Stroke Rehab
Inpatient Stroke Rehabilitation Recommended Over Nursing Homes
Whenever possible, the American Stroke Association strongly recommends that stroke patients be treated at an in-patient rehabilitation facility rather than a skilled nursing facility.
While in an inpatient rehabilitation facility, patients participate in at least three hours of intensive therapy each day with expert physical therapists, occupational therapists, and speech therapists. Licensed rehabilitation nurses provide 24-hour support, and physicians visit daily to monitor progress and adjust treatment plans. An inpatient rehab hospital may be a free-standing rehabilitation center or a specialized unit within a hospital, ensuring comprehensive stroke rehab and recovery care for every patient.
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“If the hospital suggests sending your loved one to a skilled nursing facility after a stroke, advocate for the patient to go to an in-patient rehabilitation facility instead — unless there is a good reason not to — such as being medically unable to participate in rehab. There is considerable evidence that patients benefit from the team approach in a facility that understands the importance of rehabilitation during the early period after a stroke,” said Winstein, who is a professor of biokinesiology and physical therapy at the University of Southern California in Los Angeles, California.
Hospital Discharge
Caregivers should insist that a stroke survivor not be discharged from the rehabilitation hospital until completing a structured fall-prevention program. This essential part of stroke rehab includes patient education on home safety modifications—such as removing throw rugs, improving lighting, and reducing trip hazards. Training also focuses on minimizing fall risk caused by medication side effects and safely using assistive devices like wheelchairs, walkers, and canes to support long-term stroke recovery and independence.
“This recommendation will probably change medical practice. Even the top stroke centers may not have a formal falls-prevention program, but it is very important because a high percentage of patients end up falling after a stroke,” Winstein said.
Other recommendations include:
Intense mobility-task training after stroke for all survivors with walking limitations to relearn activities such as climbing stairs.
Individually tailored exercise program so survivors can safely continue to improve their cardiovascular fitness through the proper exercise and physical activity after formal rehabilitation is complete.
An enriched environment (which might include a computer, books, music and virtual reality games) to increase engagement and cognitive activities during rehabilitation. NOTE: There is not yet enough research to determine whether specific promising new techniques, such as activity monitors and virtual reality games, are effective at helping patients.
Story Source:
Content provided by American Heart Association.
Journal Reference:
Carolee J. Winstein et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, May 2016 DOI: 10.1161/STR.0000000000000098.