Stroke Rehabilitation Challenges

After experiencing a stroke, recovery can be challenging, and it’s not impossible.

And the first thing people ask after having a stroke is – “When will I recover?”.  Recovery means different things to different people.  For some, it’s to regain the ability to do what they want and need to do again.  Whereas recovery to someone means the body can function the same way as it did before the stroke. 

As we are aware that stroke victims face challenges every moment, we hope that they manage them with the right mindset. 

The Difference in the Expectations of Recovery and Therapy

Perhaps the most challenging hurdle is the expectation of recovery and understanding the function of therapy in the recovery process.  And engaging in therapy is only one part of stroke rehabilitation.  Most importantly, the client does “homework” outside therapy sessions and incorporates the new strategies into his daily life.  In this way, we would allow the natural healing process to occur.   Otherwise, unrealistic expectations about the healing speed will lead to disappointment and demotivation.   Hence, we must understand that the body’s natural healing process does not follow our deadline.  Realistically, there are times when stroke recovery rehab therapy progress can be slow.

As such, it is essential to have an open mind. 

Everyone’s journey in stroke recovery is unique to the individual.  Therefore, it is not realistic to compare your recovery journey to the experience of others.  Because such comparison does not help provide an accurate expectation. 

Most importantly, you would need time, patience, and realistic expectations of goals in your stroke recovery rehab therapy journey.  Besides this, therapists would help manage clients’ expectations.  In addition, clients are encouraged to share their thoughts and recovery goals so that we are all on the same page.

Therapy Sessions are just Guided Recovery Sessions.

Well, therapists are merely guides to your stroke recovery rehab therapy.  In other words, they help you get the most out of mother nature’s healing processes and translate that healing into function.  Eventually, your effort will help your body connect new and existing pathways back in the brain.  Slowly, your body will take its course of healing.  However, time is of the essence if it’s hindering your function towards normality.

Regaining smooth movements requires repetition.  Brain synapses are strengthened typically with a minimum of 300 to 400 repetitions per body function.  Yes, this can be boring.  To counter monotony and maintain motivation, you may discuss with the therapist what you enjoy or what is meaningful to you.  The objective is to generate ideas on making your stroke recovery rehab therapy treatment more engaging. 

Often, there is a plethora of areas to work on.  We can only work on one at a time.  Firstly, the therapist will work on various areas of the body with fewer repetitions.  Subsequently, it is up to you whether you want to work on the rest of the repetitions as homework.   Why would you need to do therapy homework?  Because the therapy sessions with the therapist are insufficient to yield the best results.  Therefore, it is your onus to embrace ownership of your therapy homework for the therapy treatment to be more effective.   

Grieving the Loss of Function

Most people relate the stages of grief to the loss of someone close.  Similarly, we grieve the loss of the body’s function in the same fashion.  During the grieving process, it is important to acknowledge feelings such as denial, bargaining, and blame with support from friends, family, support groups, or counsellor.  When we accept these feelings, it helps open up the conversation that we need during the recovery process.

Hence, this is a crucial step to get into the right mindset before starting physical therapy.  Openness in one’s heart will ultimately benefit your actions and decisions.

Therapy and life balance

Recovery is not all about therapy all the time.  It incorporates general living such as returning to leisure activities, meaningful work, practising doing things independently, and even going out again.  In short, we need to balance therapy with life.  When stroke recovery rehab therapy intertwines with daily living, it is more effective holistically.

Other challenges that clients may face post-stroke are depression, body image changes, and changes in intimacy.  As such, we should expect these challenges not to be treated as taboos.  And we should openly discuss them with the therapist and trusted caregivers.  Hence, normalising the willingness to talk about a client’s feelings is also vital to stroke recovery.

Stroke Statistics in Singapore

According to data from Singapore’s Ministry of Health, the median age at the onset of stroke was 69 years in 2020. 

Between 2010 and 2020, there has been a rise in incidence rates.  Incidence rate is defined as how quickly a disease occurs in a population.  And the increase is 33.7% for the 40-49 age group and 13.7% for the 50-59 age group.

Over 10 years period from 2010 to 2020, the number of stroke episodes has increased by 50% from 5,890 to 8,846. 

Types of Stroke

A stroke can happen in two ways:

1.  An ischaemic stroke occurs when the blood flow to the brain is restricted due to blockage of blood vessels.

2.  Hemorrhagic stroke takes place when there is internal bleeding in the brain due to a rupture of blood vessels.

Effects of Stroke

Most people associate strokes with semi-paralysis of the body. While this is common, there are other invisible causes – meaning the person seems normal, can still walk and move normally but is forgetful or has difficulty recognising faces and names. This type of stroke affects brain functions such as hearing, speech, vision, thinking, and memory skills. 

Length Of Critical Rehab

Immediately after stroke onset, stroke survivors need to receive immediate medical attention in the acute setting. This can help reduce stroke damage and improve recovery outcomes. During this time, stroke survivors should also be monitored for any changes in their condition such as difficulty swallowing or loss of movement in an arm or leg.

During the next 24 hours, additional assessments from medical professionals to identify any additional needs such as physical therapy, occupational therapy, speech therapy, or dietetics should be carried out. In addition to medical assessments, stroke survivors should also be evaluated for problems such as confusion and depression which are common after stroke onset.

In the following three days post-stroke onset, stroke survivors need to be continuously monitored closely by their doctors to ensure their condition stabilises. It is also important at this stage that family members who can provide emotional support during this difficult time are well-informed and gain as much knowledge of the condition as possible.

During the first-week post-stroke onset stroke survivors need to continue being monitored closely by medical professionals and once the condition stabilises, occupational and physiotherapists should come in for assessments and assist with activities of daily living such as dressing and bathing. provide simple physical exercises so that functional gains can be made early on in their recovery journey. In addition to formal therapies, it may be important for stroke survivors to participate in activities that will help their recovery such as listening to music or engaging in crafts so that they remain engaged mentally and emotionally during this period of adjustment.

The month following post-stroke onset should involve continued assessment by medical professionals while focusing on improving mobility so that stroke survivors can take more steps independently. Rehabilitation exercises should focus on a range of motion exercises that will strengthen muscle groups used during walking so that further progress can be made towards independence when walking outside the hospital setting. Assistive devices such as walkers may also need to be identified during this phase so that full independence can eventually be achieved when navigating around outside environments.

From three months up until six months post-stroke onset rehabilitation exercises should focus on improving coordination between movements while incorporating everyday tasks into rehabilitation sessions so that skills practised have real-life applications outside of the hospital setting. During this time, massage therapy may also become part of the treatment plan along with home-based therapies where therapists demonstrate activities or techniques from within the most natural environment of the patient – their home – which further reinforces skills learned within a safe environment away from a clinical setting but still under professional guidance.

As we move onto one year since stroke onset many rehabilitation goals set out initially may now have been achieved however some patients may still require ongoing rehabilitation services depending on the level of functioning before injury including activities related to memory improvement, self-care abilities, and communication skills if required due to aphasia or apraxia associated with their condition. Any ongoing support needed at this stage must be tailored specifically to individual needs while incorporating family members into care plans where required so that progress made up until now remains consistent throughout one year post-stroke onset with minimal regression occurring due to lack of reinforcement of skills.

At every stage of stroke rehabilitation, it is important to ensure stroke survivors are being provided with the necessary therapies and support systems that will enable them to make the best recovery possible while improving their overall quality of life post-stroke onset. With this in mind, stroke rehabilitation must be tailored specifically according to individual needs and monitored closely by medical professionals throughout all stages of recovery so that stroke survivors can maximise their potential for a successful recovery.

This article has been written to provide readers with an overview of critical rehab length following stroke onset however it is always important for stroke survivors and families alike to consult with medical professionals before making any decisions about treatment plans related to stroke recovery as each case differs greatly from one another depending upon individual needs.

Stroke recovery is an ongoing journey but with the right care it is possible to achieve long-term success.

Cost of Stroke Recovery Rehabilitation

Many people think of cost in monetary terms but we at Lifeweavers want our clients to consider resources needed for recovery rehabilitation in Singapore. Such resources include:

– Time

Time is of the essence when it comes to recovery. The sooner you can start your rehabilitation process, the faster the recovery can be. Some considerations for clients are their work commitments like if they still need to work or if they can take time off for intensive therapy. And to adjust to other life commitments they may need to attend to.

– Insurance Coverage

Unfortunately, in Singapore, a lot of insurance policies do not include post-stroke home therapy coverage. This is despite a plethora of research showing how continuous home therapy is essential in regaining function and re-integrating into the community after a stroke and many other health conditions. #justsaying

Do check this before buying an insurance plan. 

– Space at Home

Clients will need to consider home modifications such as the installation of railings or handlebars, wheelchair access, space for therapeutic activities, and reducing fall risk. Clients will need to assess their ability to function at home such as if they are limited by steps or stairs reaching too high or bending too low for things. Such issues will need modifications for effective access.

– Social Support

We encourage dialogue and involvement with caregivers who are family members, trusted friends, and helpers. Emotional and physical support is vital to recovery. Support groups for both clients and caregivers are things to consider too. 

– Access to Stroke Recovery Rehabilitation Services

Gold standard rehabilitation requires a high frequency of continuous rehab to beat the odds. Whether public or private, it is not easy to get a comprehensive therapy plan with all the professionals required. For one, the healthcare system has a constant lack of therapists. And if we’re talking about therapists experienced in stroke recovery, the number is even lesser.

DO ensure you get as much rehab as you can afford to maximise the chances of recovering to get back a productive life. 

These are the realities that clients must consider when embarking on their recovery journey.

So feel free to Whatsapp us for a free consult on our Stroke Recovery Rehab Therapy.