The Stroke Recovery Association NSW is a non-profit organisation that advocates for and provides a range of Stroke support and information services. In order to achieve a greater proportion of recovery, a much higher intensity of therapy has to be considered 72 Greater intensity of stroke rehabilitation has been associated with improved outcomes 74 - 76 Skill learning and active participation help to promote plasticity and network activation in stroke recovery 77 , 78 Motor retraining not only enables somatotopic reorganization to happen in perilesional areas and in distant areas connected to the infarct site but also negate the inhibitory effects of myelin associated proteins and ephrins which suppress axonal sprouting 79 , 80 An enriched environment” in addition to motor retraining has been shown to facilitate motor recovery and neural plasticity in animal studies due to the numerous associated cellular and molecular effects 81 - 84 Rehabilitation facilities are ideal enriched environments as they are often situated in stimulating and specialized centers managed by a multidisciplinary team of medical professionals.
Outcomes assessed at baseline and 8 weeks and 12 weeks are gross level of disability, pain, objectively measured arm function and impairment, exercise equipment for stroke patients self-reported arm function, passive range of movement, spasticity, fatigue, participation, quality of life (QOL) and health service use.
Commonly used measures tended to be disability based, such as the Berg Balance Scale, and failed to quantify what therapists were trying to achieve (eg, building their patient's confidence and self-responsibility): Often there is no difference in time that they may take (to walk), but it's the confidence thing and they're prepared to do it themselves, without somebody on standby and that's not measurable, within the number game, that's more description” (participant 15).
Pitt researchers say that while doctors and patients had long believed that the window of opportunity for regaining most cognitive abilities closes three months after a stroke, following what's known as the acute phase, their study, published in the journal Stroke, suggests otherwise.
Because daily activities and exercise can be more tiring compared with able-bodied persons, CVA survivors can suffer an intolerance to exercise, causing reduced cardiovascular fitness, muscle atrophy, osteoporosis and impaired circulation in their lower extremities.
A recent meta-analysis by Wang Y et al. reported insufficient evidence to support the role of TC interventions in reduction of mortality and functional improvement after stroke 101 However, among all the TC interventions, home-visiting programs which focus on patients and caregivers' needs and preferences in addition to well-established rehabilitation goals via multidisciplinary approach seem to be associated with positive outcomes 101 More research regarding TC interventions needs to be conducted before any further conclusions can be made.
Consult with your loved one's healthcare provider, case manager, social worker or insurance company to find out how much and how long insurance (private or government supported) will cover medical and rehabilitation services in and out of the hospital and to determine out-of-pocket expenses.