Rehab should include intense mobility-task training for stroke patients with walking limitations.
Stroke survivors should be given individually tailored exercise programs to improve their cardiovascular fitness after rehabilitation.
Patients should be provided intellectually stimulating environments, with access to computers, books, music, etc.
Patients with impaired speech should be offered speech therapy.
Eye exercises should be given to patients with impaired eye coordination and focus.
Stroke survivors with balance issues should be provided a balance training program.
Each year, this disease affects nearly 800,000 individuals, with many survivors experiencing persistent difficulty with daily tasks as a direct consequence.
The intensity of rehabilitation care varies widely, depending on the setting, with the most intensive rehabilitation care provided in inpatient rehabilitation facilities, followed by skilled nursing facilities, which provide “subacute” rehabilitation.
Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (e.g., personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others.
Communication and coordination among these team members are paramount in maximizing the effectiveness and efficiency of rehabilitation.
It is recommended that all individuals with this disease be provided a formal assessment of their activities of daily living (ADLs) and instrumental ADLs (IADLs), communication abilities, and functional mobility before discharge from acute care hospitalization, and that the findings be incorporated into the care transition and the discharge planning process.
Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential.
An offer to patients and their partners to discuss sexual issues may be useful before discharge home and again after transition to the community. Discussion topics may include safety concerns, changes in libido, physical limitations resulting from stroke, and emotional consequences of this disease.
Individuals, who appear to be ready to return to driving, as demonstrated by successful performance on fitness-to-drive tests, should have an on-the-road test administered by an authorized person.