The process of post-stroke recovery lasts differently.
In water cases, abilities (both mental and physical) return to the patient during the first months after the illness. Others need more time.
But, unfortunately, the majority of the consequences remain for life. And here, the qualified assistance of specialists, as well as the support of relatives, becomes especially important.
After a stroke, life goes on, do not despair, because with proper persistence and appropriate mood, it is possible to restore the usual way of life.
To do this, follow the recommendations:
- visit a doctor regularly;
- daily pressure measurement;
- provide the necessary physical load on the affected limbs;
- follow a diet;
- exclude alcohol;
- no smoking.
Unfortunately, post-stroke recovery is not fast and time-consuming. And how long a person who has suffered a stroke will live depends on himself.
However, if you follow the doctor’s recommendations, eat correctly, eliminate bad habits and carry out drug prevention of the disease, it is possible to significantly improve the quality of life, but it is not yet possible to completely recover from the effects of a stroke, although there are rare cases.
A stroke is not a sentence. And the support of relatives at this difficult moment of life is a huge incentive to restore the patient’s usual way of life.
And here it is important to stop feeling sorry for yourself and “pick up”, then the quality of life will improve significantly.
After a hemorrhagic stroke in surviving patients, it is important to restore the functioning of the nervous system, internal organs and musculoskeletal system.
The recovery program after hemorrhagic stroke of the brain solves the following tasks:
- Improve the condition of the patient. It is important to eliminate the consequences of hemorrhagic stroke in the maximum volume so that the patient can engage in self-care, fully talk and move.
- Prevention of complications, such as contracture (impaired mobility in the joints from prolonged inactivity), muscle atrophy, pressure sores and infections in bedridden patients, psychological problems, depression.
- Relapse prevention is the main condition for reducing mortality from hemorrhagic stroke, since repeated attacks increase it several times. It is important to lead a correct lifestyle, observe the use of drugs and follow all the doctor’s recommendations.
It is important to remember: the sooner rehabilitation is started, the higher the chance of a full recovery. Restorative treatment should be started literally from the first days. With a well-designed program, many patients can achieve the following results:
- In the first three months, it is possible to return half of all lost functions.
- In the next quarter, the patient eliminates 20-30% of violations.
- The remaining disorders are eliminated within six months, a full recovery is possible.
Active rehabilitation should begin in the first 2-3 weeks. In parallel, treatment is carried out after a hemorrhagic stroke in the recovery period, aimed at resolving the focus of hemorrhage and preventing complications and relapses.
After suffering an intracerebral or subarachnoid hemorrhage, rehabilitation is aimed at eliminating the consequences that violate the patient’s normal life. These include:
- Disorders of movement and sensitivity. They are expressed in varying degrees, depending on the location and volume of dead brain tissue.
- Impaired coordination of movements – this complication often occurs after a hemorrhagic stroke, characterized by damage to nerve cells, which are responsible for complex and targeted movements. If rehabilitation is not carried out, the lost functions will not return in full and will lead to disability.
- Speech and swallowing disorders. Here you will need a consultation with an ENT doctor and speech therapist.
- Impaired memory, thinking, psycho-emotional problems. The degree of the disorder depends on a number of factors and requires a responsible approach during the rehabilitation period. With severe complications, a conversation is conducted with relatives who will partially control recovery from a hemorrhagic stroke at home.
Particularly great difficulties during the rehabilitation period arise in bedridden patients. This significantly limits the implementation of recovery measures, can lead to the development of pressure sores and muscle atrophy. This condition negatively affects the psyche of the patient, reducing motivation and interest in recovery.
Today, many patients are asking the question “how to recover quickly after a hemorrhagic stroke?”, But only 20% of the total number of patients turn to rehabilitation centers. Statistics show that the mortality rate in the first month when the patient is at home is 43%, and in a specialized institution – half as much. That is why doctors recommend restoration in specialized centers.
House restoration is possible only in the following cases:
- With a mild severity of hemorrhagic stroke.
- The stable condition of the patient.
- In the absence of severe motor disorders and speech dysfunctions.
Rehabilitation after a stroke is carried out by specialized neurological clinics, rehabilitation centers. In boarding houses and hospices there are patients who need constant care. In the later stages, the patient can improve health in a sanatorium.
The recovery process after ischemic stroke takes a long period of time. The most important stage here is the first three months, because it was then that 50% of surviving patients restored motor function. If significant progress was not achieved in this period, then most likely the process of destruction and dysfunction has become irreversible. The more severe the patient’s form of the problem, the less likely it is to recover completely.
A neurological hospital usually offers a number of comprehensive measures for restoring the functions of the affected body – a variety of massages, exercises with a speech therapist, occupational therapist, kinesiotherapist, neurophysiologist, physiotherapist, the use of innovative methods, in particular cold treatment, etc., as well as complex drug therapy.
After the hospital and inpatient recovery, another important stage of the patient’s recovery begins – his rehabilitation at home. It is impossible to identify its exact dates, since they depend not only on the effectiveness of the treatment, but also on the individual characteristics of the human body. Typically, basic activities need to be carried out for one to two years. The basis of recovery is systematic gymnastics, exercises and medications prescribed by the attending physician.
Shock loads are absolutely contraindicated, the emphasis is on lowering tension and muscle tone, improving microcirculation, preventing contact, protecting skin and tissues from pressure sores and resuming subtle movements. Before performing any physiotherapy exercises, it is necessary to warm up the muscles and tissues – massage and a heating pad are best in this context.
When the blow has already taken place and put in a hospital bed, it’s too late to talk about preventing it. Now the question is: how to live after a stroke? Is recovery possible? In most cases, part of the lost functions can be restored. To achieve maximum results, it is necessary to observe the main conditions of rehabilitation, then the chances of a normal life remain.
- The main thing is not to miss the first hours after a stroke. Get medical attention right away.
- Establish an accurate diagnosis, undergo examination for localization and volume of the damaged area.
- Prevent the progressive nature of the stroke or its recurrence.
- Undergo a series of rehabilitation measures both in the hospital and at home.
At the initial stage, rely on a specialist you trust. Take the patient to a clinic equipped with modern diagnostic equipment. The best option is a private hospital, a rehabilitation center, because, not everywhere, there are necessary conditions for receiving maximum care for a stroke. Regression of vital body functions depends on the severity of brain damage:
- Small (microstroke) – the patient may not be able to determine. Neurological disorders that are diagnosed as other diseases are noted. Their duration is fixed for 21 days. A person sometimes does not realize that he has suffered a stroke, and is at risk of relapse with serious consequences.
- Mild (moderate) severity of stroke – the symptoms of the disease are determined, but there is no progressive disorder or edema of the brain tissue. The task is to prevent the expansion of the area of damage, normalize the state of the cardiovascular system, blood pressure, restore lost body functions.
- Severe form of stroke – consciousness may be absent, neurological disorders progress, brain edema is recorded. The patient may be in a coma, rave or be conscious, but do not recognize anyone (dementia), do not react to events, remain in a state of “vegetable”. Most often in such cases, they assume a fatal outcome. Recovery is almost impossible.
- The consequences of types of stroke
- Features and importance of rehabilitation
- Where to start rehabilitation?
- Stroke Rehabilitation Techniques
- Work with a psychologist
- Duration of rehabilitation after a stroke
- Nutrition after a stroke
The consequences of types of stroke
– Alexander, what happens in the body during a stroke and why are its consequences so serious?
– A stroke is an acute violation of cerebral circulation, when the blood supply to any part of the brain stops. Blood supply is disrupted – and brain cells are damaged or killed, and this leads to a violation of any function of the body – speech, movement in the limbs, mental abilities, attention, memory, etc.
– Why is cerebral circulation disturbed?
– A stroke occurs either because of a blockage of a blood vessel that supplies the brain (ischemic stroke), or when a blood vessel ruptures in the brain (hemorrhagic stroke).
Vascular blockade can be caused by the formation of atherosclerotic plaques (fat deposits) or a blood clot that enters the bloodstream and causes blockage of the artery.
Rupture of a vessel with hemorrhagic stroke usually occurs in the softened wall of the artery: blood flows out, accumulates, which leads to compression of the brain tissue and damage to cells. In both cases, as a result of a lack of oxygen, part of the brain cells in the focus of the stroke die, and some are damaged.
for possible contraindications consult a specialist
– What symptoms indicate a stroke?
– There is a simple test that will help relatives recognize a stroke. You need to ask him to perform only three actions: smile, raise both hands and give his name. If the corner of the mouth is lowered with a smile, if a person cannot raise his hands due to the fact that one of them has become weak, and the name is inaudible, urgently call an ambulance.
Also, signs of a stroke can be:
sudden numbness of the face, arms, legs, weakness in the limbs,
sudden impaired consciousness, loss of ability to speak, difficulty speaking, loss of ability to understand the meaning of other people’s words,
sudden visual impairment in one or both eyes,
sudden gait disturbance, dizziness, loss of balance,
sudden severe headache for an unknown reason,
sudden nausea, pain in the face or limbs, general weakness (more often in women).
– Why is it so important to seek medical help in the first hours after a stroke?
– A stroke is an emergency. Only in the first 3−5 hours, medical care is most effective: this is the so-called therapeutic window, during which treatment can repair damaged brain cells and minimize the effects of a stroke. If you don’t ask for help in time, the cells will die irrevocably, and further treatment will only be aimed at adapting to life, taking into account the existing violations.
– How is a microstroke different from a regular stroke? Is it just as dangerous and also requires treatment?
– A microstroke, or transient ischemic attack (TIA), is a temporary violation of the blood supply to part of the brain, that is, a harbinger of a stroke. During TIA, a person may experience some or all of the above symptoms.
But take them seriously – be sure to call an ambulance! Your health and life depend on this.
Up to eighty percent of patients who survived an ischemic stroke in the brain become disabled in one group or another. Hearing impairment, vision, motor activity, aphasia, partial / complete paralysis of the body, neurological and somatic disorders, paresis are just a small spectrum of the consequences of this event.
Since there are several types of stroke, the consequences from them are different.
Hemorrhagic stroke occurs a little less often, but is accompanied by cerebral edema, coma and partial loss of some human capabilities. As for the ischemic, they rarely die from it, but often it ends with a second stroke.
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With an ischemic stroke, the patient may experience a mild loss of motor and mental abilities, but after rehabilitation they return. With regard to mortality, despite the frequency of development of this particular type of disease, the rate is about 30% in men and 40% in women, subject to prompt medical care.
With a hemorrhagic stroke, the brain suffers quite a lot, hemorrhage often begins in all areas of the cerebral cortex, lacunae can form, and then myocardial infarction begins. Therefore, the consequences are difficult to predict. This may be a coma or cerebral edema, paralysis or complete loss of speech or vision.
In this case, not only rupture of capillaries and blood vessels occurs, but also hemorrhage into the subarachnoid space of the brain. Because of this, there is little time for rehabilitation, and people often become disabled or even die. The death rate is almost 80%. Especially such a stroke is dangerous for newborns.
Features and importance of rehabilitation
Rehabilitation after a stroke is a mandatory process that is necessary for everyone who was able to survive the disease. It is best to undergo rehabilitation in specialized centers or in a hospital. If rehabilitation is not involved, then the patient may never regain the lost opportunities, and the risk of developing a second attack is doubled.
On average, recovery takes at least one to three months, but in complex cases and in advanced age it may take about six months.
You also need to understand that some functions will not be fully returned, and you need to continue the procedure after discharge, in full. Take equal time to take medication, massage, diet, relaxation and gymnastics.
Where to start rehabilitation?
– When can I begin rehabilitation after a stroke?
– After completing the treatment of the acute phase, that is, in fact, on the first day after a stroke. Even if the patient is lying, he can and must move – turn his head, move his arms and legs, try to sit down.
Even with bedridden patients, passive exercises can and should be done.
The rehabilitation program begins already in the hospital and continues at home (or in a sanatorium, medical center). Every day after a stroke is a job on the road to recovery.
for possible contraindications consult a specialist
– What should be the first step in the recovery process?
– First of all, you need to work on the correct position of the body – positioning: this facilitates the restoration of motor abilities, prevents muscle injuries, contractures, reduces pain. The main principles of positioning:
- maintain the maximum possible symmetry of key points (shoulders, shoulder blades, pelvis), keep the head, shoulders, hips in the correct position.
- gold melted – the patient lies on either side, but not on his back.
- Do not ignore the fixed part of the body. A bedside table is put on the patient’s bed on the affected side, so that when moving, for example, behind a mug, the patient stretches across the sick side and activates it. Learn to use your weak hand – to support, support, open the door, turn on the light. It is important to develop a strong habit of using a weak hand, as far as possible now.
– Does the patient need physiotherapy exercises?
– Mandatory. Exercise therapy is necessary to restore movement skills and prepare for the moment when you can move more fully. As a result of regular exercises, the shortened muscles of the hand, forearm, and back surface of the legs will stretch, weakened muscles of the hands will be activated, the amplitude of movements will increase, and the balance between sitting and standing will improve.
If the patient has impaired speech, articulation exercises are necessary (for the tongue, lips, muscles of the lower jaw, facial muscles). We need vestibular gymnastics to restore coordination of movements, exercises for rehabilitation for motor disorders. Having mastered these exercises under the guidance of a doctor, you can do them at home – first with the help of relatives, then yourself. The main thing is regularity: 5-6 times a week, 30-40 minutes a day.
The patient in this condition is most often configured to lie, but your task is to insist that he move. Adequately assess his condition, and if he can get to the toilet himself, do not put dry closets near the bed. If the patient is able to eat on his own, do not feed him with a spoon.
Rehabilitation begins with a full examination, diagnosis and conclusion of a doctor – only then can a full-fledged program be developed for gender, age and characteristics of the patient’s body. Diagnostics will help establish the cause, determine the affected areas of the brain and develop possible solutions. Next, a package of techniques will be proposed, which often consists of taking medication, surgical intervention, treating pathogens, improving the condition of the cerebral cortex and tissues, physiotherapy, diet, etc.
Stroke Rehabilitation Techniques
It is necessary to carry out a comprehensive recovery program, which includes the observation of the patient by several specialist doctors, as well as various types of therapy – from medication to alternative medicine. The conduct of the “struggle on all fronts” accelerates recovery, prevents complications and the development of repeated hemorrhages.
Medicines are the first thing to start a rehabilitation program for cerebral hemorrhages. For prevention, several groups of drugs are used that improve blood circulation, the functions of the nervous system, which strengthen the walls of blood vessels.
Supportive care after hemorrhagic stroke includes the following drugs:
- Hemostatics (Dicinon, Ethamsylate, Cyclonamide) are used to prevent re-stroke, their main task is to stop bleeding. These funds are actively used in the early days of rehabilitation and reduce mortality among patients.
- Drugs that lower blood pressure (antihypertensive drugs) are an integral part of the rehabilitation program, since an increase in pressure often leads to rupture of the vessel with the subsequent development of hemorrhage. Taking these drugs improves the patient’s well-being, complementing the rehabilitation period.
- Nootropics improve brain function, relieve fatigue, increasing the efficiency of the nervous system. To provide a pronounced effect, these drugs after a hemorrhagic stroke should be taken regularly, strictly following the doctor’s recommendations.
- Antidepressants are indicated to adjust the psychological status of the patient. According to studies at the University of Iowa, these drugs have made it possible to achieve a significant improvement in the well-being of patients who have had a hemorrhagic stroke. After their reception, memory returned, thinking improved. Scientists also argue that antidepressants contribute to the adaptation of patients to everyday life.
It is important to note that drug rehabilitation should be carried out strictly under the supervision of a doctor – with the independent use of drugs, you can harm your body.
Magnetotherapy after hemorrhagic stroke
In the recovery period after hemorrhagic stroke, various methods of physiotherapy are actively used, but before their appointment, you need to consult a doctor. If the doctor makes sure that the patient’s health is not in danger, the following methods of physiotherapeutic treatment are allowed:
- Electrical stimulation use of weak pulses of electric current in order to eliminate paresis or paralysis in the muscles. This technique is indicated for movement disorders, but it should be implemented carefully to prevent repeated hemorrhages.
- In case of violation of swallowing, muscle stimulation with a special apparatus can be prescribed, which will be carried out under the supervision of an ENT doctor and physiotherapist
- A few months after the attack, ultrasound phonophoresis, magnetotherapy, laser therapy, etc. can be performed in certain areas. – these methods restore damaged tissue after prolonged immobilization, stimulate muscle function.
To restore muscle tone on the affected limbs, patients are prescribed a gentle massage. Begin with short sessions of several minutes, gradually increasing the duration.
Massage after hemorrhagic stroke
Massage for hemorrhagic stroke:
- contributes to improved nutrition of affected tissues;
- prevents bedsores and diaper rash;
- restores neuromuscular conduction, activates the work of the motor centers of the brain;
- helps normalize muscle tone.
Massage is preferably carried out in specialized institutions with a professional masseur. If it is impossible to visit the hospital, a specialist can be called to the house, or the procedure is performed by the patient’s relative after appropriate training.
An integral part of the treatment and recovery from hemorrhagic stroke is exercise therapy. Gymnastics is very useful both for the normalization of partially lost motor activity, and for the functioning of the nervous system. Before carrying out the patient, a neurologist will consult the patient, after which a special gentle program is drawn up.
The basic rules for conducting exercises after a hemorrhagic stroke:
- In the absence of contraindications, you can start a few days after the attack, but in a supine position and sparing mode. This will save neuromuscular connections, prevent the formation of pressure sores.
- If rehabilitation is successful, after 5-7 days the patient is allowed to sit on the bed, performing special exercises with arms and legs.
- After 3 weeks, the patient learns to walk and the final skills of self-care.
All these terms are average. Of course, they will depend on the condition of a particular patient. Some patients manage to be “lifted” very quickly, while others remain bedridden for a long time.
Recently, both of these methods have been actively used to restore fine motor skills, motor activity, and self-care ability.
Mechanotherapy is the use of specialized simulators that moderate the muscles of the limbs, restoring their tone. This program includes:
- In the first days after the disease, special shoes are used with airbags, which are inflated alternately in the feet and fingers, simulating walking. This approach allows the nervous system not to “forget” the mobility skills, greatly simplifying further rehabilitation.
- After 5-7 days, a special exercise bike is used for bed patients, which develops leg muscles, improves blood circulation. This method is also the prevention of pressure sores and paralysis.
It looks like an exercise bike for a bed patient
- If the patient cannot stand up, after 14 days special medical couches are used to move the patient to a vertical position – verticalizers. This is necessary to activate the motor centers of the brain and vestibular apparatus.
- With successful treatment for the 3rd week, a standard exercise bike is used, as well as specialized exercises in the gym, performed on simulators, to develop the muscles of the arms and legs.
The program is complemented by ergotherapy – the implementation of simple labor activities to restore fine motor skills. Thanks to this method, the patient gets the opportunity to engage in self-care and adapt to everyday life.
Work with a psychologist
To stabilize the psychological state, it is advisable for patients to be observed by a psychologist, since half the success depends on the patient’s mood for a speedy recovery. The doctor conducts conversations, revealing anxiety and irritability, fear of death or suicidal thoughts.
At the initial stages, moral support is provided, if necessary, specialized drugs are prescribed. The psychologist works not only with the patient, but also with his relatives. The doctor explains to relatives and friends how to behave with the patient, preventing him from becoming depressed.
If hemorrhagic stroke is complicated by speech impairment, a speech therapist will be required. Within a few months, the patient will need to perform speech exercises aimed at “awakening” the work of the corresponding centers of the nervous system.
Typically, the correction course is as follows:
- At the initial stages, speech gymnastics is carried out for 3-5 minutes 2-3 times a week.
- Then the duration gradually increases to a quarter of an hour, the frequency of sessions remains unchanged.
- Some speech therapists consider it effective to conduct exercises in courses – 2 times a week for three months with subsequent breaks.
To achieve lasting results, you need to regularly visit a speech therapist, perform all exercises. In the absence of pronounced damage, a complete restoration of speech within a few years is possible.
Some doctors may recommend supplementing rehabilitation with various alternative medicine methods. These include:
- Acupuncture – the introduction of thin needles into certain areas of the body to stimulate reflex activity in order to relieve muscle cramps and activate the brain.
- Manual therapy – action on bone elements to improve cerebral circulation, fight contractures and motor disorders.
- Hirudotherapy – the use of medical leeches to normalize blood pressure, blood coagulation.
- Vacuum therapy – the effect of cans to improve blood circulation to tissues and metabolic processes in them.
It is important to note that the effectiveness of alternative medicine methods has for the most part not been proven in clinical trials, therefore, such recovery should be prescribed at a later date and only as an addition to the main program.
Rehabilitation methods are selected for the patient and a specific problem. Those who have lost the ability to move will need massage, swimming, the help of a neurologist and physiotherapist. If the patient can not speak, or he has problems with memory, then without a psychologist, speech therapist and taking medication can not do. At the same time, diet, medical treatment, physical activity, massages, hydrotherapy and walking are prescribed for each patient.
If you have lost memory or there are some problems with it, then most likely you will have to drink blood-stimulating pills and neuroprotectors, which will promote metabolism in the cells, help them get saturated with glucose and oxygen, and restore damaged cells and neurons. They also resort to the help of psychologists, although special exercises do not exist, because a lot depends on the age of the patient and the degree of brain damage.
If you lose the opportunity to speak or speak correctly, you need not only taking pills, but also working with a speech therapist, as well as daily exercises that children often do in kindergarten. In fact, the patient is taught to speak again. Recovery usually takes at least three months, as the left hemisphere of the brain suffers.
With a hemorrhagic stroke, vision often suffers, which is expressed in its complete or partial loss, inability to distinguish shades. It is also about damage to the left hemisphere of the brain or cerebellum. Then recovery takes at least two months, and much depends on the age of the patient, the degree of damage to the left hemisphere.
Duration of rehabilitation after a stroke
No doctor will tell you the exact dates for recovery, since often patients suffer from other chronic diseases that have to be treated along the way, which takes even more time.
In addition, the brain cells in all are not restored in the same way, and often advanced age becomes an obstacle in this process. Young people can expect a full recovery three to eight weeks after completing all the procedures. As for retirees, it may take them at least five months before at least part of their physical or mental capabilities returns. But you need to be prepared for the fact that some functions will be returned only partially.
As for the state of coma or cerebral edema, here time does not play into the patient’s hands. Since the cerebral cortex is affected more deeply, without the possibility of recovery.
When recovery from a hemorrhagic stroke was successful, the patient should adhere to the main recommendations that will prevent the occurrence of repeated attacks:
- All medicines prescribed by your doctor are taken regularly and strictly by prescription.
- Daily monitor blood pressure, with its increase – take antihypertensive drugs.
- Reduce your intake of salt and fat, control your blood sugar and cholesterol.
- Try to be less nervous, avo >
In conclusion, we will answer the common question that patients ask doctors – is it possible to sunbathe after a hemorrhagic stroke? Tanning during the rehabilitation period is not recommended, as this can worsen the restoration of motor activity, and in case of sunburn or heat stroke, lead to an increase in blood pressure and relapse of the disease.
Nutrition after a stroke
Another important factor that contributes to a speedy recovery is diet and rejection of harmful products. It is important to exclude alcohol, cigarettes, coffee, fatty and salty foods from the diet, consume as many vegetables, natural cereals, dairy products, juices, boiled meat, fiber and fruits as possible.
When implementing the recommendations of specialists, rehabilitation will be faster, and in the future you will not have to remember a stroke.
Do a diet, walks in the fresh air, moderate use of a computer, reduced stress level with your usual way of life, and then the consequences of a stroke will never bother you.
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