Skip to main content
Submitted by PatientsEngage on 17 July 2019
A woman in a pink t shirt stretching a green resistance band

G Srinithya, Senior Occupational Therapist at NIMHANS, highlights the various specialised rehabilitation programs for different types of stroke related disabilities ranging from visual, cognitive to swallowing impairment.

Which cognitive rehabilitation intervention is best for improvement of attention and memory problems in patients with stroke?

Following stroke, many people experience difficulties in arousal, attention, concentration, memory, perception, problem solving, decision making, insight and other areas of cognition that impede their ability to function in everyday activities. Cognitive abilities and disabilities must be considered in addressing all areas of functioning including communication, mobility, self-care, social interaction, recreational pursuits, and other productive activities such as school or work.

Related Reading: Stroke Rehabilitation Helps Relearn Lost Skills

Cognitive rehabilitation interventions aim to:

  1. Reinforce, strengthen or re-establish previously learned patterns of behaviour
  2. Establish new patterns of cognitive activity through internal compensatory cognitive mechanisms for impaired neurological systems.
  3. Establish new patterns of activity through external compensatory mechanism such as external aids, or environmental structuring and support.

Which Visual programme is most beneficial for visual field defects after a stroke?

Stroke-related visual problems Ocular and visual impairment in stroke patients include gaze palsies and other eye movement disorders, ptosis, anisocoria, neglect, reduced visual acuity, and visual field defects (VFDs). A thorough eye examination is necessary. Other ocular conditions such as cataract, macular degeneration, diabetic or hypertensive retinopathy and refractive errors may influence the visual function and have to be carefully evaluated.

What type of food would you use to stimulate the swallow in an acute stroke patient with known risk of aspiration?

(Dysphagia is defined as inability to swallow) A patient who is aspirating more than 10% of food or liquid consistencies or whose combined oral and pharyngeal transit time is more than 10 seconds, regardless of positioning or facilitation techniques, is inappropriate for oral eating. This patient needs a non-oral nutrition method until she or he is again capable of eating or drinking. Patients who lack the endurance to take in sufficient calories also may require non-oral feedings or supplements. The two most common procedures for non-oral feedings are the nasogastric tube and the gastrostomy. While the patient is on a non-oral program, the Occupational Therapist concentrates efforts on retraining the patient in oral motor control and swallowing. The pre-feeding training can occur whether the patient is on bolus or continuous feedings.

What are the nutritional means to fight extreme fatigue often seen in stroke survivors?

Post-stroke fatigue is described as ‘a feeling of early exhaustion with weariness, lack of energy and aversion to effort that develops during physical or mental activity and is usually not ameliorated by rest. Fatigue is a multidimensional motor-perceptive, emotional and cognitive experience.

Fatigue can be classified as either objective or subjective; objective fatigue is defined as the observable and measurable decrement in performance occurring with the repetition of a physical or mental task, while subjective fatigue is a feeling of early exhaustion, weariness and aversion to effort. Eating a healthy diet can reduce your risk of having another stroke. Eating a diet low in fat and salt and high in fruits and vegetables reduces the risk factors for another stroke like high cholesterol, high blood pressure, being overweight and diabetes.

What factors affect the outcome of stroke rehabilitation?

Motivation and participation in post-stroke rehabilitation are closely associated, in that patients who are motivated are more likely to participate in rehabilitation. Motivation is also an important determinant of favorable rehabilitation outcomes. Various studies have documented motivation as the interplay of individual characteristics. These individual characteristics include: the internal quality or personality of the individual; their psychological attributes; and the environment, which is the social context and the culturally enforced norms within it.

What percentage of stroke patients makes a full recovery?

Statistics on Recovery

  • 10% of stroke survivors recover almost completely
  • 25% recover with minor impairments
  • 40% experience moderate to severe impairments requiring special care
  • 10% require care in a nursing home or other long-term
  • 15% die shortly after stroke.

Can you provide some tips on how to choose the right rehab facility?

Decisions about rehabilitation services are typically made by the patient, family, and hospital staff at discharge from acute care. Doctors and team members should provide information about local rehabilitation program options, taking into account the patient’s needs and medical condition, but the patient and family make the final choice. Goal setting during stroke rehabilitation is a small task that can reap huge benefits. Specific, measurable, achievable, realistic, and time-framed (SMART) goals are used for goal setting for rehabilitation. They can provide coordination between a multidisciplinary team to develop a plan for the individual needs of patients.

Changed
24/Oct/2021
Condition

Stories

  • "I Will Not Let Stroke Disable Me"
    Two years back, Andrew Hyde suffered a massive stroke and was completely paralysed on one side. But, with phenomenal will power and determination, he got back on his feet and returned to a demanding job. Read his inspirational and life-altering recovery. Looking back, I should have seen it coming. I used to work in the oil rig in Kakinada(Andhra Pradesh). The job involved a great deal of physical labour and mental challenges. Sometimes we had to work for 48 hours without a break. My lifestyle…
  • When Should We Start Stroke Rehabilitation and Other Common Questions
    Rehabilitation is essential and critical to improved quality of life and recovery for a stroke patient. Experienced Physiotherapists Nicole D’souza and  Kshitija Ghole from the Neurology Foundation address some of the common questions on stroke rehabilitation. 1.   What is the aim of stroke rehabilitation? The aim of Stroke rehabilitation is to help those affected to relearn essential skills lost due to damage to the brain. These could range from re-learning how to walk…
  • How Can You Help Someone Having a Stroke?
    Stroke or Cardiovascular accident or CVA is a real medical emergency. Quick and timely intervention helps. Dr. Shital Raval tells what you should do to help someone having a stroke.  Stroke, also called Cardiovascular accident or CVA, is a Medical emergency! It occurs when blood flow to the brain or part of the brain become restricted or blocked. This may lead to damage or death of the brain cells from lack of oxygen causing temporary or permanent impairment of the functioning of the brain…
  • A woman in a pink t shirt stretching a green resistance band
    After Stroke, Many Survivors Report Vision Difficulties
    G Srinithya, Senior Occupational Therapist at NIMHANS, highlights the various specialised rehabilitation programs for different types of stroke related disabilities ranging from visual, cognitive to swallowing impairment. Which cognitive rehabilitation intervention is best for improvement of attention and memory problems in patients with stroke? Following stroke, many people experience difficulties in arousal, attention, concentration, memory, perception, problem solving, decision making,…
  • Robotic Hand therapy equipment for Stroke Patients
    Stroke Rehabilitation Helps Relearn Lost Skills
    Stroke rehabilitation is an important aspect of the management of stroke. It can help to maximize recovery and regain as much of the body functions that is lost after a stroke, emphasises G Srinithya, Senior Occupational Therapist at NIMHANS. What is Post Stroke Rehabilitation? Post stroke Rehabilitation is a patient-centred, goal driven process that attempts to maximise the functional independence of patients who suffer from variety of stroke related disabilities. The aim of rehabilitation is…
  • Profile pic of a man in a red tshirt smiling
    A Stroke Survivor’s Mantra to Live A Better Life
    Sharad Kumar Tekalkote, who lost his ability to speak after a severe stroke, had to undergo intense rehabilitation and speech therapy exercises, to resume normalcy. Today, he is a motivational speaker. Here, he shares ten tips on how to live a full life. I was diagnosed with a haemorrhagic stroke. I was given a 5% chance of making it through an operating table. While no one expects adversity or enjoys experiencing it, the fact is that challenges are a normal part of life. On 18 October, 2012,…
  • Ranjana on the right with her stroke survivor mother Vaidehi on the left
    Stroke Takes Emotional And Financial Toll On Family!
    Ranjana Rajan had a difficult time when her mother Vaidehi suddenly got a stroke and returned home with her left limbs paralysed. Here, she narrates her experiences and challenges as a caregiver of a stroke patient and suggests some measures to reduce the burden. April 6, 2014, 9 pm: While eating her dinner, my 80-year old mom’s eyes became blurry, her left jaw dropped and she fell to one side of the chair; we immediately called a nearby hospital emergency service and moved her there. Her BP on…
  • A man in a black t-shirt and blue yoga pants sitting in padmasana or lotus pose
    The Biggest Fear I had to Battle was my Loss of Speech
    Sharad Tekalkote, 44, had no idea what was happening to him when he got a severe haemorrhagic stroke. It left him paralysed on his right side and completely took away his ability to speak. Here, he recounts his traumatic story and perseverance to get back to normal. That Thursday morning lacked the usual workday frenzy as my boss was on holiday. I left home at 10 am for the Expo Centre at Whitefield in Bengaluru to visit some dignitaries. My boss called me at 12:30 pm and I spoke to him for…
  • Payal in a brown dress holding her mother in a yellow kurta and white dupatta from behind
    How Our Entire Family Rallies Around My Mother, My Dad's Primary Caregiver
    Payal talks about how she has seen her father deteriorate physically and mentally over the years due to stroke. She and her mother play an active role in his daily care which has become tougher over time. Payal, tell us about your father’s condition? My father had a brain stroke 15 years back and he has been slowly deteriorating day by day. He has lost most of his memory and struggles to even remember his children’s names. He often wanders off if left alone, so he needs to be monitored 24 hours…
  • Stroke Is One Of The Leading Disabling Conditions In The World
    On World Stroke Day, Prof Dr Dipes Kumar Mandal, Founder-President - Stroke Foundation of Bengal talks about how a condition like Stroke, which has far reaching consequences, needs to be taken more seriously. Do you think stroke is one of the most debilitating conditions? Why? Stroke is one of the leading causes of death and disabilities globally. While in USA, heart disease is the leading cause of death, in China, Stroke (Brain Attack) is the leading cause of death as well as disabilities…