Rehabilitation

Rehabilitation following a stroke should begin as soon as possible, to avoid the complications of immobility and to allow for maximal functional gains. Most functional recovery occurs within the first two to six months following a stroke, and early prediction of outcome is useful to set appropriate goals, facilitate discharge planning, and anticipate the need for home adjustments and supports. Muscle strengthening and general conditioning can reduce impairment and disability. Task-oriented exercise may be more meaningful to elderly patients and can contribute to motor recovery and gait retraining. Many stroke survivors have persistent activity limitation of the affected arm. Immobilization of the unaffected arm combined with intensive training of the affected one is occasionally used to improve arm function. Another approach involves facilitation of appropriate movement patterns in the affected arm. Depression is common after stroke and, unless treated, can interfere with recovery. Swallowing dysfunction should be looked for by an OT or speech-language pathologist.