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JAMA Patient Page
December 13, 2016

Recovery After Stroke

Author Affiliations

Copyright 2016 American Medical Association. All Rights Reserved.

JAMA. 2016;316(22):2440. doi:10.1001/jama.2016.16901

Stroke can affect the body in various ways, and rehabilitation is often an important aspect of recovery after stroke.

A stroke is an injury to part of the brain that results in the death of brain cells. A stroke can be caused by blockage of blood flow to part of the brain (ischemic stroke) or by a tear of a blood vessel causing bleeding into the brain (hemorrhagic stroke). After someone experiences a stroke, doctors determine the cause of the stroke, give treatments to limit the amount of brain injury, and recommend therapies to reduce the risk of another stroke.

Despite the best medical care, people are often left with impairments after a stroke. The particular deficits that a person might have depend on which part of the brain was injured. Common deficits after stroke include weakness, numbness, vision problems, slurred speech and swallowing problems, difficulties with language, balance and coordination problems, and problems with thinking.

Recovery After Stroke

One of the goals after a stroke is to regain as much function and independence as possible. Stroke rehabilitation encompasses a spectrum of activities designed to optimize recovery after stroke. Stroke rehabilitation often involves a team of people with various specializations:

  • Physiatrists and rehabilitation neurologists are medical doctors who specialize in rehabilitation.

  • Rehabilitation nurses coordinate care and provide support throughout the rehabilitation process.

  • Physical therapists focus on improving balance and walking.

  • Occupational therapists focus on improving function in daily activities such as bathing, dressing, and personal hygiene.

  • Speech and language therapists assess and treat problems with speech and language, swallowing, and thinking.

Therapies can take place in hospitals, nursing facilities, outpatient offices or clinics, or at home. Formal rehabilitation programs commonly last for up to 3 or 4 months, but additional recovery efforts may be continued if ongoing improvements are noted.

Complications After Stroke

In addition to impairments caused by direct brain injury from the stroke, complications can also occur because of changes in the stroke survivor’s abilities. For example, if a limb that has been weakened by a stroke is not used or moved for a prolonged period, a contracture may develop. A contracture is a fixed shortening of the muscles or supportive tissues around a joint that limits movement of the joint. Skin breakdown and bed sores (pressure ulcers) can also develop after stroke. Pressure ulcers are often related to a decreased ability to move and may be prevented with frequent repositioning and good skin hygiene. Loss of control over urination frequently occurs after stroke but often improves over time. Mood problems, including depression and anxiety, are also common after stroke and may interfere with the rehabilitation process. If mood problems develop, they should be discussed with a doctor right away so that treatment may be considered.

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Article Information

Sources: American Heart Association/American Stroke Association

Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: a guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke. 2016;47(6):e98-e169.

Topic: Neurology