Rehabilitation After Stroke

 Programs | Goals | Specialists | Maximizing benefits

Spontaneous recovery accounts for most improvements in the first month after a stroke. However, rehabilitation can play an important part depending on the extent of the damage, the attitude of the person, the rehabilitation professionals involved and the help of family and friends.

Mobility improvements are most seen in the first six months after a stroke. There may be improvements in language, steadiness and self-care skills for up to two years.

You will want to discuss your choices of programs with your doctor. The type of rehabilitation needed may change as the person recovers.

Types of Rehabilitation Programs

Hospital programs - These programs can be provided by special rehabilitation hospitals or units within an acute care hospital. Complete rehabilitation services are available. The patient stays in the hospital during rehabilitation and a team of professionals provides therapy. These programs are usually more intense than other programs and require more effort from the patient.

Nursing home programs - The person stays at the facility during rehabilitation. These programs are very different from each other, so it is important to get specific information about each one. They vary from providing a complete range to only limited services.

Outpatient programs - Outpatient programs allow a patient who lives at home to get a full range of services by visiting an outpatient department, outpatient rehabilitation facility, or day hospital program.

Home-based programs - The patient can live at home and receive rehabilitation services from visiting professionals. An important advantage of home programs is that the person learns skills in the place where they will use them .

Choosing rehabilitation - Things to consider

-	Does the program provide the services the patient needs?
-	Does it match the patient's abilities or is it too demanding or not demanding enough?
-	What kind of reputation for quality does the program have in the community?
-	Is it certified and does the staff have good credentials?
-	Does it actively involve the patient and family members in rehabilitation decisions?
-	Does it encourage family members to participate in some rehabilitation sessions and practice with the patient?
-	How well are its costs covered by insurance or Medicare?
-	If it is an outpatient or home program, is there someone living at home who can provide care?
-	Is transportation to the program available?

What happens during rehabilitation? People recovering from stroke spend several hours a day doing physical, occupational, speech and recreational therapies. There are group activities and patient and family education. Therapists and patient will work on maintaining and relearning skills. Time is spent learning new ways to do things such as using one hand for tasks that usually need both hands.

Sources for this report include the National Institute of Neurological Disorders and Stroke and Consumer Guide No. #16 AHQR pub. no. 95-0664 US Agency For Healthcare Research and Quality.

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