Understanding Stroke Recovery & Neuro Rehab

Neurology Rehabilitation

The brain and spinal cord are complex structures. Any form of injury to the brain or spinal cord will result in neurological impairments that can affect our motor, sensory or visceral functions.

Neuro rehabilitation is crucial to help patients recover after a sudden stroke, a traumatic incident involving the brain or spinal cord or disorders related to the nervous system. For example, Parkinson's disease (PD), Progressive Supranuclear Palsay (PSP) or brain tumor. Most of these disorders are progressive and lead to problems with movement and other health and social issues.

NEUROPLASTICITY

Neuroplasticity is the ability of the brain to adapt and change over time by creating new neurons ("nerve cells") and new pathways. The concept of neuroplasticity guides our physiotherapy intervention in neuro rehabilitation.

Neuroplastic interventions that physiotherapists use are typically task-specific training, motor learning, neurodevelopmental technique and constraint-induced movement therapy.

THE "GOLDEN WINDOW" FOR STROKE RECOVERY

After getting proper medical treatment post-stroke, the golden period for stroke rehabilitation is 3 to 6 months. Rehabilitation must happen as soon as possible to maximize brain recovery. The following timeline illustrates a typical journey post-stroke in Singapore:

At Rehab Space, we see stroke cases as early as 3-4 weeks post-stroke (immediately post-discharge from acute hospital) and even cases that have had a stroke many years ago. Goals of rehab will change with time and throughout stages (acute, sub-acute and chronic). For those who are unable to leave home due to their physical limitations or social reasons (no one to assist), Rehab Space provide home therapy services. It is common for our physiotherapists to start with home therapy for clients to improve their function at home (most familiar environment) and slowly transit to clinic rehabilitation after several weeks or months.

GOALS OF STROKE REHAB

Goals of stroke rehab include:

Return to as close to premorbid function as possible
Prevent complications of prolonged bed rest and immobility (i.e. bed sores, infections)
Prevent a recurrent stroke
Improve physical and cognitive function
Improve symptoms of pain and stiffness due to immobility or spasticity
Educate and train compensatory movement for safety purposes
Caregiver training
Work with other healthcare professionals to provide holistic care (speech therapists, occupational therapists, psychologists etc)

FACTORS AFFECTING OUTCOMES

Age
Severity of stroke
Type of stroke (ischemic vs. hemorrhagic)
Premorbid level of function
Previous lifestyle
Other existing conditions (eg. hypertension, high cholesterol, diabetes)
Cognition
Motivation
Social support

Even with the same diagnosis, each person's recovery is different. It is important not to compare and focus on yourself.

SETTING S.M.A.R.T GOALS

It is important to work with your physiotherapist closely in setting S.M.A.R.T goals (Specific. Measurable. Achievable. Realistic. Time). Example of S.M.A.R.T goals are:

To get out of bed independently without assistance in 1 month
To be able to walk within the house with a quad stick with minimal assistance in 2 months
To be able to perform all basic activities of daily living (ADL) independently in 2-3 months
To be able to walk around the community (crossing roads, navigating and negotiating obstacles) with a walking stick with independently in 1 year

We are with you every step of the way.