After you or a loved one has experienced a stroke there is a sense of shock that is evident. Questions such as, will I walk again without an assistive device, will I be able to cook for myself, will I use the restroom alone, or  will my speech be less garbled are likely to arise.

Upon discharge from the hospital, these questions will be addressed by your outpatient rehabilitation team. This team includes highly skilled therapists including a Physical Therapist, Occupational Therapist, and Speech-Language Pathologist. Each member of the team will perform an individualized evaluation and create a treatment plan based on results of the evaluation. Taking into account the size and location of your stroke, the team will work together to promote your recovery!

Physical Therapy for Stroke Recovery

A physical therapist’s main goal when treating stroke patients is to help you return to your activities at home, at work, and in the community. One of the first activities a physical therapist will address is your bed mobility and moving from one location to another, also known as transfers. Your physical therapists will support your ability to walk as soon as you are safe to do so.

Physical therapy will help with:

• Dynamic balance training (changing your posture often) to facilitate a safe return to walking
• Functional Electrical Stimulation (pain-free electrical stimulation) to improve strength and response of muscles in the legs and ankles to help to return strength and range of motion.
• Gait training with or without adaptive equipment such as a cane or walker
• Comprehensive muscle re-training/strengthening program
• Provide family training to support safe mobility in and out of the home

Occupational Therapy for Stroke Recovery

Occupational therapists, also known as OTs, believe that engaging in desired daily tasks (or daily occupations) make us healthy and well.  They also understand the importance of emotional well- being post-stroke. In stork recovery, an OT will address your ability to engage in basic activities of daily living skills such as eating, grooming, dressing, bathing, and using the bathroom. In addition, occupational therapists will support functional and correct movement of the arm if it was affected. This includes improving range of motion, strength, dexterity, and sensory changes.

The following techniques are often used to address arm movement and function, post-stroke:

Modified Constraint-Induced Movement Therapy (mCIMT)
If a person meets the range of motion recommendations for the protocol, mCIMT is a technique used where the strong arm is constrained via a mitten “forcing” you to use the arm affected by the stroke. mCIMT can help improve strength and coordination in the affected arm but requires multiple hours of day, several days a week to be successful.

Functional Electrical Stimulation (FES)
FES uses small, electrical pulses to stimulate nerves and helps muscles move. This technique can improve shoulder subluxation, pain, and arm weakness as well as improve muscle recruitment for elbow, wrist or hand weakness.

Motor Imagery & Visual Imagery
Your “affected” arm did not forget HOW to move, it’s simply in a weakened state because the brain many not be able to talk to it as easily. The use of visual imagery allows the brain signals to communicate to the arm without movement and improves “mapping” from the brain to the arm, which can then in turn improve movement.

Occupational therapy can also support a person’s ability to return to cooking, reading, housekeeping skills (yes, you do still have to do your laundry!), and driving skills.

Speech-Language Pathology for Stroke Recovery

After a stroke, your Speech-Language Pathologist (SLP) will assess your ability to communicate, as well as abilities to swallow food/liquids post-stroke. If your ability to swallow was affected, a unique and interesting evaluation called a modified barium swallow study (MBSS) can be used. This evaluation can be conducted using a mobile van surface that can come to your home or the clinic. A radiologist and SLP watch a person swallow using live x-ray. Food or liquid that is caught in any part of the throat can be evaluated. Should problems be noted, your clinic-based SLP can suggest safe swallow strategies, dietary changes to avoid choking, and exercises to improve swallowing.

Communication can also be affected after a stroke. This includes confusion with words, referred to as aphasia. Words being spoken to you may not make sense (receptive aphasia) and/or words you say may come out incorrectly (expressive aphasia). Your SLP can support the return of your language skills by providing you with the first sound of words, giving you plenty of time to speak, using songs/familiar books to encourage calm expression of speech, and empowering you to let others know about your language deficits so you can remain engaged and not spoken down to.

Speech-language pathologists also support:

• The muscles needed to breathe and control your breath during speech
• The strength of muscles in the mouth for clear articulation of your words
• The ability to read and write
• Train your family to support the return of clear and understandable speech

To learn more about how therapy can help with stroke recovery, visit MoveForwardPT.com, the official consumer information website for the American Physical Therapy Association, or give us a call to schedule an appointment with one of our highly trained therapists.

We can help!

If you or someone you care for is looking for a therapist trained in stroke rehabilitation, we can help! Our very own Jennica Colvin and Suzanne McCrum are both certified in stroke rehabilitation therapy. Give us a call today to make an appointment to see either of our Certified Stroke Rehabilitation Therapists.

Jennica Colvin, Owner & Occupational Therapist
Trio Rehabilitation & Wellness Solutions
Boerne, Texas