Is it possible to fully recover from an ischemic stroke - all you wanted to know. The value of therapy in the complex of rehabilitation measures. Recovery of memory and intelligence

29.07.2019

Ischemic stroke of the brain is a dangerous disease that can disrupt speech and motor functions, thinking, memory, but its successful treatment gives hope even to an elderly patient for partial or complete recovery. The instructions of doctors, an individual rehabilitation program and the sensitive attitude of loved ones can create a miracle in a short time.

There are two types of disease - ischemic and hemorrhagic. The first is associated with blocking the blood flow to the brain, so all therapeutic measures are aimed at restoring normal blood supply. The hemorrhagic type is the opposite of the ischemic type. Its cause, as a rule, becomes a hemorrhage in the brain. In this case, surgical intervention and the appointment of drugs that improve blood clotting are possible.

Drug treatment of ischemic stroke is aimed at:

acceleration of metabolic processes;
activation of brain cells and improvement of its blood supply;
normalization of blood sugar levels;
lowering cholesterol levels;
removal of hypertension;
improvement of the psycho-emotional state.

The individual patient rehabilitation program includes four stages:

The main phase of the recovery period falls on the first year. They prescribe drugs that support brain function, improve the memory of a patient who has experienced an ischemic stroke, dilate blood vessels, and also:

nootropics;
alpha blockers;
tranquilizers;
blockers;

It is important to monitor the emotional state, not to succumb to negative thoughts, depression, and to practice functional-restorative gymnastics for the brain, which includes the repetition of dates and events in order to train memory.

Patients affected by an ischemic attack are prescribed drugs after a stroke:

actovegin and cerebrolysin (improve blood circulation in the brain);
piracetam (activates memory);
pantogam (accelerates metabolic processes in nerve cells);
vinpocetine (responsible for the qualitative transmission of impulses through the nervous system).

If the patient shows aggression, loses control of emotions and breaks down in public, then sedative pills, a course of antidepressants and periodic rest in sanatoriums are indicated.

Rehabilitation at home

Lost functions can only be restored by 70% of patients who survived a stroke, while the rest can only receive partial rehabilitation.

The patient has speech pathologies:

aphasia - problems in understanding and forming sentences;
dysarthria - speech defects.

The patient will need from one to three years to restore speech skills. To speed up the process, you need a specialist who will teach you the correct pronunciation, pronounce the words and ask questions. Simple exercises:

Tongue Twisters;
gymnastics for the tongue;
baring of teeth;
slight squeezing of the upper and lower lips with the teeth.

Therapy after an ischemic stroke includes the restoration of the vestibular apparatus. If the patient is very tired from simple household chores, complains of dizziness, he often gets sick in transport, doctors recommend repeating the following exercise: sit on a chair and periodically sway from side to side.

Treatment of ischemic stroke at an early stage of rehabilitation takes place at home. It includes:

physiotherapy;
proper nutrition;
homeopathy.

Physical therapy is necessary to:

learn to walk correctly;
take care of yourself;
restore balance;
become operational again.

It is important to adhere to food restrictions - give up spicy, pickled, fatty foods, cut back on foods high in carbohydrates in the diet.

Remember that every patient has a chance for a successful recovery. Modern methods and recommendations of doctors and the desire to live will help you get back on your feet and return to a full life!

Acute cerebrovascular diseases of the brain are considered one of the most important medical and social problems of modern society due to the huge economic damage to the state, high mortality (up to 35% of all cases of ischemic stroke) and long-term disability of patients, which is associated with the development of neurological and mental defects. Rehabilitation after ischemic stroke is a complex of active medical, psychological, pedagogical, socio-economic and professional measures aimed at full or partial restoration of impaired functions and social readaptation of patients. Concomitant treatment with neuroprotectors and vasoactive drugs, which improves the prognosis for the recovery of neurological defects, is of great importance during rehabilitation measures.

Disabling neurological consequences

The main consequences of ischemic stroke are persistent neurological and mental defects (damage), as well as impaired abilities and social functioning (the ability to self-care and the ability to perform certain household skills).

Neurological damage that develops after a brain stroke includes:

movement disorders (paresis, paralysis and ataxia);
cognitive and emotional-speech defects;
speech disorders;
visual and sensory disturbances;
bulbar and pseudobulbar lesions (dysphagia, dysphonia, dysarthria);
pelvic and sexual disorders;
epileptic seizures;
falls and thalamic pain.

In connection with the development of persistent neurological defects, most patients develop impaired abilities - impaired walking, speech, and the ability to self-care (the ability to independently dress, eat, maintain personal hygiene, use the bathroom and toilet, and carry out independent movement within the premises and on the street) .

Principles and goals of rehabilitation

The main goal of the rehabilitation of patients who have had an ischemic stroke of the brain at the hospital stage and after the patient is discharged from the hospital is to restore impaired functions, prevent and treat post-stroke complications (pneumonia, bedsores, urinary tract infections, deep vein thromboembolism of the extremities, arthropathy, septic diseases of infectious diseases). inflammatory genesis), learning to walk and speak, as well as self-care skills.

The principles of rehabilitation measures for post-stroke consequences include restoration (full or partial) of impaired functions, psychological and social readaptation, differentiated treatment and prevention of recurrent strokes (hemorrhagic or ischemic) of the brain.

A new tool for the rehabilitation and prevention of stroke, which has a surprisingly high efficiency - Monastic Collection. The monastery fee really helps to fight the consequences of a stroke. Among other things, tea keeps blood pressure normal.

Factors affecting the degree of recovery of patients

A great influence on the outcome of ischemic stroke and the degree of recovery of impaired functions has the timeliness of hospitalization of the patient in a medical institution, treatment at the hospital stage and subsequent early admission of the patient to specialized rehabilitation centers.

The stage-by-stage, regularity and duration of the rehabilitation process with active participation in the rehabilitation activities of the patient (with the obligatory desire and faith in the successful restoration of lost functions), as well as his relatives and friends, has a huge impact on the prognosis for life, social adaptation and working capacity.

Also, an important aspect that affects the possibility of a more complete recovery of neurological and mental defects after an ischemic stroke is the inclusion of specialists in various specializations in the rehabilitation process - neurologists, speech therapists, aphasologists, neuropsychologists, massage therapists, physiotherapists, social workers, specialists in kinesitherapy (therapeutic gymnastics) , occupational therapists, biofeedback specialists with the mandatory complexity and adequacy of rehabilitation measures.

Recovery periods

Rehabilitation of post-stroke consequences of the brain is carried out in accordance with an individual program developed for each patient. It is based on the nature of the underlying disease, the presence of clinical syndromes, the age of the patient and the severity of concomitant somatic diseases and complications.

Recovery periods are conditionally divided into four periods:

recovery in the acute period (the first three to four weeks after ischemic stroke);
rehabilitation in the early recovery period (the first six months after a cerebral infarction);
rehabilitation measures in the late recovery period (from six months to a year);
rehabilitation in the residual period (more than a year after ischemic stroke).

Features of rehabilitation after a cerebral infarction

Recovery of patients after a cerebral infarction usually lasts from several months to two to three years. It is best to spend the early recovery period of rehabilitation in a local specialized (neurological sanatorium), where all disorders (motor, vestibular, neuropsychopathic syndromes and sensitivity disorders) are restored with the help of exercise therapy (therapeutic exercises and physical education), physiotherapy, massage, mud therapy and reflexology and treatment with neuroprotective and vasoactive drugs.

Rehabilitation of patients with movement disorders

The main motor disorders after a cerebral stroke include paralysis and paresis (usually unilateral hemiparesis) with a decrease in strength and limitation of movement in the limbs, a violation of tone and sensitivity.

In the recovery of patients with motor disorders after ischemic stroke of the brain, adequate timely treatment of neurological defects, a complete examination and early use of physical rehabilitation methods - massage, kinesitherapy (therapeutic exercises and exercise therapy), physiotherapy, reflexology, biofeedback and manual therapy are of great importance. .

The leading role in the restoration of motor lesions is played by therapeutic exercises and/or exercise therapy (LFK), learning to walk and self-care skills, as well as feedback biofeedback and concomitant treatment with vasoactive drugs and neuroprotectors. Additional, but no less important methods are massage and electrical stimulation of the neuromuscular apparatus.

Therapeutic gymnastics and exercise therapy

Each period of rehabilitation after a cerebral stroke has certain tasks for restoring movement disorders.

The complex of physical exercises of therapeutic gymnastics and exercise therapy is aimed at increasing the range of motion, normalizing increased muscle tone, increasing the ability for voluntary muscle movements (tension and relaxation). And then teaching the main motor skills - walking, standing and the lost skills of household self-service.

In the acute and early recovery periods, passive movements predominate, stimulating the appearance of active movements, preventing the development of contractures, improving blood and lymph circulation and reducing muscle hypertension with the gradual addition of active movements. Also in these periods, the training of patients to sit, stand, walk and self-service begins.

In the late recovery period, physical exercises are aimed at improving walking skills and training in a stable upright posture and balance therapy.

Feedback biofeedback method

One of the modern rehabilitation technologies for recovery after a cerebral infarction is the method of functional biocontrol using feedback with an active appeal to the patient's personality about the effectiveness of performing individual movements and behavior in general.

The main component of this technique is the registration of individual parameters of the physiological functions of the body (heart, brain, muscles) with their subsequent conversion into light and sound signals. Then these signals are shown to the patient, and the body opens the channels of functional reserves, and also creates conditions for the patient to actively use his own self-regulation mechanisms to correct movement disorders after a brain stroke.

The value of therapy in the complex of rehabilitation measures

Rehabilitation of patients after ischemic stroke is carried out against the background of taking medications that stimulate metabolic processes in the neurons of the affected area, aimed at stabilizing and gradual regression of neurological symptoms associated with the "retraining" of neurons in intact parts of the brain. Treatment with neuroprotectors activates the formation of new connections between neurons with a change in the properties of nerve cell membranes.

Early differentiated treatment - improves the prognosis of ischemic stroke in terms of outcome and rehabilitation options (full or partial).

Speech disorders after ischemic stroke

Speech disorders cause patients to feel hopeless, isolated from the outside world, and powerless. They are usually combined with movement disorders and are considered the second most common and significant post-stroke defect.

The main groups of speech disorders after cerebral infarction are:

aphasia (systemic impairment of various aspects of speech function associated with local damage to the speech areas of the left hemisphere of the brain);
dysarthria (violation of the pronunciation side of speech - articulation, rhythm, voice formation and speech tempo, associated with a violation of the innervation of the peripheral speech apparatus).

Rehabilitation of speech disorders

The basis for the correction of speech defects is treatment with drugs that activate the processes of restoring lost brain functions - drugs that stimulate the metabolism of nerve cells - vasoactive drugs, amino acid drugs (cerebrolysin), nootropics and precursors of neurotransmitters and active classes with specialists - a speech therapist-aphasologist or neuropsychologist.

The most intensive restoration of speech occurs in the early recovery period (in the first three to six months after a cerebral stroke) and lasts from two to three years, depending on the extent of the lesion, the timeliness of the start of therapy and rehabilitation. Differentiated treatment of stroke is carried out in accordance with the localization and prevalence of the focus and depends on the pathogenetic features of the development of the disease.

Rehabilitation measures for lesions of the cerebellum

Acute disorders of cerebral circulation of the ischemic type, due to embolism of the inferior or superior cerebellar artery, causes the development of an infarction focus in the cerebellum and pons. This type of ischemic stroke is manifested by symptoms - dizziness, nausea, vomiting, tinnitus, cerebellar ataxia and mimic muscle paresis.

Restoration of impaired functions in the focus of infarction in the cerebellum is aimed at restoring impaired coordination of movements associated with vestibular disorders and normalizing the function of walking, as well as restoring defects in facial muscles. All rehabilitation measures for cerebellar strokes are carried out against the background of active therapy and consist of individual complexes of kinesitherapy, selective massage, balance training and the stabilogram biofeedback method.

Recovery of patients with astheno-depressive disorders

Astheno-depressive syndrome is characterized by a combination of depression with increased fatigue, a decrease in the level of activity, exhaustion and inability to long-term mental and physical stress.

Rehabilitation of patients with asthenia and depressive disorders consists of individual therapeutic exercises with additional breaks, massage, work with psychologists and teachers, and long-term treatment with nootropics, piracetam and antidepressants (stimulating or sedative).

Rehabilitation of elderly patients

Elderly patients constitute a special rehabilitation group. The complex of rehabilitation measures consists in short individual sessions of therapeutic exercises, sessions with a psychologist, active treatment with cardiovascular drugs, long-term use of neurotrophic and anti-sclerotic drugs and vitamin therapy. The use of physiotherapy methods in patients of this group is limited, and the lower intensity of rehabilitation exercises is compensated by the longer duration of the course of general rehabilitation treatment.

Stroke recovery outcomes

The results of the restoration of impaired functions in patients after ischemic stroke are summed up in the late recovery period.

Recovery outcomes are classified into five recovery classes:

Grade 1 (the highest degree of recovery of neurological defects and disability with complete regression of the neurological deficit);
Grade 2 (corresponds to a significant, but incomplete regression of lesions with a return to the previous job, but with restrictions or a transition to a less qualified job and complete independence from others in everyday life);
Grade 3 (consists of disability and partial dependence on others - they need help using the bathroom, lacing shoes, dressing and moving outdoors);
Grade 4 (corresponds to a significant dependence on loved ones in everyday life with a violation of all types of adaptation, with outside help, patients can move around the room, wash, dress and use the toilet);
Grade 5 (complete loss of self-service and dependence on others).

You are at risk if:

experience sudden headaches, flies, and dizziness;
"jumps" pressure;
feel weak and tired quickly;
get irritated over trifles?

All these are harbingers of a stroke! E. Malysheva: “Signs noticed in time, as well as prevention in 80%, help prevent stroke and avoid terrible consequences! To protect yourself and your loved ones, you need to take a penny remedy ... "

Pushkareva Daria Sergeevna

Neurologist, website editor

In the event of a stroke, patients have a chance of recovery. Despite the fact that the pathology of the circulatory system threatens with complications, with modern assistance, as well as during rehabilitation, there is a possibility of a favorable outcome. It is necessary not only to follow the doctor's instructions, but also to ensure complete psychological rest for the patient, since it is necessary to restore speech and motor activity.

When an ischemic stroke occurs, the doctor does not guarantee that the patient will be able to recover completely. It is likely that after some time the person will fully recover, however, in some cases, only some functions of the body can be restored. Before choosing a rehabilitation program, it is necessary to take into account which part of the brain was affected, and also to find out the degree of the pathological process.

When compared with other similar disorders, ischemic stroke is characterized by the most favorable prognosis. This disease is one of the most common, while the patient has the opportunity to restore their usual life. Recovery depends not only on proper care and selection of optimal therapy, but also on the localization of the lesion. Not only the factors influencing the course of the disease are important, but also receiving sufficient care from loved ones, the patient's desire to recover, to return to normal life.

Many doctors believe that full recovery is almost impossible if the stroke occurred with the following factors:

The affected area is too large, the vital parts of the brain, large bundles of nerves are affected. Perhaps not only incomplete recovery, but also falling into a long coma, death.
Previously, the patient has experienced serious acute or chronic diseases, suffers from diabetes, atherosclerotic vascular lesions, and has a lot of bad habits.
Reached the age of more than 70 years.

How much time will it take?

It is not always possible to determine the exact period for recovery. Not only the affected area is taken into account, but also the timeliness of medical care, the ability of relatives to care for a person. Sometimes it is necessary to prescribe maintenance therapy, conduct regular preventive examinations to exclude a re-exacerbation of the disease.

Ischemic stroke is divided into three groups according to severity. The form of the disease determines not only the patient's condition during an acute attack, but also indicates the possibility and timing for full or partial recovery.

Degrees of ischemic stroke:

Light. The lesion has a minimal size, a person feels a strong lack of coordination, dizziness manifests itself several times a day. Rehabilitation is usually required, which lasts about 1-2 months. Sometimes patients get the opportunity to fully restore all body functions in 3 months.
Average. There is paralysis of the face on one side completely. The patient completely loses the ability to coordinate movements. To achieve a positive result, it will take at least six months. In this case, there is a partial recovery, in which the patient cannot return to his usual life. It will take more than a year to ensure full restoration of functions, in some cases a positive effect cannot be achieved.
Heavy. In addition to the listed moderate symptoms, the patient suffers from a neurological deficit. It will take more than a year to partially reduce the symptoms of the disease. It is almost impossible to fully recover from this form of the disease.

With a severe neurological deficit, the possibility of a complete recovery is rarely predicted. Not always healthy brain cells are able to perform the functions of those that were affected as a result of severe bleeding. Sometimes long-term rehabilitation is required throughout the life of the patient. A course of drug therapy is required, which should be taken daily. Measures are being taken to help prevent the recurrence of a stroke. Recovery time depends on the individual characteristics of the body, health status, mental balance, as well as the presence of motivation.

Recovery periods

Immediately after the discharge of a patient who has experienced a stroke, relatives must adapt to a new lifestyle. If the rehabilitation process is carried out completely at home, it takes a long time to work on the implementation of the doctor's recommendations. This process is difficult not only for the patient himself, but also for those who care for him. Not only drug or alternative therapy is important, but also the constant maintenance of an optimal psychological state. First of all, it is necessary to normalize the daily routine, stabilize the daily routine, allocate time for a little physical activity and rest.

If the patient cannot rise independently, it is necessary to find a comfortable position for the limbs that have been paralyzed. About every 3 hours, the position of the legs or arms should be changed to prevent the formation of bedsores. With complete immobilization, regular massage is indicated to normalize muscle tone.

Be sure to purchase a tonometer, with which you can measure blood pressure several times a day. Indicators must be recorded in order to monitor them yourself or show the doctor to form a complete picture of the disease. Patients are warned about the need for proper nutrition, timely implementation of drug treatment, physiotherapy and other measures that allow you to restore your general condition. Features of the rehabilitation period vary depending on the specific period.

First three months

At this time, it is possible to stabilize the condition of a patient who has recently been discharged from the hospital. takes place in complete rest, as well as with the provision of proper care. You should not refuse to undergo massage courses. Do not forget that after a stroke, patients have a significantly increased risk of muscle atrophy, since they practically do not move. Often additional stimulation is required. Make sure the patient is exercising several times a day.

Immediately after the improvement of the patient's condition, he must adapt to a new life. Self-care skills should be improved. To improve the quality of life, the independent performance of many important things is very important, since patients often want to feel independent from other people. Do not forget that it is necessary to make every effort so that the patient can dress himself and go to the toilet.

Approximately one month after an acute attack of ischemic stroke, the patient must learn to stand up on his own, be able to control the body, that is, restore impaired coordination. If one side of the body is injured, walkers, crutches should be used as a support, if not available, furniture can be used. Don't forget to help the patient in order to reduce the stress level, as well as speed up the approach of the positive effect of physical activity.

3-6 months

By this time, most patients have already learned to serve themselves on their own. Sometimes they can perform the necessary functions completely, in some cases only partially, moving a minimum distance. You should gradually increase moderate physical activity to consolidate a positive result. Walking in the fresh air, leisurely climbing stairs, household work that does not involve too much effort is shown. As a result, patients manage to strengthen muscles, restore the overall tone of the body.

To bring the moment of full recovery after a stroke closer, it is necessary to monitor not only the general state of health, but also to activate fine motor skills. The patient can write, learn to use cutlery independently. Some are suitable for modeling, drawing, assembling a constructor. Despite the fact that such classes are more adapted for children, patients who have had an ischemic stroke receive significant relief when using such tools. So you can activate many parts of the brain, restore the activity of speech centers.

If the patient has the opportunity to take walks on his own, it is necessary to allow him to do so if such a desire is revealed. Make sure the patient always has a phone with them. To ensure that a call is received when a degradation occurs, it should be possible to reach a specific subscriber with the push of a button. So the sick person will not have unnecessary difficulties when trying to report problems to relatives.

To perform competent at home, you need to achieve positive dynamics, not to relax when you get the expected result. In many cases, it is possible to achieve a complete restoration of motor functions, speech centers. When the expected result is obtained, it is necessary to consolidate the effect by intensifying the training.

What will be the quality of life of a person who has had an ischemic stroke? This question worries both the patient and his relatives and close people. A lot, of course, depends on the area of the damaged brain and the degree of damage. But doctors are unanimous in their opinion that the early start and systematic rehabilitation measures can significantly increase the chances of a person returning to a healthy life.

Ischemic stroke is a disease that can lead to temporary or permanent disability. The main complications after a stroke include:

paralysis or paresis of a group of muscles;
speech disorders;
visual disturbances;
violations in the process of swallowing;
complete or partial loss of memory;
problems with understanding;
problems with assimilation of information and memorization;
changes in behavior;
complete or partial loss of self-service skills;
pain sensations of varying intensity.

Rehabilitation of a patient with ischemic stroke is a long and systematic process, the main task of which is the most complete restoration of impaired functions and skills, adaptation and socialization of the patient in society.

How long will it take to recover from an ischemic stroke? It depends on many factors: what part of the brain is damaged, how extensive is the area of damage, the age of the patient, the presence and complexity of concomitant diseases. The desire for the maximum possible recovery of the patient himself and the support of his family members and loved ones cannot be underestimated.

Basic principles and periods of rehabilitation for ischemic stroke

The most actively disturbed functions are restored in the first days and months from the onset of the disease. Therefore, during this period, rehabilitation measures should be carried out as intensively as possible - only in this way will the maximum effect be achieved. It is also very important how a person who has suffered a stroke is involved in the rehabilitation process, how great is his understanding of the role and need for recovery, whether he is ready to make every effort to achieve a result.

Modern medicine conventionally distinguishes five periods of stroke:

Acute (lasts up to 5 days).
Acute (from 5 to 21 days).
Early recovery period (up to six months).
Late recovery period (up to two years).
Persistent residual effects.

Effective rehabilitation should begin already in the acute period of ischemic stroke, even during treatment in the neurological department of the hospital. If, after the end of hospitalization, the patient needs to undergo rehabilitation, then rehabilitation measures are carried out in specialized clinics or centers. But in modern realities, very often rehabilitation after an ischemic stroke becomes the concern of the patient's relatives.

For rehabilitation to be as effective as possible, it is necessary to follow the basic principles of its implementation:

Start as early as possible. Early rehabilitation prevents the development of stroke complications caused by partial or complete immobility (thrombophlebitis, pneumonia), the development of spastic contractures;
duration and consistency. It is necessary to strictly follow individual rehabilitation programs drawn up by an experienced rehabilitation doctor who will tell you how to recover from a stroke;
Complexity. The patient will need the help of specialists in various branches of medicine: a neurologist, a cardiologist, a therapist, an aphasiologist, a speech therapist, a neuropsychologist, physiotherapists, as well as specialists in physical therapy and social workers.
Staged. The duration of each stage is determined by the attending physician.

The beginning of the way. Rehabilitation after ischemic stroke

Rehabilitation measures begin already while being in hospital after an ischemic stroke. After it is established that the patient's life is not in danger, medical workers begin to carry out activities aimed at restoring functions. The patient is changed the position of the body in order to avoid the occurrence of spasticity and bedsores. If the patient is in a satisfactory condition and in a clear mind, breathing exercises, passive exercises are connected. Taking into account the degree and areas of brain damage and the presence of concomitant diseases, the doctor may prescribe active exercises, a transition to a sitting and vertical position, and small static loads. But the main activities in the rehabilitation process will be drug therapy, massage, speech restoration classes and therapeutic exercises.

Medical therapy

Strictly speaking, drug treatment is not the rehabilitation of the patient in its purest form. Its main task is to prevent. Patients are assigned:

antihypertensive drugs to control blood pressure;
anticoagulants that reduce blood clotting and prevent the formation of blood clots;
statins to control cholesterol levels and other disorders of fat metabolism;
neuroprotectors - agents that prevent damage to brain neurons;
antioxidants
vasoactive drugs with metabolic and vasodilating effects.

Drug therapy provides optimal conditions for effective rehabilitation and is prescribed exclusively by the attending physician.

Massage

While the patient is in a hospital, it is done only by a highly qualified specialist. The main goals of the massage are to bring those muscles that are in good shape into a relaxed state, and stimulate the opposite muscle group, restore blood circulation in the tissues. Therefore, massage in patients who have had an ischemic stroke in rehabilitation should be determined by a doctor and have a dosed regimen. Massage sessions begin from 5 minutes, and by the end of the 2nd week, rehabilitation can reach 30 minutes or more.

After discharge from the neurological hospital, the patient's relatives can also massage, but only after consulting a doctor. The massage technique after a stroke, depending on the affected limbs, consists of the following: the patient is placed on a flat surface face up, the injured (from paralysis or paresis) arm is taken to the side so that it fits at shoulder level. It is necessary to ensure that the patient's fingers and hand are in an extended state. It is necessary to massage all the bending flexor surfaces of the hand, fingers and elbow. Massage should not cause acute pain and muscle tone in the patient. Massage should be done without jerky movements and slowly. If the lower limb is paralyzed, then the massage is performed in a similar way, but a roller is placed under the knee.

When the patient has a working hand and is properly motivated, he can carry out massaging movements himself. For these purposes, there are special massagers and devices - an expander, balls, rubber toys. To restore fine motor skills, you can use cubes, sorting out the rosary, fastening buttons or zippers.

How to restore speech after an ischemic stroke

You need to understand that if there are speech disorders after a stroke, they will not go away on their own. In patients who have had an ischemic stroke, the restoration of speech skills is a very long and painstaking process that will require the help of a specialized specialist, patience and perseverance of the patient himself and his relatives, and attempts to practice at home, without using the necessary skills and developed methods, will not bring the desired result. With a satisfactory condition of the patient and a clear mind, speech therapy classes are started even in a hospital setting already 1-3 weeks after the onset of the disease, an early start of classes gives a higher chance that speech will recover faster. But even if speech therapy assistance was not provided in the first weeks after a stroke and speech disorders became persistent, the professional work of a speech therapist-aphasiologist makes it possible to partially or completely restore speech in the later stages of rehabilitation. In the acute period of a stroke, due to increased fatigue of the patient, short sessions (no more than 20 minutes) are indicated. Later, the duration of classes can be doubled. Restoration of speech skills requires quite a long time - sometimes up to 2-4 years.

Physiotherapy

The tasks of exercise therapy include the restoration of movement skills and self-care of patients. During manipulations, the compensatory mechanisms of the body are involved in the recovery process, muscle memory is restored, and repeated repetition of the same movement creates conditions for the emergence of new reflex connections. Classes should be started under the guidance of an exercise therapy instructor immediately after the stabilization of the patient's condition.

Basic rules for physical therapy:

Exercises for the healthy side of the body are done first;
General strengthening exercises alternate with special ones;
Classes are held according to the regime and regularly;
There should be a trend towards a gradual increase in the intensity of the load;
During gymnastics, a positive emotional background of the patient should be maintained.

Therapeutic exercises, depending on the condition of the patient, can be carried out in the supine, sitting or standing positions.

What else can help?

Due to the prevalence of this disease and the fact that stroke is getting younger all the time, scientists and physicians are constantly creating new methods of post-stroke rehabilitation. These relatively new methods in early and late recovery include:

forced movement therapy;
physiotherapy;
the use of computerized and robotic systems of kinesiotherapy;
functional electrical stimulation;
transcranial magnetic stimulation.

It is good if it is possible to undergo a course of recovery of a patient after a stroke in a special rehabilitation center or clinic. If this is not possible for a number of reasons, then you should not despair. Desire and work, regular classes and training, the care and help of relatives will help to cope with many difficulties on the way to a healthy life!

After discharge from the hospital, the patient must be observed by a local neurologist. Relatives should receive from the doctor all comprehensive information about the procedures, exercises and methods of rehabilitation measures. Today's medicine offers a ready-made program for the gradual adaptation of a stroke patient to home conditions. You just need to be prepared to work hard and strictly follow the recommendations of doctors!

Rehabilitation of patients after ischemic stroke can take from 3 months to several years. The degree of restoration of lost functions is determined by the site of brain destruction, the severity of neurological and cerebral disorders. Patients who have had a cerebral infarction are recommended a set of measures to improve movements, sensitivity, speech, memory, and self-care skills.

Read in this article

Is it possible to fully recover from an ischemic stroke?

The success of rehabilitation of patients after acute cerebrovascular accident depends on the location and extent of the brain lesion, the age of the patient, and the presence of concomitant pathology.

The most favorable is with minor neurological symptoms - weakness in the limbs with preserved or slightly reduced sensitivity, transient visual impairment, and unsteady gait. In such cases, improvement occurs on average for 2 months, and a fairly complete restoration of functions by 3 months from the onset of a stroke.

An important role in the rehabilitation process is played by getting rid of the cause of the development of the disease (smoking, drinking alcohol, unhealthy diet, overweight), as well as compensation for the course of hypertension, diabetes, high cholesterol in the blood.

As a rule, patients after a massive stroke lose the ability to self-care, independent movement, effective communication, and adequate behavior. This leads to a complete loss of ability to work, it determines the disability group. Most of them need the help of outsiders.

Full recovery usually does not occur. Rehabilitation takes one to two years, it is considered successful if the patient can sit in bed and eat, control the processes of urination and defecation.

If right/left side

Residual effects of hemispheric strokes are muscle weakness in the limbs or paralysis, it can also affect the facial muscles. There is a loss or decrease in sensitivity, as well as speech disorders. The patient pronounces words slowly, with impaired articulation, in severe cases, can only communicate with sounds.

The duration of partial rehabilitation with the return of the ability to self-service takes about six months, within a period of up to a year, lost functions are restored to the maximum, complete normalization of the condition is doubtful. In the future, only slight progress or stabilization of neurological disorders is possible.

If a cerebellar stroke

After a stroke, balance is disturbed in the cerebellar zone, patients complain of dizziness, unsteadiness when walking, falls, and difficulty in coordinating movements. The most difficult to recover is cerebellar ataxia. It is a set of symptoms:

violation of proportionality of movements - earlier or later termination;
inability to perform multidirectional actions at an accelerated pace (for example, hand up, then palm down);
when writing, the letters become large and distorted;
deviations to the side when walking and turning the body, gait like a drunk person;
speech becomes slurred.

Cerebellar stroke

The rehabilitation period usually lasts 9-12 months, a full recovery can be achieved in exceptional cases.

Recovery course

The rehabilitation program includes many methods of influencing paralyzed limbs, teaching walking, eating, maintaining personal hygiene, and self-service. It includes such areas as kinesiotherapy (treatment by movement), training, memory, dietary nutrition, medication, physiotherapy, massage.

Watch a video about recovery after a stroke:

Motor program

You need to start moving as early as possible. At first, it can be flexion and extension of the fingers, hands and feet of the healthy side of the body. This speeds up the recovery of brain cells in the affected area. Subsequently, usually simultaneously with the massage, the physical therapy instructor conducts gentle flexion and extension, rotation sequentially in all joints of the arm and leg.

Restoring finger movement after a stroke

To restore the function of the upper limb, a towel is hung over the bed, and the patient grabs it and moves back and forth, sideways, up and down. After mastering these, the towel is hung higher.

Also, a rubber bandage is used as a training device, it is tied into a ring (the length of the strip is about 80 cm) and fixed on a fixed object or between the arms, legs, arm and leg. In the process of training, you need to stretch the ring.

The lower limbs in bed can be developed by passive movements in the ankle, knee and hip joints, and then the patient is invited to slide the heel along the bed. To eliminate spasm under the knee, you need to put a hard roller.

Exercise in bed

The next stage of training is classes in a sitting position on the bed, and then standing on the floor. The following exercises may be included in the rehabilitation complex:

pick up from the table, and then from the floor boxes of matches;
stand on your toes with your arms raised above your head;
expander compression;
torso inclinations;
hand movements like scissors;
squats.

Special simulators for recovery after a stroke significantly speed up the rehabilitation process and can be used from the first days

Speech training

Speech is restored later than movement in the limbs, it can even take several years. To restore the ability to speak, it is important that the patient constantly hear the conversation addressed to him, even if he is not yet able to answer. Even the perception of someone else's speech activates the corresponding centers of the brain, which contributes to their disinhibition. If speech is completely absent, then the following techniques can be applied for training:

the patient finishes the word (the part without the last letter, syllable is pronounced to him), then the sentence;
repetition of simple phrases;
well-known poems;
Tongue Twisters;
joint singing.

Speech therapist tips for restoring speech

In order to force the development of the muscles involved in articulation, the patient is asked to move the lower jaw daily, stick out the tongue, lick the lips in different directions, and roll them into a tube.

Memory recovery

Against the background of drug therapy (nootropic drugs), special memory development exercises:

repetition of the digital series with closed eyes;
learning proverbs, sayings, poems;
retelling of a read text or a song heard;
board games.

Board games for memory recovery

The best results can be obtained if the sessions are combined with the patient's previous hobbies so that the training process is accompanied by positive emotions.

Nutrition

It is most difficult to feed patients with impaired swallowing and sensitivity in one half of the oral cavity. They have to learn to eat again. To do this, you can use exercises to restore lost abilities:

the patient simulates coughing, swallowing and yawning;
puffs out cheeks;
rinse mouth and throat.

Cheek Puffing Exercise

When organizing the nutrition of patients with impaired chewing and swallowing functions, the following features should be taken into account:

food should only be warm and smell appetizing;
exclude viscous and hard dishes - rice, dry cottage cheese, dried bread, crackers;
the garnish should have the consistency of a thick puree, and soup or juice can be added to meat and fish;
eating takes at least 40 minutes, you can not rush the patient;
it is necessary to feed in such a way that food gets on the healthy side;
for drinks and water, it is convenient to use a drinking bowl or a straw for a cocktail.

The easiest foods for stroke patients with eating problems to swallow are:

boiled carrots, potatoes, mashed or cubed;
cauliflower, broccoli;
minced meat;
baked flounder, sardines;
omelette;
avocado, banana;
soft pear cubes;
baked or mashed apples;
jelly, pudding;
soft cheese;
porridge from flakes or grains (thoroughly boiled).

Pureed vegetable, meat, fish soups

It is unacceptable to include fatty meat, fats, fried and spicy foods, alcoholic and caffeinated drinks in the diet.

Preparations

The choice of medicines for rehabilitation is carried out exclusively by a neurologist. The following groups of drugs are used:

If there are indications, antiplatelet agents (Tiklid, Aspirin), hypocholesterolemic agents (Atocor, Vasilip) are used.

Physiotherapy

The appointment of procedures can be no earlier than 1 - 2 months from the onset of a stroke. The following methods are shown in the recovery period:

electrophoresis on the collar zone;
sulfide baths for hands;
magnetotherapy on the neck area;
general baths with sea salt, coniferous extract, carbonic and pearl;
ozocerite or paraffin, mud or galvanic mud on the affected limbs;
reflexology - acupressure or;
electrical stimulation with sinusoidally modulated currents;
darsonvalization of limbs.

Massage

Shown from the first week of illness daily, starting from 10 minutes to half an hour. All movements are slow and low-intensity, especially in the presence of muscle spasm. On the healthy side, the technique of massage movements can be classic. Massaging sequence:

Scapular region.
Shoulder.
Forearm and hand.
Pelvic, femoral region.
Leg and foot.

The course requires from 30 to 50 sessions, after which you need a break for a month, then for maintenance therapy, massage can be done 10 sessions 3-4 times a year.

Watch the video about massage and exercise therapy after a stroke:

Recovery time after ischemic stroke

After inpatient treatment, the patient is discharged for further treatment. The most productive recovery period is the interval from the onset of a stroke to 3 months, then the possibilities gradually decrease, and after one year it is quite difficult to make progress.

Nevertheless, cases are described when the lost functions with persistent treatment appeared after a few years.

Approximate terms for which partial improvement can be achieved:

With regard to complete recovery, the prognosis is worse - this can be achieved only with a small lesion, in relatively young patients without concomitant pathology, with early diagnosis and initiation of treatment, and comprehensive rehabilitation.

Ischemic stroke has consequences in the form of a violation of the patient's ability to move, speak, remember events and information. This leads to a significant limitation of self-service, hinders social activity and professional activities.

The possibilities of rehabilitation are directly related to the place of brain damage, the severity of the stroke. For rehabilitation therapy, exercises, massage, physiotherapy, medicines, and special nutrition are used.