilitation services in many areas do not have sufficient capacity to see patients frequently enough or long enough so there may be patients with the potential to recover better who are missing out.
Some patients benefit from the targeted use of computer-controlled devices such as robotic-assisted walkers, or specialised upper limb rehabilitation aids. These devices are useful for a minority of patients as part of a planned expert rehabilitation programme. They are not available in many centres.
Functional electrical stimulation technology can help some patients who have loss of motor function. One form of this treatment helps stroke survivors with leg weakness to walk better. For some people this can make a large difference to walking if they can obtain the treatment.
Spasticity, which is increase in muscle tone, that occurs after stroke can contribute to disability, and in itself cause discomfort and reduced quality of life. Expert treatment of spasticity involves teamwork between therapists and doctors and may involve the coordinated use of therapy, medication and botulinum toxin injections. Wider use of such treatments may help more people in their recovery after stroke.
