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Stroke (Condition)

What is stroke?

Stroke, also called brain attack, occurs when blood flow to the brain is disrupted. Disruption in blood flow is caused when either a blood clot blocks one of the vital blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke).

The brain needs a constant supply of oxygen and nutrients in order to function. Even a brief interruption in blood supply can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen. The area of dead cells in tissues is called an infarct. Due to both the physical and chemical changes that occur in the brain with stroke, damage can continue to occur for several days. This is called a stroke-in-evolution.

A loss of brain function occurs with brain cell death. This may include impaired ability with movement, speech, thinking and memory, bowel and bladder, eating, emotional control, and other vital body functions. Recovery from stroke and the specific ability affected depends on the size and location of the stroke. A small stroke may result in problems such as weakness in an arm or leg. Larger strokes may cause paralysis (inability to move part of the body), loss of speech, or even death.

According to the National Stroke Association (NSA), it is important to learn the three R’s of stroke:

  • Reduce the risk.
  • Recognize the symptoms.
  • Respond by calling 911 (or your local ambulance service).

Stroke is an emergency and should be treated as such. The greatest chance for recovery from stroke occurs when emergency treatment is started immediately.

Stroke is the third largest cause of death, ranking behind diseases of the heart and all forms of cancer. Strokes kill more than 144,000 Americans each year. Almost 80 percent of strokes are preventable.

The -stroke rehabilitation program:

Rehabilitation of the patient with a stroke begins during the acute treatment phase. As the patient’s condition improves, a more extensive rehabilitation program is often begun.

The outlook for stroke patients today is more hopeful than ever due to advances in both stroke treatment and rehabilitation. Stroke rehabilitation works best when the patient, family, and rehabilitation staff works together as a team. Family members must learn about impairments and disabilities caused by the stroke and how to help the patient achieve optimal function again.

The goal of stroke rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life – physically, emotionally, and socially. Rehabilitation is designed to meet each person’s specific needs; therefore, each program is different. Some general treatment components for stroke rehabilitation programs include the following:

  • treating the basic disease and preventing complications
  • treating the disability and improving function
  • providing adaptive tools and altering the environment
  • teaching the patient and family and helping them adapt to lifestyle changes

According to the National Institute of Neurological Disorders and Stroke (NINDS), in general, there are several types of disabilities that stroke can cause: paralysis or problems controlling movement such as walking or balance and/or swallowing; sensory (ability to feel touch, pain, temperature, or position) disturbances; difficulty using or understanding language; thinking and memory problems, and emotional disturbances. Stroke rehabilitation can help you recover from the effects of stroke, relearn skills, and new ways to perform tasks and depends on many variables, including the following:

  • cause, location, and severity of stroke
  • type and degree of any impairments and disabilities from the stroke
  • overall health of the patient
  • family support

Areas covered in stroke rehabilitation programs may include:

Patient need:

Example:

Self-care skills, including activities of daily living (ADLs)

Feeding, grooming, bathing, dressing, toileting, and sexual functioning

Mobility skills

Walking, transfers, and self-propelling a wheelchair

Communication skills

Speech, writing, and alternative methods of communication

Cognitive skills

Memory, concentration, judgment, problem solving, and organizational skills

Socialization skills

Interacting with others at home and within the community

Vocational training

Work-related skills

Pain management

Medications and alternative methods of managing pain

Psychological testing

Identifying problems and solutions with thinking, behavioral, and emotional issues

Family support

Assistance with adapting to lifestyle changes, financial concerns, and discharge planning

Education

Patient and family education and training about stroke, medical care, and adaptive techniques

The stroke rehabilitation team:

The stroke rehabilitation team revolves around the patient and family and helps set short- and long-term treatment goals for recovery. Many skilled professionals are part of the pulmonary rehabilitation team, including any/all of the following:

  • neurologist/neurosurgeon
  • physiatrist
  • critical care nurse
  • internist
  • rehabilitation nurse
  • physical therapist
  • occupational therapist
  • speech/language pathologist
  • audiologist
  • dietitian
  • social worker
  • psychologist/neuropsychologist/psychiatrist
  • case manager
  • orthotist
  • recreation therapist
  • vocational counselor
  • chaplain
Types of stroke rehabilitation programs:

There are a variety of stroke treatment programs, including the following:

  • acute rehabilitation programs
  • subacute rehabilitation programs
  • long-term care rehabilitation programs
  • home health rehabilitation programs