Convential Stroke Treatments
Rehabilitation nurses play an important part of the recovery process for stroke survivors that may have lost motor coordination or had some paralysis following a stroke. They specialize in teaching stroke survivors techniques for coping with everyday activities that need to be performed, mainly related to personal hygiene, safely moving from position to position (from a bed to a chair, for example), and keeping track of any medications that may have been prescribed. Rehabilitation nurses can also help with incontinence issues, teaching the patient exercises to strengthen the pelvic muscles and follow a bathroom schedule to regularly empty the bladder and bowels.
Occupational therapists also teach stroke survivors techniques to help them reacquire the day to day skills they may have lost that are related to paralysis or sensory issues. Activities such as personal grooming, house cleaning, and preparing meals can be quite difficult if there is numbness or lack of responsiveness of the limbs. Occupational therapists can help patients adapt by showing them compensatory strategies for keeping balance and performing tasks with just one hand or one side of the body. They can also introduce substitutions in the patient's environment to assist them, suggesting Velcro instead of laces and buttons, for example. Occupational therapists can also aid in making the home safer through installation of safety bars and removal of barriers that may hinder the stroke survivor's independence.
Physical therapists have a thorough understanding of the anatomy and physiology behind human movement and are vital in physical rehabilitation of stroke survivors. Through exercises designed to keep muscles flexible and strong, they can improve a stroke survivor's balance, endurance, and help them regain the motor functions they will need to stay mobile. This is mainly done through repetition of muscle movement designed to strengthen a muscle group and retain range of motion of the limb. A new technology called transcutaneous electrical nerve stimulation (TENS) may also be used to stimulate the nerves within unresponsive muscle tissues. Rehabilitation of individual muscle groups will help encourage all possible recovery of limb use. In addition to helping build muscles around weakened limbs, they can also teach some compensatory techniques to minimize the risks of falling or other injuries as the patient works toward reacquiring independence. More complex series of movements will also be practiced repeatedly to retrain the muscles for complex muscular tasks, such as stair climbing or navigation of obstacles in a room. Initially, these may be performed with a safety harness or in a pool of water (hydrotherapy) if the patient cannot yet support their own weight. As the stroke survivor becomes stronger, these therapies are very goal-oriented. Much physical therapy is oriented toward achieving completion of normal everyday tasks, but games are also quite popular, as they combine physical tasks with limb coordination, sequences of muscle movements, and cognition.
Stroke survivors can also work with speech and language therapists to regain their capacities to use and understand language. This may be necessary if there has been facial paralysis, which can make the physical parts of speech difficult. Though the brain may remember the words and the motions within the mouth and tongue that create speech, the mouth and tongue may not be as responsive as they once were. In these cases, speech pathologists can help a person relearn how to form sounds to communicate. Just as physical therapists teach movements that can compensate for lost muscular responsiveness, speech therapists can also teach the patients techniques that can help them make sounds that approximate the proper sounds and help their words be understood. If there has been any impairment in swallowing, patients can also be taught physical exercises to assist with swallowing and detection of food that may remain in the mouth during eating. Recommendations for modifying eating habits may also be made, such as thickening of liquids to reduce the chances of choking. If there are difficulties with aphasia, there are also therapies to help improve short term memory and comprehension of language. Through rehearsal and coaching, language therapists can assist stroke survivors in relearning to recognize social cues and remember specific words that they may have difficulty remembering.
Nearly 75% of stroke survivors have some sort of difficulty that prevents them from going back to work. Vocational therapists can help these people identify that strengths that they have and help them find jobs where they can use these strengths. They are, in essence, career counselors, and can also aid in finding employers and offering referrals. They may also be helpful in helping employers accommodate stroke survivors in the work place in compliance with the Americans with Disabilities Act. The ability to go back to work can be a very important part of the physical and emotional recovery of stroke survivors.
Finally, between 30 and 50% of stroke survivors experience depression, so counseling is also quite common. Psychologists and psychiatrists can help stroke survivors cope with the trauma of the stroke incident, as well as the aftermath. Antidepressants are sometimes prescribed to help a patient through this time, as they are working to regain their strength and their independence.
Additional Therapies Available in Patients Medical's Stroke Rehabilitation Program
To those recovering from a stroke, Patients Medical can provide a personalized hands-on rehabilitation program combining traditional medicine with modern technologies. Our integrative physicians will take into consideration your full medical history in addition to any difficulties you may be having following a stroke. Your personal goals for rehabilitation are very important to us, so you will also have a hand in designing your treatment program.
Because incidence of a second stroke is common, we will help identify factors that may have contributed to your first stroke in order to eliminate them. In addition to the conventional dietary recommendations traditionally made to stroke survivors to help them lose weight, manage their blood sugar, and cholesterol levels. Special care will be taken not to interfere with other medical prescriptions you are taking, but it is advised that you communicate with all your physicians about what treatments you may be receiving during your rehabilitation. Your dietary modifications will also be made considering the type of stroke that occurred. For example, garlic supplements may be advised following an ischemic stroke, as it has natural properties that help thin the blood and reduce clot formation. This would be ill advised for recovery of hemorrhagic stroke, however, as it may contribute to bleeding complications. Depending on your case, we may be able to prescribe natural supplements to aid in lowering your blood pressure. Vasotensin®, for example, is a supplement rich in fish proteins that have been shown to help maintain healthy blood pressure. Arginine Plus™ with Magesium is a supplement formulated with amino acids and minerals that can promote better circulatory health and heart muscle function.
To complement traditional physical and occupational therapy, massage therapies such as Reiki may also be recommended. In addition to relaxing the muscles and improving blood flow, Reiki is thought to stimulate healing processes in the body by harnessing natural, spiritual energies. Although Reiki treatments can be focused on specific injuries, the effects of Reiki are typically felt throughout the entire body, promoting healing not just of the body, but of the mind and spirit.
We also have facilities where stroke survivors may receive hyperbaric oxygen therapy (HBOT) as part of their stroke rehabilitation program. Although it is commonly thought that damaged areas of the brain are not salvageable, scientific studies dating back as far as the 1970's have demonstrated remarkable rates of improvement for stroke patients that undergo HBOT. It is thought that although the damaged tissue itself may not be revived, there are areas surrounding this tissue that may be restored with proper oxygenation.
During HBOT, the patient lies in a chamber that is pressurized beyond normal atmospheric pressure. The concentration of oxygen that air can contain is directly related to the pressure it is under; at higher pressure, the air can contain more oxygen. As the patient breathes in the highly oxygenated air, their blood oxygen levels can also collect much higher levels of oxygen. Not only will the hemoglobin, which normally binds and carries the oxygen molecules, become completely saturated, transport of the oxygen via blood plasma will also increase. As this highly oxygenated blood flows through the brain, the tissues will be nourished and dormant areas of the brain may reawaken. Scientists have reported a remarkable increase in recovery rate in patients that undergo HBOT, including improved speech, memory, and cognitive abilities. Stroke survivors may also notice recovery of vision, balance, motor skills, and physical mobility.
Next Steps:
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We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.
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Article Last Updated: 06/26/2009