Stroke recovery

Stroke recovery
Other namesStroke rehabilitation
Stroke habilitation
SpecialtyNeurology
MeSHD000071939
MedlinePlus007419

The primary goals of stroke management are to reduce brain injury and promote maximum patient recovery. Rapid detection and appropriate emergency medical care are essential for optimizing health outcomes.[1] When available, patients are admitted to an acute stroke unit for treatment. These units specialize in providing medical and surgical care aimed at stabilizing the patient's medical status.[2] Standardized assessments are also performed to aid in the development of an appropriate care plan.[3] Current research suggests that stroke units may be effective in reducing in-hospital fatality rates and the length of hospital stays.[4]

Once a patient is medically stable, the focus of their recovery shifts to rehabilitation. Some patients are transferred to in-patient rehabilitation programs, while others may be referred to out-patient services or home-based care. In-patient programs are usually facilitated by an interdisciplinary team that may include a physician, nurse, pharmacist, physical therapist, occupational therapist, speech and language pathologist, psychologist, and recreation therapist.[3] The patient and their family/caregivers also play an integral role on this team. Family/caregivers that are involved in the patient care tend to be prepared for the caregiving role as the patient transitions from rehabilitation centers. While at the rehabilitation center, the interdisciplinary team makes sure that the patient attains their maximum functional potential upon discharge. The primary goals of this sub-acute phase of recovery include preventing secondary health complications, minimizing impairments, and achieving functional goals that promote independence in activities of daily living.[2]

In the later phases of stroke recovery, patients are encouraged to participate in secondary prevention programs for stroke. Follow-up is usually facilitated by the patient's primary care provider.[2]

The initial severity of impairments and individual characteristics, such as motivation, social support, and learning ability, are key predictors of stroke recovery outcomes.[5] Responses to treatment and overall recovery of function are highly dependent on the individual. Current evidence indicates that most significant recovery gains will occur within the first 12 weeks following a stroke.[5]

  1. ^ Jauch EC, Cucchiara B, Adeoye O, Meurer W, Brice J, Chan YY, et al. (November 2010). "Part 11: adult stroke: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S818-28. doi:10.1161/CIRCULATIONAHA.110.971044. PMID 20956227.
  2. ^ a b c Duncan PW, Zorowitz R, Bates B, Choi JY, Glasberg JJ, Graham GD, et al. (September 2005). "Management of Adult Stroke Rehabilitation Care: a clinical practice guideline". Stroke. 36 (9): e100-43. doi:10.1161/01.STR.0000180861.54180.FF. PMID 16120836.
  3. ^ a b Lindsay MP, Gubitz G, Bayley M, Hill MD, Davies-Schinkel C, Singh S, and Phillips S. Canadian Best Practice Recommendations for Stroke Care (Update 2010). On behalf of the Canadian Stroke Strategy Best Practices and Standards Writing Group. 2010; Ottawa, Ontario Canada: Canadian Stroke Network.
  4. ^ Zhu HF, Newcommon NN, Cooper ME, Green TL, Seal B, Klein G, et al. (January 2009). "Impact of a stroke unit on length of hospital stay and in-hospital case fatality". Stroke. 40 (1): 18–23. doi:10.1161/STROKEAHA.108.527606. PMID 19008467.
  5. ^ a b Teasell R, Bayona N, Bitensky J (2011). "Background Concepts in Stroke Rehabiliitation" (PDF). Evidence Based Review of Stroke Rehabilitation (Version 13): 1–44. Retrieved 13 May 2011.[permanent dead link]