Sunday, January 12, 2014

Physical Therapy After a Stroke

by Chuck Jones

I'm not a medical professional I'm a computer geek so, before acting on anything I say in this post, I suggest you talk it over first with your doctor or physical therapist (PT). Recovering from the effects of a stroke is the most difficult thing a survivor and caregiver together must face when he or she returns home from the hospital. When a person suffers a stroke it has been estimated that they are losing 1.9 million brain cells per minute. You can see how this rapid deterioration, if left unchecked, is going to eventually seriously affect a persons physical well being as well as their mental one. The length of time this is allowed to go on is then going to affect how severe the deterioration is going get.

Stroke survivors have to relearn things previously taken for granted, perhaps, all over again. How much is determined by the factors mentioned above. Fortunately the brain can be retrained. With physical therapy the brain can be convinced it must try to repair or reroute paths around the damaged areas that used to control those muscles or mental faculties before the stroke. I'm going to be addressing only the physical part in this post. That damage can range from extreme weakness to an affected limb to that limb being completely paralyzed. Physical therapy with a licensed physical therapist is essential to get those arms and legs working again. We are talking about sitting, standing, walking, even something as simple as getting in and out of bed or a car. From the camps I've been to, I have seen how difficult these seemingly simple things can be to a survivor. But, as difficult as they are to them, they can be conquered to a great degree, if not completely, with physical therapy.

Oh, and you may have wondered what the difference is between physical therapy and occupational therapy, both being essential elements towards recovery? A simple explanation is that an occupational therapist helps you learn how to do things like feed and dress yourself while a physical therapist helps with muscle building and mobility training, i.e.: the sitting, walking, moving about I mentioned earlier.

The goal of the PT is to get the survivor moving as soon as possible and getting them to do this on their own. This is pretty much true for any type of hospital stay where motion has been affected, such as knee replacements and the like. You don't want those muscles to atrophy. After an evaluation of the patients condition, the PT will decide what needs to be done and many times, if the patient can't do it on their own, the PT will begin by doing it for them. The important thing is to get those muscles working.  

It's very important to note that the survivor is not and should not be alone in this. Caregivers and family members need to be involved also. Much encouragement and positive reinforcement from others is needed, and I believe the speed of physical improvement is directly related to how much and how often this is given. Expect the physical therapist to get others involved in sessions.

Physical therapy will often start in the hospital but it will, and must, continue even after discharge. The same therapist may even be involved but, if not, there are other programs and physical rehab centers available. The hospital should be providing this information prior to discharge. 

Of course, there is that ugly head of rehab costs that always affect the amount that can be afforded. Everyone's insurance and financial situation is different and so complicated I won't even attempt to cover that now. Just get it and get as much as you can and learn what needs to be done and do it with or without extended professional help. However, I believe recovery is faster, easier on the caregiver and more complete with professional care.

Here is an excellent link that can describe rehabilitation much better than I can in this space.

http://www.webmd.com/stroke/tc/stroke-rehabilitation-what-to-expect-after-a-stroke

Sometime in the near future I'll describe some of the exercises that are taught by the physical therapist. I won't be able to show you how to do them properly but I think I will be able to give you a general idea of what they are. Physical therapy is much more complex than what I can describe in a blog and a physical therapist is essential to make sure they are done correctly and without introducing more damage.

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