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Rehabilitation and recovery after stroke in the home

Treatment of stroke patients is a very long and gradual process, which will undergo a number of successive stages. First patients being treated in the intensive care unit, where there is a struggle for their lives, then to a neurological hospital, where we deal with the recovery of the affected cells.

But equally important is the recovery phase after discharge from the hospital. Because the neurological deficit, which includes the patient, it is impossible to recover by medication, since the brain cells are destroyed.

But it is possible to adapt man to life at the expense of other neurons, which remained intact. To achieve this, should take a long time. Naturally, this is only possible through self-recovery after a stroke at home when the patient and his relatives actively interested in the process.

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How long to recover from the stroke?

In the question about recovery time post-stroke period, a clear indicator can not be. It all depends on the size and localization of the lesion in the brain, type of stroke, time since the occurrence of the disease to provide specialized medical care. The more the value of these parameters, the worse the forecasts for the full recovery of the patient. Such people have to work for a very long time, almost for life, at least in order not to aggravate the existing neurological deficit. The tentative dates and predictions can be represented in the form of a table.

The type of stroke and its consequences

The recovery period

Ischemic stroke with minimal neurological deficit (mild paralysis of the limbs and face, loss of coordination, vision, dizziness)

Partial recovery 1-2 months

Full recovery 2-3 months

Any kindstroke with severe neurological deficit (severe paralysis of the limbs and face, persistent discoordination disorders)

Partial restoration with the possibility of self-service 6 months.

Full recovery is rare and takes years

Heavy massive ischemic and hemorrhagic stroke with persistent neurological deficit (disability due to paralysis on one side and other defects)

Partial restoration with the ability to sit independently – 1-2 years;

Full recovery is not possible

From the above table it becomes evident that the more severe was the stroke, the longer must be the recovery treatment. Patients with ischemic stroke recover slightly faster than after a hemorrhagic.

With the available gross neurological deficit in the backdrop of a stroke is not always possible full recovery of the person that is determined by the necrosis of the important clusters of neurons in the brain, the function of which is not able to take the neighboring healthy cells. Therefore, the recovery period after any stroke never ends. Need for life recreation type of short-term courses or daily. This will not only help in the recovery of lost abilities, but also to prevent new stroke attack.

You should never lose heart, no matter what kind of stroke has not been moved, and despite the obvious projections. Vital resource because every person is different, especially in relation to the brain. Only regular sessions on yourself can help more fully and in the shortest possible recover after a stroke.


Exercises for rehabilitation after a stroke

One of the primary tasks of the recovery period after a stroke is to resume the motor function of limbs. On them largely confined neurological deficit in this disease. To start the recovery movements must almost from the first days after stroke onset.

Common features of exercises characterized by such moments:

  1. The decrease in muscle tone and tension. Any stroke causes paralysis, characterized by hypertonicity of muscles, nervous excitability;

  2. The improvement of microcirculation. Stroke innervation of all tissues. As a consequence of the disruption of their blood supply;

  3. Prevention of contractures. On the background of long-term neurological deficits and spastic paralysisadditionally there is a hardening of the muscles being in a constant state of tension;

  4. Protection of the skin of the limbs from pressure sores. This is especially true in relation to the feet. In places of the greatest pressure and contact, which are the metatarsal area, most often there are sores;

  5. The renewal of the delicate movements. Among the most important functions of the limbs, which in fact, characterize the full recovery of the nervous system. This is most relevant in relation to hands and upper limbs in General.

Before beginning any exercise after a stroke it is advisable to consult with your doctor, and even better with narrow with a physiotherapist. It will help not only to choose the right set of exercises, but to tell about all the intricacies and stages of implementation. In General terms, is to point to the fact: all exercises should start from more simple with the gradual increase of their volume, depending on the functional abilities of the patient.

On the background of physical therapy, even patients with the same problem and the severity of stroke can recover different. Why should not man be overstuffed. It is as harmful as the lack of medical gymnastics in General. Before performing any exercises it is better to heat the tissue to be addressed in their action. If it is possible, for this purpose you can use warm water treatments. In case of contraindications or other reasons why this action is not feasible, it will be enough light massage for 15 minutes immediately before exercise. In extreme cases, to warm the affected extremity by using heating pads.

All patients after severe stroke with gross neurological deficit have to help someone close to you, because to cope with this task they can not. Better if the set of exercises will be performed 2-3 times per day kind of short courses, lasting approximately one hour. They should not cause the patient severe fatigue and exhaustion. If any of this speaks to the incompatibility of loads and the actual abilities of the patient at a particular stage of rehabilitation period.

A strictly individual approach with a clear compliance with the General rules of physical therapy can be called the only right step on the path to rapid recovery of patients after stroke.

Exercises in conditions of bed rest

Of course, in this case, it is extremely difficult to do something in large volume, since the functional abilities of patients is very limited. So you need to help, others these patients, people. This set of exercises should be performed by all persons in the acute period after any stroke and also to those who have a severe spastic paralysis of the limbs with marked increase in muscle tone. These patients are not able to straighten the limbs, as they are firmly fixed in a bent position. Exercise should be aimed at reducing the tone and the gradual increase in the amplitude of movements.

A typical gym looks like this:

  1. Simple extension and flexion of the fingers and hands, forearms and elbows, feet and knees, limb movement in the shoulder and hip joints;

  2. Rotational motion of the specified segment. Done with the help of those who care for the sick. They should mimic the movements that are able to perform a healthy people;

  3. Exercise to restore hand. Stretching of spastic limbs with the help of the Longuet and other devices. Shown with persistent paralysis. This bent the limb gradually unbent from the fingers and the bandage is fixed to a solid flat plate or other device. The stages are made the same actions with the upper parts of the hand (the hand and the forearm). In this position, the extremity is fixed for half an hour, but can be longer if the patient is not uncomfortable;

  4. Over the bed hung a towel. The following exercise can perform a person with the restored function of the brush. This towel grab it and produce all possible movements (abduction and adduction, lifting and lowering of the shoulder, flexion-extension at the elbow). Gradually raise the towel above and the exercise is hampered by the own weight of the patient;

  5. Of strips of rubber of medium thickness and width required to make a ring with a diameter of 40 cm With the help of this device you can perform a number of exercises. It jumped between the hands, forearms, hand and foot, brush and any subject. In this stretch the rubber by diluting its ends from each other;

  6. To eliminate muscle spasm of the lower extremity in the popliteal region fit rigid roller, the thickness of which gradually increases. This is achieved by stretching muscles and increasingmovements;

  7. Obvalivanie shins above the ankle, with further bending-straightening of the legs in the knee joints by sliding stop in bed;

  8. Lying in bed, you need to gradually raise your arms over your head and try to grab it back. After this run incomplete pull-UPS with simultaneous stretching of feet and fingers (as if stretching);

  9. Exercises for the eyes. Restore the function of the mobility of the eyeballs and adapt. For this you need to produce eye movement in different directions several times. Circular motion. Repeat the procedure with the closed eyelids;

  10. Fixing the gaze at one point with the subsequent rotational, sternocleidomastoid and circular movements of the head without departing from this point of fixation;

Exercises in a sitting position

They aimed at restoring purposeful movements of the arms, strengthening the back and training the legs to walk. Their technique is this:

  1. The patient placed in the sitting position, hands grasping the edge of the bed. Inhalation is subsidence in the back with simultaneous stretching of the body in a state of tension. On the exhale to relax. The cycle consists of 8-10 reps

  2. Starting position sitting on the bed, legs at the body level (not down). Alternately raise and lower the left and then the right leg several times;

  3. Original sitting position in bed. Hands are pushed back. On the inhale produces the closest approach of the blades to each other with simultaneous tilting the head back. On the exhale to relax;

Exercises in standing position

Shown after the expansion of motor mode and a partial recovery of the patient. Their main goal – restoring the subtle movements for maximum removal of neurological disorders. Typical examples are as follows:

  1. Lifting a matchbox from the floor or table. Fulfills fine targeted traffic;

  2. Initial position standing with hands down. On the inhale raise the hands up above the head, simultaneously stretching and getting up on the toes. On the exhale, relax, bending the body downward and dropping. Repeat several times;

  3. Flexion-extension of the brush in a fist with the expander simultaneously diverting the hands from the body;

  4. In the standing position, feet shoulder width apart, hands are placed on the belt. Made of torsoleft and right, forward and backward;

  5. From the previous starting position perform the exercise scissors (alternate movement stretched before him crossed hands, on the opposite side;

  6. Squats from the initial standing position with the United way. During the execution of exercises should be possible to hold back and not tear the heel from the floor;

During exercise related to recovery of fine movements, you can continue exercises from previous phases, especially if it strengthens the muscles and expands the volume of movements in General. Allowed therapeutic exercises with light dumbbell and strength exercises.

In order for physiotherapy really was restorative in nature, it should be part of the lifestyle of the patient.

Recovery of speech after a stroke

Regenerative processes in the brain in relation to speech functions are much slower than motor disorders. They can last for several years. So deal with the sick need to constantly starting from the first day of the recovery period after stabilization of General condition. The main task in this difficult process falls on the patients themselves and their relatives. Only the stubborn desire to adopt them. You cannot stop training, despite the long absence of a significant effect. Sooner or later, all efforts will be rewarded with a gradual improvement in speech.

Recommendations about exercises for the recovery of speech is quite clear. Their main focus is the initiation of nerve cells located in the affected region of the speech centre, to perform lost functions. This can be achieved through regular training of the function of speech and hearing. For the patient regained the ability to self-conversation, he needs to hear it. All must keep talking to him. Thus he will be able to play sounds.

As for the immediate pronunciation of words, in the case of a complete loss of language ability required to start the pronunciation of individual sounds and syllables. For this patient saying part of a word or phrase, not negotiating endings. The patient himself have to say. Gradually the volume of reproduced words should increase. The most recent step is the repetitionrhymes and tongue twisters.

Beneficial effects on the development of language ability is affected by singing. If the patient will hear the singing, and later together with loved ones will try to sing it it is much faster to get than normal speech. Therefore, be sure to include this method of rehabilitation of patients after stroke to restore speech abilities.

It is extremely important for recovery of speech is to renew the ability to pronunciation of sounds. After all, people can potentially to be able to talk, but due to the long innervation of the facial and masticatory muscles undergo a kind of hardening.

In such cases they are subject to active development by:

  1. Folding of the lips into a tube;

  2. Skalyvanija teeth;

  3. Maximum pushing of the tongue forward;

  4. Easy prokusyvanie jaws alternately upper and lower lips;

  5. Licking lips language in both directions (left-to-right and Vice versa).


Restore memory after a stroke

One of the functions of the brain that is disrupted by stroke, is memory. It is very important to approach the restoration process in this regard. Like all other abilities of higher nervous activity, work on it should begin as early as possible. This usually corresponds to the period after the elimination of a direct threat to human life and phenomena of cerebral edema on the background of the stroke lesion.

The first thing doctors is the medical support of the affected neurons. Patients assigned to intravenous infusion of nootropics (drugs that enhance the metabolic processes in the brain and memory). Their reception must be continued at the stage of outpatient treatment, but in tablet form. The most common and effective nootropics include piracetam, lucetam, nootropil, fezam, tiocetam. All of them are quite slow, so it is important to observe the duration of reception, which shall be not less than 3 months. After a short break, the treatment course should be repeated.

In addition to drug correction should be done and functional rehabilitation treatment. It involves constant practice the brain's ability to memorize. This process is one of the longest of all the types of rehabilitation treatment after stroke and takes many months and even years. Includes memorization and constantthe repetition of numbers, specific words, rhymes, first short, then longer. The same beneficial effect on memory is influenced by Board games and other activities with game elements, when the patient is simultaneously distracted from the outside world and focused on a specific action.

How to make the menu after a stroke?


The drugs for recovery after stroke

Of critical importance in the rehabilitative treatment of stroke patients belongs to medical treatment of brain dysfunction. Be sure to stick to their course receiving alternating periods of active treatment and breaks in between. Preferably twice a year intravenous to enter cerebroprotector (drugs that enhance blood circulation and brain activity).

It is important to remember that you should not take krovanistaya funds after hemorrhagic strokes. This is not only not appropriate, but can provoke the recurrence of stroke. All other drugs are not differentiated, regardless of the type of stroke.

A tentative classification of medications for post-stroke rehabilitation period is given in the form of a table:

Group of drugs

Specific representatives

Improves the blood flow to the brain

  1. Pentoksifilin;

  2. Cavinton;

  3. Cerebrolysin;

  4. The drugs on the basis of aspirin;

Improves metabolic processes in brain cells

  1. Ceraxon;

  2. Actovegin;

  3. Solcoseryl;

  4. Cinnarizine;

  5. Ginkgo-Fort;

  6. Cortexin;

Nootropics

  1. Piracetam;

  2. Antibiotic;

  3. Lucetam;

Tool combination (consist of a few drugs)

  1. Fezam;

  2. Neuro-norms;

  3. Tiocetam;

Otherdrugs

  1. Glycine reduces the excitability of the nervous system;

  2. Sirdalud – eliminates muscle tension and muscle spasm and hypertonicity;

  3. Medicinal plants and herbal teas;

  4. Antidepressants (gidazepam, adaptol)

With medication recovery brain and its functions clearly consistent tactic used sequential therapy. It involves step-by-step administration of drugs, since the intravenous administration, and ending with reception of tablets containing identical active ingredients. In this respect, modern pharmaceutical companies that manufacture cerebroprotectors, created different dosage forms most common active ingredients. This enables patients to take one drug, which is especially true when it is ideal the patient.

To appoint or replace the medicines have solely a doctor or specialist who monitors the patient. The patient and his family have only strictly to follow the recommendations and not to miss any doses of the drug at the appointed time.

* There are contraindications, before applying you should consult with a specialist