Once the immediate treatment to restore blood flow to the brain has taken place, then the focus is to prevent any further damage or further strokes / TIAs (secondary prevention) occurring, to restore as much lost function that was caused by the stroke as possible and to prevent any long term complication. This is called Medium Term Treatment, and usually occurs within the Rehabilitation Unit.
In order to prevent any further strokes /TIAs it is imperative to reduce risk factors i.e. control BP, improve glycose control if you have DM, reduce cholesterol levels and encourage smoking cessation if you smoke. As a result of this, you may suddenly find yourself starting a number of life-long medication. [please see section on PREVENTION for further information about reducing risk of stroke/TIA]
Rehabilitation is the main process directed to your individual needs depending on your symptoms and their severity. This process begins while you are in hospital and continues in your community, at your own home or a specialist clinic.
In order to try to restore as much function, post-stroke and to prevent long term complication after the stroke, it is important to have a team of specialist working in a coordinated fashion. This is referred to as the Stroke Rehabilitation Team and consists of specialists including physiotherapists, occupational therapists, speech therapists, dietitians, specialist nurses, psychologists, doctors and social workers. They should have access to other services for example:
In modern hospitals with an acute stroke unit you should be assessed by members of the specialist rehabilitation team as soon as possible once you are clinically stable and multidisciplinary goals should be agreed.
This assessment should take into account:
During this assessment the rehabilitation team should take into consideration the impact of the stroke on your family and/or carers and, if appropriate they should help identify sources of support. To this end, information should be given to your family and carers about support for them too.
As an inpatient within a dedicated stroke unit with a well staffed multidisciplinary rehabilitation team, you should expect approximately 45 minutes of each relevant stroke rehabilitation therapy for a minimum of 5 days per week, however this will depend on your ability to participate, and where functional goals can be achieved. Then if more rehabilitation is needed at a later stage the intensity needs to be appropriate for your individual needs.
If you are unable to participate for 45 minutes of each appropriate therapy, then you should still be offered therapy for 5 days a week but for a shorter time and at an intensity to suit you.