JAMA PATIENT PAGE | Neurology

Recovery After Stroke

Stroke can affect the body in various ways, and rehabilitation
is often an important aspect of recovery after stroke.
A stroke is an injury to part of the brain that results in the death of
brain cells. A stroke can be caused by blockage of blood flow to part
of the brain (ischemic stroke) or by a tear of a blood vessel causing Stroke rehabilitation often involves a team
of people with various specializations.
bleeding into the brain (hemorrhagic stroke). After someone ex-
Rehabilitation goals after a stroke include:
periences a stroke, doctors determine the cause of the stroke, give
treatments to limit the amount of brain injury, and recommend thera-
Medical doctor
pies to reduce the risk of another stroke. Rehabilitation nurse
Despite the best medical care, people are often left with impair- Speech therapist
Physical therapist
ments after a stroke. The particular deficits that a person might have Occupational therapist
depend on which part of the brain was injured. Common deficits
after stroke include weakness, numbness, vision problems, slurred
speech and swallowing problems, difficulties with language, balance
Improving speech and language skills
and coordination problems, and problems with thinking. and treating problems with swallowing

Recovery After Stroke

One of the goals after a stroke is to regain as much function and
independence as possible. Stroke rehabilitation encompasses a
spectrum of activities designed to optimize recovery after stroke.
Stroke rehabilitation often involves a team of people with various
specializations:
Physiatrists and rehabilitation neurologists are medical doc- Improving mobility,
tors who specialize in rehabilitation. balance, and walking, and Improving function
Rehabilitation nurses coordinate care and provide support preventing complications, in daily activities
such as contractures
throughout the rehabilitation process.
Physical therapists focus on improving balance and walking.
Occupational therapists focus on improving function in daily
can also develop after stroke. Pressure ulcers are often related to a
activities such as bathing, dressing, and personal hygiene.
decreased ability to move and may be prevented with frequent
Speech and language therapists assess and treat problems with
repositioning and good skin hygiene. Loss of control over urination
speech and language, swallowing, and thinking.
frequently occurs after stroke but often improves over time. Mood
Therapies can take place in hospitals, nursing facilities, outpa-
problems, including depression and anxiety, are also common after
tient offices or clinics, or at home. Formal rehabilitation programs
stroke and may interfere with the rehabilitation process. If mood
commonly last for up to 3 or 4 months, but additional recovery ef-
problems develop, they should be discussed with a doctor right
forts may be continued if ongoing improvements are noted.
away so that treatment may be considered.

Complications After Stroke

In addition to impairments caused by direct brain injury from the
FOR MORE INFORMATION
stroke, complications can also occur because of changes in the
American Heart Association/American Stroke Association
stroke survivors abilities. For example, if a limb that has been www.strokeassociation.org/STROKEORG/AboutStroke
weakened by a stroke is not used or moved for a prolonged period, /Lets-Talk-About-Stroke-Patient-Information-Sheets
a contracture may develop. A contracture is a fixed shortening of _UCM_310731_Article.jsp#.V-lfoMmwmiz
the muscles or supportive tissues around a joint that limits move-
ment of the joint. Skin breakdown and bed sores (pressure ulcers)

Author: Christopher C. Muth, MD
Sources: American Heart Association/American Stroke Association
Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and
recovery: a guideline for health care professionals from the American Heart
Association/American Stroke Association. Stroke. 2016;47(6):e98-e169.
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