Is it possible to fully recover from an ischemic stroke - all you wanted to know. Recovery period after a stroke

A few decades ago, a stroke (acute cerebrovascular accident) almost always ended in the death of the patient. Death due to impact was common. His victims were Bach, Catherine II, Stendhal, Roosevelt, Stalin, Margaret Thatcher ... The development of pharmaceuticals and neurosurgery increased the chance of salvation. Doctors have learned to save patients with blockage or even ruptures of cerebral vessels.

But interrupting the process of nerve cell death is half the battle. It is equally important to cope with the consequences of those violations that occur in the first minutes of an attack, even before the ambulance arrives. According to statistics, about 70% of people who survived a stroke become disabled: they lose their sight, hearing, speech, and the ability to control their arms and legs. It is no secret that some of them, in a fit of despair, tend to regret that they survived, feel like a burden for relatives and see no hope in the future.

Taking into account the fact that the incidence of cardiovascular diseases in developed countries continues to grow, such a medical direction as post-stroke rehabilitation is becoming increasingly in demand. In this article, we will cover:

• what role do rehabilitation courses play in the prognosis of recovery in stroke patients;
• how rehabilitation in specialized medical centers differs from rehabilitation at home.

Ischemic stroke of the brain: what is behind the diagnosis?

The work of the brain is the most energy-consuming activity of our body. Not surprisingly, without oxygen and nutrients, nerve cells die faster than any other tissue in the body. For example, muscle fibers and bones, deprived of blood supply due to the application of a tourniquet when the vessels are injured, remain viable for an hour or more, and neurons are destroyed already in the first minutes after a stroke.

The most common mechanism of stroke is ischemia: a spasm or blockage of the artery of the brain, in which those areas that are located close to the pathological focus primarily suffer. Depending on the cause of the attack, its location, and the duration of the oxygen deprivation, doctors will eventually make a diagnosis. The latter will allow predicting the consequences of a vascular accident for the patient's health.

Depending on the cause of a stroke, the following types are distinguished:

• atherothrombotic (caused by a cholesterol plaque that clogs the lumen of the vessel);
• cardioembolic (caused by a blood clot brought into the brain vessel from the heart);
• hemodynamic (occurs due to a lack of blood in the vessels of the brain - with a sharp decrease in blood pressure);
• lacunar (characterized by the appearance of one or more lacunae - small cavities formed in the brain due to necrosis of the nervous tissue around medium-sized arteries);
• rheological (occurs due to changes in the coagulation properties of blood).

In some situations, the human body is able to independently overcome the threat of a stroke, due to which the first symptoms of an attack recede without medical intervention soon after the onset. Depending on the duration and consequences of ischemic stroke is:

• microstroke (by type of transient ischemic attack). This group includes strokes, the symptoms of which disappear a day after the first manifestations;
• small - symptoms of disorders persist from a day to three weeks;
• progressive - symptoms increase over 2-3 days, after which the functions of the nervous system are restored with the preservation of individual disorders;
• total - a violation of cerebral circulation ends with the formation of a delineated zone of damage, a further prognosis depends on the compensatory capabilities of the body.

Even if a person “easily” suffered a stroke and does not have significant disorders in the work of the nervous system, one cannot relax. So, if during the first year after a stroke 60-70% of patients remain alive, then after five years - only half, and after ten years - a quarter. Last but not least, survival depends on the rehabilitation measures carried out.

Consequences and predictions

It is not easy to predict what a violation of blood circulation in the brain can lead to. Neurologists note that the stereotypes that young patients tolerate stroke more easily, and the severity of the manifestations of an attack determines its consequences, are far from being true in all cases. So, often patients taken to the hospital unconscious, with signs of paralysis or severe disorders of higher nervous activity, recover from an attack in a few weeks. And people who have experienced a series of transient ischemic attacks eventually “accumulate” such a number of pathological changes that turns them into profound invalids.

At the age of 59, Stendhal died from a repeated transient ischemic attack. The first seizure of the writer happened two years before his death and led to a violation of speech and motor skills of the right hand. Winston Churchill was diagnosed with dementia by a series of small strokes.

None of us is able to influence the scale of a vascular catastrophe, but the subsequent life of the patient will depend on the consciousness of the patient and his relatives, as well as on the timeliness and quality of medical care. It is not enough to suspect trouble in a timely manner and call an ambulance - already at this stage it is important to think over a further strategy. So, experts in post-stroke rehabilitation recommend starting recovery measures literally from the first days of the patient's hospitalization, including those cases when he is unconscious. Massage and physiotherapy (with the permission of the attending physician) can improve the prognosis for the restoration of the patient's motor functions, and the communication of the latter with a psychologist can set the person in a positive way.

Unfortunately, sometimes the stage of early rehabilitation is missed. This reduces the chances of a full recovery in patients with severe consequences of an attack. However, you should not assume that a person who had a stroke a few months or even years ago will not be helped by rehabilitation therapy courses. Rehabilitators often seek to improve the quality of life of their wards who seek help late. If earlier patients could not do without round-the-clock supervision by relatives or nurses, then after a course of rehabilitation, they partially or completely regained their ability to self-service.

Emergency care and initial treatment

What can be done to help a person with signs of a developing stroke? If the situation arose outside the walls of a medical institution (and in most cases it happens), it is necessary to deliver the patient to a hospital with a neurological department as soon as possible. The best thing to do is to call an ambulance. The ambulance car is equipped with resuscitation equipment and medicines that can slow down or stop brain damage already in the process of transportation. However, if the patient is in a remote area or the symptoms of ischemic stroke develop in a car passenger, it makes sense to take the victim to the clinic in a private vehicle. Remember: every minute counts, so do not waste time thinking or trying to somehow help the patient at home. Without instrumental diagnostic methods (such as computed tomography or magnetic resonance imaging) and the administration of drugs, the outcome of a stroke will be unpredictable.

Subsequent recovery after ischemic stroke

Traditionally, post-stroke rehabilitation is usually divided into early (the first six months after an attack), late (from 6 to 12 months after an attack) and residual (work with patients whose disorders persist for more than a year). Experts note that the effectiveness of activities is directly proportional to the date of their commencement.

Directions of rehabilitation

Rehabilitation measures are planned taking into account the localization of the stroke and the amount of damage. If the patient has paralysis or weakness in the limbs - the emphasis is on restoring motor abilities, in case of damage to the sense organs - on stimulation of hearing, vision, language, olfactory and tactile receptors, in case of speech disorders - on working with a speech therapist, in case of dysfunction of the pelvic organs - on restoring the natural ability to control urination and defecation, etc.

Methods and means of rehabilitation

There are various methods to achieve the desired recovery, but modern rehabilitation centers are gradually coming to the development of comprehensive treatment programs for patients who have experienced a stroke. They include consultations of narrow specialists, massage sessions, manual therapy, kinesiotherapy, physiotherapy exercises, occupational therapy.

The best rehabilitation centers assign an important role to training on specialized simulators, which are necessary for debilitated patients, people with severe coordination disorders, tremors and other syndromes that do not allow them to develop muscles on their own. It is the technical equipment of the clinic and daily monitoring by doctors that allow patients undergoing rehabilitation programs to achieve significantly better results than at home. In addition, it is important to remember about such a success factor as a psychological attitude. A long stay within the four walls - albeit relatives - but in an altered physical state often depresses patients. They feel like prisoners of their own apartments and suffer acutely from the inability to return to their former affairs and hobbies. Without the help of professional psychologists, relatives cannot set up a person who has survived a stroke in a productive way. Often people close to him tend to feel sorry for him too much, thereby slowing down or completely stopping the progress of recovery. On the contrary, having found himself in an unusual environment, surrounded by other patients who have faced similar life difficulties, and doctors who have experience in dealing with wards of varying degrees of motivation, yesterday's "hopeless patient" may well open up a second wind and desire for recovery. And this, in the end, will help him overcome the consequences of the disease.

“That which does not kill us makes us stronger,” said Friedrich Nietzsche. This thesis can be illustrated by the life stories of people who have undergone rehabilitation after a stroke. Paradoxically, the need for mobilization and the desire to regain freedom of action often harden those who, before the attack, due to age or life circumstances, had already partly lost interest in life. Of course, the best wish for each of us will never know from personal experience what a stroke is, however, awareness will help patients and their relatives to quickly navigate in an emergency and take all necessary measures for its successful resolution.

A stroke is a serious disease, after which most people lose some functions of the musculoskeletal, speech apparatus, and memory. To prevent a recurrence or complications, it is necessary to follow some medical recommendations. Even after a severe stroke in elderly patients with various pathologies, a significant recovery of lost abilities is possible. Thanks to the joint efforts of the patient himself, his relatives, as well as health workers, many patients manage to return to a full life.

How long is the rehabilitation period

Rehabilitation requires great efforts, patience of the patient and his relatives, who must be ready for a long, difficult process of restoring the patient's lost functions. According to statistics, only in rare cases a person who has had a stroke can fully restore brain activity, more often patients manage to only partially rehabilitate. The duration of recovery depends on the type of stroke and the severity of the patient's condition.

Rehabilitation at the medical center "Three Sisters"

"Three Sisters" is a private rehabilitation center that uses the latest methods of recovery and rehabilitation in the United States and Europe. The "Three Sisters" Center employs top-level specialists who have had internships in foreign rehabilitation centers. The Three Sisters Center specializes in rehabilitation after a stroke, oncology, cerebral palsy, joint replacement, spinal and craniocerebral injuries of varying degrees of complexity. Rehabilitation programs are developed individually for each patient, which allows you to achieve maximum results. The goals of rehabilitation are agreed in advance with the patient and his family. The results of rehabilitation are evaluated independently and objectively, according to the FIM functional independence scale.

The official website of the rehabilitation center "Three Sisters": http://www.three-sisters.ru.

Recovery period after ischemic stroke

Recovery of patients after an attack of ischemic stroke is carried out according to an individually developed program for each patient. It is compiled based on the characteristics of the disease, the presence of various clinical syndromes or complications, the severity of other somatic diseases (if any), the age of the patient. The stages of rehabilitation are conditionally divided into 4 periods:

1. Rehabilitation measures in the acute period (the first month after an ischemic attack).
2. Recovery at an early stage (up to 6 months).
3. Late recovery (6-12 months).
4. Rehabilitation during the period of residuality (more than 12 months).

After a hemorrhagic stroke

The time it takes to recover the brain of a person who has had a hemorrhagic stroke depends on the severity of the disease. Often with an extensive attack, recovery takes several years. As a rule, patients retain disorders of the musculoskeletal system until the end of their lives. According to statistics, only about a quarter of patients return to their former full-fledged life. The stage of early rehabilitation lasts the first two years after a hemorrhagic stroke. Further recovery of the patient is slow, often stretching for life.

Stages and program of rehabilitation of patients

The more nerve cells located around the lesion can be preserved during post-stroke treatment, the more effective rehabilitation will be. The recovery program for each patient should be selected and carried out on the basis of individual factors. It depends on various aspects, for example, the severity of the stroke, the nature of the disorders caused by it, etc. However, there are basic general guidelines that apply to all patients:

1. Therapeutic exercises, massage to restore motor functions.
2. Psychological assistance, social adaptation of the patient.
3. Recovery of memory, speech.
4. Prevention of re-attack, preventive measures against complications.

Recovery of motor functions

The most common consequence of a stroke is a violation of human motor functions. This is expressed to varying degrees in absolutely all patients, regardless of what kind of attack happened (hemorrhagic or ischemic). Such violations are expressed in the form of partial (paresis) or complete (paralysis) loss of motor abilities of the limbs. There are cases when the severity of changes in different parts is not the same, and it is more difficult to restore the hand due to the need to re-develop fine motor skills and learn to write.

There are the following methods for restoring motor functions:

1. Electrical stimulation and massage.
2. exercise therapy (physiotherapy).
3. Biofeedback method (tracking the physiological state of the patient with a computer).

Speech and memory functions

A stroke often results in speech and memory impairments. When patients experience difficulty in expressing their own thoughts or understanding someone else's speech, this is aphasia. Other patients fail to pronounce sounds, which is typical for dysarthria. The restoration of speech functions, as a rule, takes several years. Therefore, much attention should be paid to home communication with the patient - it is necessary to form the correct skills of interaction with a person:

• Ask him easy questions that the patient could answer in monosyllables.
• Speak the words clearly, slowly.
• If you do not understand what the patient is saying, ask him gently.
• Practice with the patient special exercises on the pronunciation of sounds or words.

Along with speech, memory often suffers after a stroke. The sooner you start working on it, the better. As a rule, rehabilitation begins immediately after the elimination of the threat to the life of the patient. The first step is to support the affected brain cells with medicines prescribed by a doctor. Their reception is mandatory and takes place not only during inpatient treatment, but also after discharge, at home (however, already in a tablet company). Since the drugs act slowly, it is important to observe the duration of their administration. The course of treatment lasts at least 3 months.

It is very important to monitor the patient's well-being, normalize the blood circulation of the brain as soon as possible and prevent the recurrence of a critical situation and its complications, which can be serious diseases of the cardiovascular system. Therefore, along with the procedures, doctors recommend drinking drugs to restore blood circulation after an illness. For example, the combination drug Vasobral improves metabolism and blood circulation in the brain. The components of the drug prevent thrombosis, reduce the permeability of the walls of blood vessels, increase the resistance of brain tissues to oxygen deficiency, increase mental and physical performance. The effectiveness of the drug in the prevention of headaches has been clinically proven.

In addition to memory correction with the help of a course of medications, functional and restorative treatment should be carried out. It consists in constant training of the brain's ability to remember information. This work is laborious and takes longer than all other processes, taking months or even years. It includes the memorization and repetition of words, numbers, rhymes, images.

Psychological and social rehabilitation

In addition to restoring the patient's physical abilities, the patient's social and psychological adaptation plays a huge role. It plays an important role in able-bodied, young patients with a small brain lesion, who have a chance to return to their previous way of life. In addition to creating a psychologically comfortable atmosphere at home, training with a psychotherapist and, if necessary, taking antidepressants show a good effect. Specialized rehabilitation centers are another effective method of social adaptation of a patient after a stroke.

Prevention of complications and recurrent strokes

For decades, aspirin (acetylsalicylic acid) has been used to prevent thrombosis and coronary disease, but long-term use of it can lead to problems in the gastrointestinal tract, such as heartburn, gastritis, nausea, stomach pain, etc.
To reduce the risk of such undesirable consequences, it is necessary to take funds in a special enteric coating. For example, you can use the drug "Trombo ACC®" *, each tablet of which is coated with an enteric film coating that is resistant to the effects of gastric hydrochloric acid and dissolves only in the intestine. This avoids direct contact with the gastric mucosa and reduces the risk of heartburn, ulcers, gastritis, bleeding, etc.
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To avoid a relapse and the development of complications after a stroke, the following rules should be observed:

• Continue the started rehabilitation activities for the maximum time after discharge from the hospital.
• Apply physiotherapy techniques to eliminate increased muscle tone in the affected limbs, for example, carry out laser therapy or heat therapy.
• Monitor blood pressure, take antiplatelet drugs prescribed by your doctor.
• Normalize the patient's lifestyle, eliminate bad habits, follow the right diet.

For decades, aspirin (acetylsalicylic acid) has been used to prevent thrombosis and coronary disease, but long-term use of it can lead to problems in the gastrointestinal tract, such as heartburn, gastritis, nausea, stomach pain, etc. To reduce the risk of such undesirable consequences, it is necessary to take funds in a special enteric coating. For example, you can use the drug "Trombo ACC®", each tablet of which is covered with an enteric film coating that is resistant to the effects of gastric hydrochloric acid and dissolves only in the intestine. This avoids direct contact with the gastric mucosa and reduces the risk of heartburn, ulcers, gastritis, bleeding, etc.

Methods of rehabilitation at home

Recovery work after a stroke is very important, because how a person undergoes rehabilitation depends on his ability to live his former life. As a rule, the recovery process lasts a long time, but each specific case, like a person, is individual - some patients bounce back faster, others do it harder. How to recover at home?

Special exercises

The most common and affordable method of recovery is exercise therapy. It is aimed not only at developing lost strength and muscle tone in paralyzed limbs, but also at restoring the ability to maintain balance, walk, perform standard household tasks and take care of oneself. There are many modern devices and simulators that help to rehabilitate the patient's body, but it is possible to do without them. Below are some effective healing exercises.

• Flexion, extension of the fingers, elbows, knees, hands, translational movements in the hip and shoulder joints.
• Stretching the limb with splints and other devices. To do this, the bent arm or leg is slowly unbent from the fingers and fixed with a bandage to a plank or other even solid object. In this position, the limb remains for 30 minutes or longer.
• To restore the functioning of the brush, a towel is used. It is hung over a bedridden patient, after which they grab a towel with a brush and perform all possible movements (raising, lowering, adduction or abduction, flexion, extension). Over time, the towel is raised higher, which makes the exercise more difficult.
• To eliminate muscle spasm of the leg, a solid roller is placed in the popliteal area. This stretches the muscles and increases range of motion.
• You will need a strip of rubber from which to make a ring (about 40 cm in diameter). With the help of such a device, it is possible to perform a huge number of exercises. The ring is thrown between the hands, arm and leg, forearms, after which the patient should try to stretch the elastic band.
• Sitting on the bed (legs do not fall), raise and then lower the right and left legs alternately. This exercise is suitable for patients who have already been able to sufficiently develop the affected limbs.

Proper nutrition

There are no strict dietary restrictions for patients, but concomitant pathologies should be taken into account when choosing foods consumed. For example, if there is a malfunction of the digestive organs in a bedridden patient, it is worth excluding food that strengthens and increases the amount of fiber, fruits, and vegetables consumed. To eliminate problems associated with the urinary system, you need to refrain from salty, sour foods. After an ischemic stroke, you should not eat fried, fatty foods and foods containing simple carbohydrates.

Video: a set of exercises for recovery after a stroke

If the cerebral circulation is disturbed, the patient's body loses various abilities associated with damage to a certain section of the central nervous system. Often, patients have impaired musculoskeletal and speech functions. In severe cases, the patient cannot sit down, get up, communicate with other people, eat, take care of himself. The most effective and widely available rehabilitation method for paralysis is therapeutic physical culture.

Stroke- acute cerebrovascular accident remains one of the main causes of death and disability in patients with cerebrovascular diseases.

The outcome of the disease depends on the speed and quality of the medical care provided, because a stroke is a clinical syndrome characterized by rapidly emerging symptoms of loss of focal brain, and sometimes cerebral functions; these symptoms are accompanied by structural changes in the brain, if they last more than 24 hours, they lead to death. If neurological symptoms lasted less than 24 hours, then such cerebrovascular accidents can be restored.

Stroke Symptoms

Focal cerebral stroke symptoms include:

• movement disorders (weakness or paralysis in the limbs of one half of the body),
• decrease or increase in pain sensitivity,
• crawling sensations,
• speech disorders (the patient cannot speak or understand speech),
• disorders of coordination of movements (unsteadiness when walking),
• visual impairment, memory impairment, etc.

Cerebral symptoms of a stroke are manifested by headaches, nausea, vomiting, impaired consciousness, psychomotor agitation.

With age, the frequency of cerebrovascular accidents increases, especially in people who lead a sedentary lifestyle. The metabolism in the brain proceeds with high intensity, so it needs a huge amount of oxygen. The mass of the brain is approximately 1400 g, which is 2% of the total mass of a person, but the brain absorbs 20% of all oxygen and 17% of all glucose entering the body. The brain does not have a reserve supply of oxygen, and irreversible damage to its nerve cells develops even as a result of local anemia (ischemia) lasting more than five minutes.

Blood supply to the brain provided by its vascular system. A stroke, or apoplexy, occurs as a result of the cessation of the normal supply of blood to the brain. This occurs either due to rupture of the vessel, which leads to cerebral hemorrhage, or due to blockage or spasm of the vessel, resulting in local bleeding of the nervous tissue - cerebral ischemia.

During a stroke, some brain cells die and some are damaged. In the acute period of a stroke, the damaged areas are significant in size due to both damage and tissue edema. In the subacute period - after a few weeks - the area of ​​brain damage decreases. A stroke requires emergency care in a specialized hospital, in the future - the supervision of a neurologist.

What should be done to prevent a stroke, and how to rehabilitate the patient?

Stroke treatment, rehabilitation at home

For stroke rehabilitation at home use and folk remedies.

• In the people, a stroke is treated with lemon and orange. Pass 2 lemons and 2 oranges through a meat grinder, removing the seeds, mix them with 2 tbsp. spoons of honey. Keep overnight in a glass jar at room temperature and store in the refrigerator. Take 1 tbsp. spoon 2-3 times a day with tea.
• The consequences of a stroke in the people are treated with a special balm. To do this, mince 5 peeled lemons and 2.5 heads of peeled garlic through a meat grinder. Mix this mass with 0.5 l of honey, leave for 30 days in a cool place, shaking from time to time. Take 1 teaspoon 30 minutes before meals, sucking it.
• Naturopaths offer such a recipe for curing the effects of a stroke: 5 mature pine cones with seeds, pour a glass of 70% alcohol or water, leave in a dark place for 2 weeks. Strain and take 1 teaspoon in a glass of weak tea 1 time per day after meals.

Pine cones contain vitamins, phytoncides and tannins, which are very useful for stroke, as they do not allow cells to die.

Bedsores are common in stroke patients. To prevent this complication, I use a special mattress with a thickness of at least 1 cm, filled with millet. Helps prevent bedsores mattress stuffed with hay. The back of the patient should be wiped with camphor oil. and then lubricate with castor oil. If bedsores still form, they can be treated like this. Take 2 chopped onions and 2 tbsp. tablespoons of vegetable oil and simmer them in an enamel bowl for 20-30 minutes. Then select the onion with a slotted spoon, and dissolve a quarter of the wax church candle into the remaining oil. Lubricate bedsores with the resulting ointment 2 times a day.

Celandine grass is able to dissolve scars in the heart muscle after a heart attack, as well as scars in the brain after a stroke.

• Take 1 tbsp. a spoonful of celandine grass, pour a glass of boiling water in a thermos and leave for 15 minutes, no more. Strain and drink 1 tbsp. spoon 3 times a day before meals.
• Take the whole bean plant with pods, leaves, roots, stems and pour boiling water so that the contents are completely covered with water, and, wrapping up, leave for several hours. You can drink an infusion of beans in unlimited quantities, and after 3-4 weeks a person will get out of bed, and after six months there will be no trace of a stroke left.

With a stroke, special rubbings that are easy to prepare at home will help.

• Take 30 g of bay leaf, pour a glass of olive oil and leave for 2 months in a warm dark place, strain, bring to a boil, cool. Rub into paralyzed limbs. And another recipe for ointment from bedsores.
• Boil a glass of vegetable oil, cool and pour the egg white into it, beat until smooth. Lubricate bedsores 3 times a day. After 2-3 days, the wounds should heal.

Recovery after ischemic stroke at home

For those whose families have directly suffered such a misfortune, treatment becomes the hope for a return to normal life. That is why rehabilitation, as the most important process of recovery after a stroke, should become a priority for the patient and his environment. How to competently approach this process in order to get results? This article describes in detail.

The overall chances of the patient for rehabilitation

It is quite reasonable to start with whether the treatment of stroke will bring a 100% effect, or is the patient's chances negligible? Turning to statistics, ischemic stroke is considered a less severe form of the course of the disease than hemorrhage, but it also occurs more often. On average, 75-80% of all recorded calls are related to ischemic disease.

However, the chances of recovery depend on the lesion, its size and localization. So, for example, if a stroke is unilateral and affects only one zonal area of ​​the cerebral cortex, the patient partially loses his capacity, for example, he does not orient himself in space or sees poorly.

The most common consequence of a unilateral stroke, in which recovery is actually considered possible, is left-sided or right-sided paresis, i.e. partial loss of function of the limbs of one side. Rehabilitation usually takes from 3 months to a year.

Finally, the determining factor in the return of capacity lost during a stroke is the timeliness of assistance. Remember: from the moment of convulsions or thrombosis of the vessel and the cessation of oxygen supply to the brain until the complete necrosis of cells, an average of 3 hours pass. If blood circulation is not restored within this period, the chances of successful treatment are close to zero.

In what cases, besides this, rehabilitation is unlikely?

• In case of damage to the vital centers of the cerebral cortex during a stroke, especially the stem nerve bundle. In this case, coma or instant lethality occurs in 99%.
• With too large lesions. For example, in the case of lacunar ischemic stroke, the diameter of the lacuna exceeds 5 mm.
• In elderly patients - from 70 years.
• In patients with severe forms of chronic diseases, poor body condition due to the use of drugs and alcohol.

Goals of rehabilitation in the long term

However, you should not despair, because treatment depends on timely and comprehensive assistance to the patient. In order to maximize the effect, the doctor will advise relatives or other caregivers to adhere to a rehabilitation plan for a year (shorter period).

Rehabilitation in the first 3 months

Treatment of a stroke during this period implies stabilization of the patient's condition. As soon as the body copes with the primary consequences of a stroke, relatives can take the person from the hospital to home treatment. At first, of course, peace and care is needed. But it’s not worth delaying, as soon as the patient himself feels that he is ready to start the “recovery” program, he should devote enough time per day to it:

• Independently take a sitting, and then a standing vertical position. By the end of the period, the patient should be able to at least partially independently dress and serve himself, go to the toilet and take a shower.
• During this period, treatment with a course of rehabilitation exercise therapy and massage is of great importance. Atrophied limbs need to be developed at least in 2-3 sets per day.
• By the end of 2 months, the patient is usually on his feet and learning to balance.

Use mandatory support, provide the person with a walker and stick, other types of supports. The object or supporting hand of the escort must be on the injured side after the stroke.

Exercises for flexion-extension of the joints, swings and other movements in the work of the knees, shoulder, and hip joint help well.

Rehabilitation from 3 to 6 months

So, when a person has learned to at least partially self-serve himself, he can move separately from the satellite for short distances, go into public transport. The restoration of motor functions continues, long walks in the fresh air and climbing stairs are allowed.

It is imperative for a person to have a phone with emergency dialing with one button, so that in case, God forbid, a fall or a repeated ischemic stroke, there is a connection with him.

Rehabilitation from 6 months to a year

The treatment of ischemic stroke is already bearing visible results: the patient can overcome obstacles and move long distances by exercising his legs. Speech functions recover more slowly, but speech should become less incoherent.

A good set of exercises for this period will be the development of fine motor skills of the fingers: fastening buttons, washing dishes, knitting or playing a musical instrument, collecting a Rubik's cube.

According to statistics, 85% of victims of ischemic stroke completely return to a more or less normal life after 18 months. Of these, 2/3 of people are cured in the first 3-4 months in conditions of constant work on themselves.

As you can see, the tasks posed by the treatment of stroke are quite serious and require constant monitoring by a number of specialists. Among them are the attending therapist and neurologist, physio- and ergotherapists, massage therapists and exercise therapists, speech therapist and psychologist, up to the intervention of a nutritionist.

Where to start recovery

As it was said, the first days after a person has recovered from a stroke should be devoted to rest and adjustment to a normal lifestyle. While the sleep and nutrition regimen is being put in order, while the patient is bedridden (and this can take from several days to months), urgent supervision and care is required for him.

Treatment and rehabilitation begin with taking the right position for paralyzed limbs. The patient's position should be constantly changed, turning him over in bed every 2 to 2.5 hours. Warming up the limbs will not only help to avoid bedsores, but also preserve muscle tone and muscle memory during the period of inactivity.

Keep in mind that your blood pressure will be an indicator of how your treatment is progressing after a stroke. Regularly measure blood pressure on an empty stomach and at bedtime in order to keep statistics on the state of the body and determine the norms of the rehabilitation load.

The nutrition of the patient after a stroke should contain as much as possible a balanced menu and mandatory medications prescribed by a doctor. From the very first weeks, recovery involves active relaxation and physiotherapy, communication with a psychologist and speech therapist. Remember, the patient should not be plunged into a state of depression, let him know that he is a burden. The positive attitude of the inner circle will give hope to the most affected.

What should be followed after a stroke?

And these parting words are directed to the patients themselves and should help them to endure the treatment:

• Excessive fatigue is bad for the body. Set small goals and work towards them consistently.
• If a motionless limb becomes numb in a dream, try to place a pillow or roller under it.
• Stand as often as possible on the injured leg, use your "non-working" arm and always try to give the same load on both sides of the body.
• Do not be distracted at the time of training by external irritating factors. This is especially true for classes on the restoration of mental and speech functions.

A set of rehabilitation exercises after a stroke

Leg exercises

The most acceptable treatment is the transition from simple exercises to their more complex variations, with a gradual increase in operations. For example, in the first weeks the patient tries to stretch the ankle and knees, making simple movements back and forth and to the sides. In the next couple of weeks - starts walking, the main task is to maintain balance.

When this goal is achieved, it's time to perform more complex coordination exercises, such as squatting or curb walking, as well as working out on simulators to gain muscle mass.

A popular exercise for treating stroke from rehabilitators is called "swing" - the patient sits on a swing and tries to push off with a sore leg without lifting his toe off the ground.

Hand exercises

Following the same pattern, start with simpler warm-up exercises for the hand, shoulder, elbow. Gradually develop fine motor skills. It is very suitable for patients after a stroke to sort out small objects - laying out cards, a rosary, collecting puzzles, etc. At the same time, the grasping reflex is trained, the functions of handling instruments are restored.

Rehabilitation with the help of folk remedies

At home, the treatment of stroke with medications and physiotherapy is supported by traditional medicine recipes. Only this way and not otherwise! Because folk remedies, as a rule, can only act as an auxiliary tool of influence. A few effective and proven recipes just in case, for those who are ready to defeat a stroke:

1. Citrus fruits are a well-known antioxidant that restores the functioning of the vascular system after a stroke. Take half a lemon and an orange each, pass through a meat grinder and chop them with 2 tbsp. honey. Store the medicine in the refrigerator, taking with tea twice a day for a tablespoon.
2. Treatment of paresis of the extremities after a stroke may accompany the reception of a balm: peeled 2 lemons are passed through a meat grinder with 2.5 heads of garlic, honey is added to make a homogeneous mixture. The balm is taken on an empty stomach, 1 tsp.
3. Alcohol tincture on pine cones containing fintocides and tannins avoids necrosis of nerve cells during a stroke.

Another effective remedy for bedsores in stroke is a mattress or special bedding at least 10 mm thick, filled with millet or salt. If the trouble in the form of bedsores still made itself felt, the ointment from bedsores helps. You should take 2 onions and chop them by adding vegetable oil. Simmer the onion in oil for 20-30 minutes, then remove and add wax to the oil. You get an ointment that you need to lubricate the sore spot in case of a stroke twice a day.

conclusions

Thus, after an ischemic stroke, even the most hopeless patient has some chances for rehabilitation. The question of how long it will take depends on an integrated approach. At home, relatives can provide the necessary support to help a person mentally and physically survive a stroke.

Stroke. Rehabilitation at home

Probably most people know about the existence of such a disease as a stroke.

Many even know what exactly provokes this disease and who is in the so-called risk groups. But when trouble in the form of a stroke comes to our home, this knowledge alone is not enough.

Health does not tolerate confusion and delay, therefore everyone should know what to do if a stroke patient appears in the house. How to help the injured person and organize his future life?

From seizure to rehabilitation

It is almost impossible to cope with a stroke without medical assistance, and therefore, in the acute stage of the disease, all patients are sent for inpatient treatment. The goal of treatment is to stop the spread of damage in the brain cells and restore as much as possible the nervous tissue that has already been damaged by the disease. For these purposes, there are special drugs - neuroprotectors and neuroreparants. Neuroprotectors are the protectors of healthy cells, they help stop the so-called vascular catastrophe, preventing it from spreading further to healthy cells. The purpose of neuroreparants is different - to restore those cells that the disease has managed to damage. Despite such a difference in functions, there are drugs that combine the properties of both neuroprotectors and neuroreparants, which makes them indispensable assistants both in the treatment of stroke in its acute phase and in support at an early stage of rehabilitation.

When the acute condition can be removed, the rehabilitation process begins. Both the patient and his relatives need to tune in to long-term and systematic work. The first stage of rehabilitation begins in the hospital. The patient will be shown what exercises need to be performed to restore lost motor functions, what to do in order to regain full-fledged speech, restore all reflexes. The first classes will be held under the supervision of specialists. Only when the doctors are convinced that the danger has passed, and the patient knows and knows how to perform rehabilitation procedures, the patient is allowed to go home.

Home Rehabilitation: Preliminary Arrangement

A stroke brings many changes to a person's life. Alas, the changes are unpleasant. What was done almost without thinking before the illness, after the illness becomes, at times, an impossible task. Therefore, it is necessary to make certain changes in the usual way of life.

The bathroom must be equipped with handrails, and even better - change to a shower. Handrails also need to be installed in the toilet, at the patient's bed and in other places in the apartment where the patient will have to sit down and get up.

The floors in the house must be free of unnecessary things, carpets and wires - they create a risk of falling, which is already high for a person who has suffered a stroke.

Get a bath thermometer - after a stroke, the sensitivity of the skin often decreases, and this device will help to avoid burns.

If the motor functions are severely impaired, you will have to get a wheelchair and make sure that you can easily move around the apartment with it.

What does home rehabilitation include?

1. Therapeutic gymnastics. Carefully follow the exercises that the specialist will show the patient - at home you will need to help him daily in their implementation and make sure that the work is carried out regularly and to the fullest. Exercises "for show" will not bring results.

2. Speech therapy exercises. Restoration of speech is one of the most complex and lengthy processes in a person who has suffered from a stroke, therefore it depends only on strict adherence to all prescribed exercises whether the patient will be able to regain full-fledged speech.

3. Massages. Not everyone can master the technique of therapeutic massage, therefore, it may be necessary to regularly invite a specialist to the house.

4. Often, in order to restore motor activity, it is necessary to lay out and fix the affected limbs in a certain way. You have to remember how this is done, and carry out this procedure daily. And also make sure that bedsores do not form on the patient's body.

5. Remember that medical supervision is necessary at any stage of rehabilitation, and therefore regularly visit the appropriate specialist with the patient. This will help to adjust the rehabilitation course in time.

6. Monitor the patient's condition. A recurrent stroke, alas, is not uncommon, therefore, at the first symptoms of the resumption of the disease, immediately seek medical help.

Remember, life after a stroke is hard in many ways. Give your loved one attention and support, instill in him faith in his own strength, remind him that a stroke is not a sentence and you can recover from an illness! Only your confidence and support will help the victim endure all the hardships of post-stroke life and regain their health.

Acute cerebrovascular accident is not a sentence. Is it possible to quickly and completely restore the brain and functionality after a stroke?

With proper rehabilitation after a stroke at home, some body functions (speech, visual, motor) can be partially or even completely restored.

And proper care and support improve the quality of life even for a bedridden patient.

How to prevent complications during recovery after a stroke? In acute cerebrovascular accident nerve tissue in the affected area dies. There is a violation of functions (speech, motor, visual). But thanks to the phenomenon of neuroplasticity, the nervous system transfers these functions to other cells.

In order for the transfer to take place correctly, neurorehabilitation needed. Otherwise, there is a possibility that the processes will go in a different direction, as a result of which compensatory movements will form, which will cause inconvenience and worsen the quality of life.

The recovery period depends on the type of stroke.

There are three levels of recovery:

• true - return to the original state;
• compensatory - transfer of functions from affected structures to healthy ones;
• readaptation - with a large lesion and the impossibility of compensating for impaired function.

The recovery period is divided into the following periods:

• early - up to six months of illness;
• late - six months to a year;
• residual - after a year.

Restoration of speech, psyche, social rehabilitation takes more time.

The principles of rehabilitation are:

• early start;
• systematic;
• duration;
• involvement of doctors and relatives in the process.

Specialists from various fields are working on returning to normal life - neurologists, therapists, speech therapists, physiotherapists, psychologists, etc.

To your attention a video about methods of rehabilitation after a stroke and recovery at home:

Home care for bedridden patients

Even before the arrival of the patient, the following items should be prepared:

• vessel;
• diapers for adults;
• absorbent diapers;
• antidecubitus circles, mattresses;
• a pole by the bed or reins near the back;
• soft carpet near the bed;
• chair, etc.

Every day, 2 times a day, the patient is washed, teeth are cleaned, mucous membranes are washed, ears are cleaned 1-2 times a week.

To prevent bedsores, the bed is straightened without leaving wrinkles.. The body is allowed to be lubricated with a special agent prepared from 200 ml of vodka, 1 tbsp. shampoo, 1 liter of water. Every 2-3 hours the patient is turned on its side.

With the loss of chewing, swallowing function, food is mashed, fed through cocktail sticks. As an alternative food, canned children are used.

Feeding is not forced- it causes vomiting. If the appetite is poor, give your favorite dishes (as part of the prescribed diet). Portions are small, meals - 6 times a day. Before eating, the body of the ward is given a semi-sitting position.

Uncommon - incontinence or urinary retention. In the latter case, there is a need for catheterization. In case of incontinence, when it is impossible to regulate the process with medication or other methods, sanitary pads and diapers are used.

If the patient is able to move independently, then the first actions are sitting.

The first days - for a few minutes, the time is gradually increased.

The next stage is standing, then walking, mastering the transfer of body weight from one leg to another.

Walking skills return gradually. In order not to turn the foot, wear high shoes.

You need to move with support. A cane or a special attachment with 3-4 legs is used as a support.

Diet and food

The menu includes the following products:

• vegetable oils - rapeseed, soybean, olive, sunflower (no more than 120 g per day);
• seafood - at least 2 times a week;
• vegetables, fruits rich in fiber, folic acid - from 400 g daily;
• purified water - up to 2 liters per day (if there are no contraindications).

Blueberries have a beneficial effect on the body, containing a large amount of antioxidants, and bananas rich in potassium.

It is important that the patient receives enough folic acid, vitamins A, E, C, which help to overcome the consequences of the disease and reduce the risk of relapse.

Meat, fish, dairy products are consumed in moderation, low-fat diet varieties. Products are steamed, stewed or boiled. The layer of fat is removed from the surface. If you cook these products correctly, then the fat content is halved.

It is useful to consume legumes - a rich source of folic acid. Meat and potatoes (only baked) are given no more than 2-3 times a week.

In the diet includes cereals - brown rice, oatmeal, bran, durum wheat.

From the menu remove smoked meats, spicy, spicy dishes. Bread and other pastries, sweet, fatty desserts, animal fats are contraindicated.

These foods increase cholesterol. Salt is excluded or reduced to a minimum level.

Under the ban - alcohol. Your doctor may recommend moderate consumption of natural red wine. but exceeding the prescribed dose is life-threatening.

Physical activity, exercise therapy, sex life

The first two weeks after discharge, if there are no other appointments, physical activity consists only in changing the position of the body. , the purpose of which is to relax and prepare the muscles for work.

When the patient moves physiotherapy methods are applied to it- massage, manual therapy, thermotherapy (ozocerite and paraffin applications), magnetotherapy, laser therapy, exercises on simulators, individual and group gymnastics.

The day starts with a warm-up- shallow squats, sips, bends. It is recommended to alternate loads - light running, walking, exercise bike.

The program is compiled individually. It is impossible to change the mode on your own, since a repeated stroke is possible.

Exercises that increase muscle spasticity are prohibited - squeezing the ring, the ball. Sexual desire returns approximately 3 months after the attack. In some cases, the disease provokes an increase in sexual desire., since the hypothalamus and the center responsible for the release of hormones work differently.

There are cases when a person returned to an active sexual life even before speech returned to him. But no matter what scenario is embodied, a doctor is consulted before starting sexual activity.

The program of Elena Malysheva contains interesting information on how to restore movement after an illness:

habits

Correction of habits is necessary for quick normalization of the state. So, give up smoking or minimize the number of cigarettes smoked. No alcohol allowed.

A sedentary lifestyle is contraindicated- need moderate physical activity, which correspond to the condition.

Medical control and treatment

In the treatment of stroke, the following groups of drugs are prescribed:

All patients who have suffered a cerebral stroke, subject to dispensary observation by a neurologist.

Psychological support

Stroke negatively affects the quality of life. That's why increased likelihood of depression.

Those affected by the disease need communication, moral support, contact with the outside world. These requirements remain even if such a person is not able to speak, but perceives speech by ear. Topics for conversation are varied - from children to politics. It is important for the bedridden to hear that he will recover.

Patients can hardly tolerate dependence on other people, especially those who are distinguished by love of freedom and independence.

Therefore they have personality traits such as grumpiness, irritability may develop. With depression, any help, including medical help, can be rejected.
If contact is interrupted, the help of a psychologist or psychotherapist is needed, as well as drug treatment with antidepressants.

It is forbidden in the presence of the patient to discuss his problems, the negative consequences of the disease, speech difficulties.

But at the same time, rewarding achievements, even if they are insignificant, have a great effect on self-esteem and well-being. Then recovery comes faster.

Relatives should also not forget about psychological relief . They are shown positive emotions, relaxation in the form of sports, meditation, massage, aromatherapy.. You may need vitamin treatment.

How to recover psycho-emotionally, you will be told here:

Disability, group, return to work

Statistically, only about 20% of stroke victims return to work and normal life. In the past five years, doctors have observed a trend according to which the picture of severe cases of the disease is deteriorating.

Terms of temporary disability - 3–6 months. In violation of cerebral circulation, the dynamics of restoration of functions, the state of the mental sphere are important.

If the prognosis is unfavorable, rehabilitation is slow, there are lesions of other organs, in old age the patient is referred to the VTEC (medical labor expert commission).

According to the norms (Federal Law No. 181-FZ), stroke survivors are entitled to disability registration. To do this, you need to get medical evidence.

Distinguish between disability groups I, II, III. Every year, the patient, who was recognized as disabled, is re-examined.

The exceptions are men and women who have reached the age of 60 and 55, respectively. An extraordinary re-examination is carried out if the condition has changed significantly.

After 3–6 months, with a favorable prognosis and a quick recovery, rational employment is allowed. When choosing a job, take into account contraindications that increase the likelihood of relapse:

• increased nervous, psychological, physical stress;
• high air temperature and humidity;
• contact with neurotropic poisons (arsenic, lead, etc.).

With a slight hemiparesis (paralysis of the muscles of half of the body), labor activity is possible, in which one hand is involved. Among such specialties are a quality checker, quality control inspector, work in the office and etc.

And the treatment of atherosclerosis of the brain with folk remedies, we will tell you separately.

How to restore speech

Speech restoration is one of the most important tasks. Begin classes as soon as the condition stabilizes. A specialist is involved in the process - a speech therapist.

Family members also take an active part in the process. To do this, for example, they read the primer so that the patient pronounces sounds, syllables, whole words.

Speech during communication is quiet, measured, calm. It is useful to ask the victim questions, sing with him, learn tongue twisters. A retelling of the texts he heard is useful.

If speech does not return to the patient for a long time, may need to learn sign language.

Watch a video about methods of restoring speech after a stroke:

Return of sight

With the defeat of the visual centers, the visual function of the cavity is restored in approximately one third of the cases of the disease.

Under such conditions useful gymnastics for the eyes. A popular exercise is with a pencil or other object, which is held at a distance of 40–43 cm from the patient's eyes and is moved alternately up and down, right and left. The patient is asked to follow the object without turning his head.

You can stock up on puzzles, where it is required to spell words, considering the letter matrix. Also on the network are special computer programs.

The best centers and sanatoriums

The best results are achieved if you trust the care of professionals. Where is the best place to undergo rehabilitation after a stroke and what results can be achieved?

The rehabilitation centers provide comprehensive assistance, the patient is under the supervision of specialists around the clock.

The choice of an institution is an individual matter, which takes into account, among other things, the financial factor. Here are a few institutions worthy of attention.

Medical and Rehabilitation Center of the Ministry of Health

The center was founded in 1918. It has a rehabilitation department. It provides a full range of medical services- from outpatient clinic to rehabilitation.

The medical staff has at its disposal diagnostic equipment, a 24-hour neuro-reanimation department.

Rehabilitation of patients who have had a stroke is carried out in the following areas:

• restoration and improvement of the vestibular apparatus;
• restoration of the function of swallowing and larynx;
• development of fine motor skills of the hands;
• return of memory, speech, ability to self-service;
• psychological and psychotherapeutic consultations;
• physiotherapy;
• physiotherapy procedures.

Rehabilitation center in Sestroretsk

The center is located in a picturesque resort town, half an hour from St. Petersburg. Created on the basis of the hospital.

Physiotherapists work here there is a gym with robotic equipment, a swimming pool. A speech therapist deals with patients. Patients who move on their own can not live in a rehabilitation center, but rent a house nearby.

Adeli Center (Slovakia)

Clinic specializes in rehabilitation after a stroke, as well as the treatment of children with cerebral palsy. The center is located in Piestany, a well-known health resort.

The rehabilitation program is drawn up with the expectation that each method enhances the effect of the other.

Adele's suit is used for treatment.

The suit creates a load on the musculoskeletal system and helps to correct postures and movement.

A wide range of physiotherapy procedures are used - massage, manual therapy, mud therapy, mechanical hippotherapy and others.

Sheba State Hospital (Israel)

The hospital is located in Ramat Gan, not far from Tel Aviv. Rehabilitation is carried out in the following areas:

• physiotherapy;
• occupational therapy;
• speech therapy - restores speech skills and understanding of words addressed to the patient;
• psychology, neuropsychology;
• psychiatry;
• rehabilitation.

According to Sheba Clinic statistics, after the end of the course of treatment, 90% of patients fully or partially restore their movement skills.

Measures to prevent relapse

The risk of recurrent stroke in the first 24 months is estimated at 4-14%.

Prevention of recurrent stroke begins in the first days of treatment and continues constantly. Its purpose is correctable factors.

With insufficient secondary prevention, the risk of secondary stroke increases. Every fourth case of acute disorders of cerebral circulation is a relapse of a stroke.

For the purpose of prevention, patients are prescribed preventive treatment:

sick limit the number of cigarettes smoked or ban smoking as well as the use of narcotic substances, alcohol abuse. Weight adjustment is necessary if obesity is the cause of the stroke. In the diet, the proportion of foods containing fats and cholesterol is reduced, replacing them with fresh vegetables and fruits. Moderate exercise is good for the body.

Antihypertensive therapy (treatment of high blood pressure) is carried out with caution to prevent cerebral hypoperfusion (reduction of cerebral blood flow below 50 mm Hg. Art.).

Full recovery after stroke is possible. The main condition for this is the strict observance of medical prescriptions.. And even in severe cases, it is possible to significantly improve the quality of life of the victim of the disease.

Stroke Recovery: Directions, Approaches, Relapse Prevention

Despite the fact that the prevalence of acute vascular disorders in the brain (strokes) and mortality from them are quite high, modern medicine has the necessary methods of treatment that allow many patients to stay alive. What then? What conditions and requirements does the patient face in his future life after a stroke? As a rule, most of them remain permanently disabled, and the degree of restoration of lost functions depends entirely on timely, competent and comprehensive rehabilitation.

As is known, in violation of cerebral circulation with brain damage, various abilities of the body are lost, associated with damage to one or another part of the central nervous system. In most patients, motor function and speech are most often impaired; in severe cases, the patient cannot stand up, sit, eat independently and contact staff and relatives. In such a situation, the possibility of at least a partial return to the previous state is directly related to rehabilitation after a stroke, which should be started, if possible, from the first days after the onset of the disease.

Directions and stages of rehabilitation

It is known that the number of neurons in the brain exceeds our daily needs, however, in conditions of trouble and their death during a stroke, it is possible to “turn on” previously inactive cells, establish connections between them and, thus, restore some functions.

To limit the size of the lesion in the earliest possible time, such drugs are prescribed after a stroke that are capable of:

• Reduce swelling around the affected tissue (- mannitol, furosemide);
• To have a neuroprotective effect (actovegin, cerebrolysin).

Restorative measures should be selected and carried out individually, depending on the severity of the condition and the nature of the violations, however, they are carried out for all patients. in the following main areas:

1. The use of physiotherapy exercises and massage for the correction of movement disorders;
2. Recovery of speech and memory;
3. Psychological and social rehabilitation of the patient in the family and society;
4. Prevention of delayed post-stroke complications and recurrent stroke, taking into account existing risk factors.

Or a heart attack, accompanied by necrosis and death of neurons with impaired function of that part of the central nervous system in which it developed. As a rule, cerebral infarctions with small sizes and hemispheric localization have a fairly favorable prognosis, and the recovery period can proceed quickly and very effectively.

It takes the life of most of those who have undergone it, and in surviving patients, it most often leads to persistent violations of various functions without the possibility of their full or even partial recovery. This is due to the fact that during a hemorrhage, a significant amount of nervous tissue dies, and interactions between the remaining neurons are disrupted as a result of cerebral edema. In such a situation, even years of regular and hard work, unfortunately, do not always give the expected result.

Recovery after a stroke can take a long time, so the effectiveness of the measures taken at this time depends on the patience and perseverance of relatives, friends and the patient himself. It is important to instill a sense of optimism and faith in a positive outcome, praise the patient and encourage, as many of them are prone to manifestations of apathy and irritability.

With damage to some parts of the brain, astheno-depressive syndrome is especially pronounced, so you should not be offended if a person close to you who has had a stroke is not in the mood, grumbles at family members and refuses to do exercises or massage. It is not worth insisting on their obligatory conduct, perhaps it will be enough just to talk and somehow distract the patient.

Disability after a stroke still remains a significant medical and social problem, because even with the most thorough and timely treatment and rehabilitation, most patients never fully regain their lost abilities.

Therapy, which will help the patient recover faster, should be started early. As a rule, you can start it on stage of inpatient treatment. In this, methodologists of physiotherapy exercises, rehabilitation doctors, masseurs in the department of neurology or vascular pathology of the brain will provide significant assistance. As soon as the patient's condition stabilizes, it is necessary to transfer him to rehabilitation department to continue rehabilitation. After discharge from the hospital, the patient is observed in polyclinic at the place of residence, where he performs the necessary exercises under the supervision of a specialist, visits physiotherapy, massage, a psychotherapist or a speech therapist.

It would not be superfluous to refer the patient to a rehabilitation center, modern and well equipped, designed for neurological patients, where there are all the necessary conditions for further correction of lost functions. In view of the high prevalence of acute vascular pathology of the brain, which more and more often affects the young and able-bodied population, the creation of such centers, although costly, is quite justified, since it allows the use of the maximum possible number of intervention methods with the fastest return of patients to their usual way of life.

Recovery of motor functions

Among the consequences of a stroke, motor disorders occupy one of the main places, since they are expressed to one degree or another in almost all patients, regardless of whether a heart attack or cerebral hemorrhage has taken place. They are expressed in the form paresis(partial loss of movement) or paralysis(complete immobilization) in the arm or leg. If both the arm and the leg on one side of the body are affected at the same time, they speak of hemiparesis or hemiplegia. It happens that changes in the limbs are not the same in severity, however, it is much more difficult to restore the function of the hand due to the need to establish fine motor skills and writing.

There are various motor function recovery methods:

• electrical stimulation;
• Using the biofeedback method.

Physiotherapy

The main and most affordable way to recover from paralysis is physical therapy (kinesitherapy). Its tasks include not only the development of the former strength, range of motion in the affected limbs, but also the restoration of the ability to stand, walk, maintain balance, and also perform ordinary household needs and self-service. Such habitual actions for us as dressing, washing, eating can cause serious difficulties if even one limb is affected. Patients with severe disorders of nervous activity cannot sit up in bed on their own.

The volume and nature of the exercises performed depends on the severity of the patient's condition. In cases of deep violations, it is applied first passive gymnastics: exercise therapy instructor or relatives move the limbs of a bedridden patient, restoring blood flow in the muscles and developing joints. As the state of health improves, the patient learns to sit down on his own, and then to get up and walk independently.

If necessary, use a support - a chair, headboard, stick. If there is sufficient balance, it becomes possible to walk first around the ward, then around the apartment and even down the street.

Some patients with small areas of brain damage and good recovery potential begin to get up and even walk around the ward within the first week after the onset of a stroke. In such cases, it is possible to maintain working capacity, which is very important for young people.

With a favorable course of the post-stroke period, the patient is discharged from the hospital for recovery at home. In this case, the main role is taken, as a rule, by relatives and friends, on whose patience further rehabilitation entirely depends. Do not tire the patient with frequent and prolonged exercises. Their duration and intensity should gradually increase as one or another function is restored. To facilitate the movement of a sick person at home, it is good to provide him with special handrails in the shower, toilet, and small chairs for additional support will not be superfluous.

Video: a set of active exercises after a stroke

Particular attention should be paid to the restoration of hand function with the ability to perform fine movements and writing. It is necessary to perform exercises to develop the muscles of the hand, to return the coordination of finger movements. It is possible to use special simulators and carpal expanders. It will also be useful, along with gymnastics, to use hand massage, which helps to improve trophism in the muscles and reduce spasticity.

This process can take a lot of time and perseverance, but the result will be the performance of not only the simplest manipulations such as combing, shaving, tying shoelaces, and even cooking and eating on your own.

With a favorable course of the rehabilitation period, it is necessary to expand the circle of communication and household duties of the patient. It is important that a person feels like a full member of the family, and not a helpless disabled person. Do not neglect conversations with such a patient, even if he cannot fully answer questions. This will help to avoid possible apathy, depression and isolation of the patient with unwillingness to further recovery.

Ways to "stir up" the patient from the outside

Electrical stimulation method muscle fibers is based on the impact of pulsed currents of different frequencies. At the same time, trophism in the affected tissue improves, muscle contractility increases, tone normalizes with spastic paresis and paralysis. It is especially advisable to use electrical stimulation for long-term patients in whom active restorative gymnastics is difficult or impossible. Currently, there are many different devices that allow you to use this method at home under the supervision of the attending physician of the clinic.

Using biofeedback method the patient performs certain tasks and at the same time, together with the doctor, receives sound or visual signals about the various functions of his body. This information is important for the doctor to assess the dynamics of recovery, and the patient, in addition, allows you to increase the speed of reaction, speed and accuracy of actions, as well as observe a positive result from the exercises. As a rule, the method is implemented using special computer programs and games.

Along with passive and active kinesiotherapy, massage after a stroke also gives a good effect., especially with a tendency to spasticity and long-term rehabilitation. It is carried out using conventional techniques and does not have any significant differences from that of other neurological diseases.

It is possible to start the massage even in the hospital in the early stages of the post-stroke period. This will help the masseur of the hospital or rehabilitation center. In the future, massage at home can also be entrusted to a specialist, or relatives themselves can master its basic principles.

Restoration of speech and memory function

Restoration of speech after a stroke is an important stage, first of all, in the social rehabilitation of the patient. The sooner contact is established, the sooner it will be possible to return to normal life.

Speech ability suffers in most stroke survivors. This may be due not only to impaired functioning of the muscles of the face and articulation, but also to damage to the speech center, located in right-handed people in the left hemisphere. With the defeat of the corresponding parts of the brain, the ability to reproduce meaningful phrases, count, and also to understand addressed speech may disappear.

In case of such disorders, a specialist will come to the aid of the patient - a speech therapist - an aphasiologist. With the help of special techniques and constant training, he will help not only the patient, but also give advice to his family and friends regarding the further development of speech. Exercises to restore speech should be started as early as possible, classes should be regular. The role of relatives in regaining the ability to speak and communicate with others cannot be overestimated. Even if it seems that the patient does not understand anything, you should not ignore him and isolate him from communication. Perhaps, even without the ability to say something, he perceives the addressed speech well. Over time, he will begin to pronounce individual words, and then whole sentences. The restoration of speech contributes a lot to the return of the ability to write.

Most stroke patients have memory impairment. They hardly remember past events of their lives, the faces of relatives may seem unfamiliar to them. In order to restore memory, it is necessary to constantly train it with the help of simple exercises and techniques. In many ways, these exercises can resemble classes with young children. So, with the patient, you can learn nursery rhymes that are easy to remember and reproduce. First, it is enough to memorize one sentence, then a whole stanza, gradually complicating and increasing the amount of memorized material. When repeating phrases, you can bend your fingers, forming additional associative connections in the brain.

In addition to poems, you can recall events from the life of the patient, how the day went, what happened a year or a month ago, and so on. As memory, speech and cognitive functions are restored, you can move on to solving crossword puzzles, memorizing various texts.

It is useful to conduct memory recovery classes all the time: at meals, when cleaning the house, on walks. Most importantly, they should not cause anxiety to the patient and cause negative emotions (memories of unpleasant events from the past).

Video: exercises for restoring speech with afferent aphasia

Psychological and social rehabilitation

In addition to caring for a patient after a stroke, restoring motor and cognitive functions, psychological and social adaptation is of no small importance. It is especially important in young and able-bodied patients with a small amount of brain damage, who are likely to return to their previous lifestyle and work.

Considering the possible pain syndrome, the inability to perform habitual actions, participate in social life, as well as the need for constant help from others, such patients are prone to depression, bouts of irritability and isolation. The task of relatives is to provide a favorable psychological environment in the family, to support and encourage the patient.

Sometimes there are hallucinations after a stroke, and the patient can describe them to relatives. In such cases, do not be afraid: as a rule, the appointment of special medications is sufficient to eliminate them.

The rehabilitation measures performed should correspond to the actual functional capabilities of the body, taking into account the depth of neurological disorders. It is not necessary to isolate the patient, referring to the loss of his ability to normal speech or forgetfulness - it is better to tell him the right word or entrust him with simple homework. For many, for effective recovery and an optimistic attitude towards exercise, it is important to feel needed.

In addition to creating psychological comfort at home, classes with a psychotherapist and, if necessary, prescribing medications (sedatives, antidepressants) give a good effect.

Social adaptation plays an important role in returning to normal life. It is good when there is an opportunity to return to the previous work or perform another, simpler one. If a person is already retired or the violations that have appeared do not allow him to work, you need to look for other ways of socialization: visiting the theater, exhibitions, finding a hobby.

A specialized sanatorium is another method of social adaptation. In addition to physiotherapy procedures, classes with various specialists, the patient sometimes receives such a necessary change of scenery and additional communication.

Prevention of late complications and recurrent strokes

Most patients and their relatives are interested in the question: and its complications in the future? What treatment is needed after a stroke? To do this, it is enough to follow simple conditions:

1. Continuation of the initiated rehabilitation measures (exercise therapy, massage, memory and speech training);
2. The use of physiotherapeutic methods of influence (magnetic, laser therapy, heat therapy) to combat increased muscle tone in the affected limbs, adequate pain relief;
3. Normalization of blood pressure (with a hemorrhage and presence), appointment (with ischemic brain damage);
4. Normalization of lifestyle with the exclusion of bad habits, compliance with the diet after a stroke.

In general, there are no strict restrictions and significant features in nutrition, so you can eat after a stroke everything that does not harm a healthy person.

It is necessary, however, to take into account the accompanying pathology and the nature of the existing changes. If the function of the pelvic organs is impaired, the patient is lying down, it is advisable to exclude products that slow down the passage of intestinal contents, and increase the proportion of vegetable salads, fruits, and cereals. To avoid violations of the urinary system, it is better not to get involved in sour, salty, as well as sorrel dishes.

The diet for stroke of the brain depends on the mechanism of occurrence of acute cerebrovascular accident and previous causes. So, with hemorrhages as a result, it is better not to eat salty foods, drink plenty of water, strong coffee and tea.

It is necessary to adhere after a stroke of the ischemic type (cerebral infarction). In other words, you should not give preference to fatty, fried foods, easily accessible carbohydrates, which contribute to the development of atherosclerotic lesions of the vascular walls. It is better to replace them with lean meats, vegetables and fruits.

Stroke and alcohol don't go together regardless of whether the patient had a heart attack or hemorrhage. The use of even small doses of alcohol leads to an increase in heart rate, an increase in blood pressure, and can also contribute. These factors can cause recurrent stroke with aggravation of neurological disorders and even death.

Many patients, especially young people, are interested in whether sex is permissible after a stroke. Thanks to a variety of studies, scientists have proven not only the absence of harm from it, but also the benefits in the rehabilitation process. However, there are certain nuances associated with a severe illness:

• Possible dysfunction of the organs of the genitourinary system, decreased sensitivity and potency;
• Reception of antidepressants, irritability and apathy with a decrease in sexual desire;
• Movement disorders that make it difficult to have sex.

With a favorable course of the recovery period, a return to normal marital relations is possible as soon as the patient feels strength and desire in himself. The moral support and warmth of the spouse will also contribute to the improvement of the psycho-emotional state. Moderate physical activity and positive emotions at the same time will have an extremely favorable effect on further recovery and return to a full life.

The consequences of a stroke for a person's general health depend directly on the volume and location of the lesion in the brain. In severe and extensive strokes, complications from other organs are inevitable, the most common of which are:

1. Inflammatory processes of the respiratory organs (congestive pneumonia in bedridden patients);
2. Dysfunction of the pelvic organs with the addition of a secondary infection (cystitis, pyelonephritis);
3. Bedsores, especially with improper care;
4. Decrease in intestinal peristalsis with a slowdown in the movement of contents through it, which is fraught with the development of chronic inflammation, constipation.

When caring for a patient who has had a stroke, it must be remembered that a person who has suddenly lost his former way of life, the ability to work and communicate in his usual environment, requires manifestations of not only moral support, but also affection and kindness.

In general, rehabilitation after an ischemic stroke is faster and easier than after a hemorrhage. Many patients return to their usual way of life early enough, and young and able-bodied people even restore their skills at their previous jobs. The outcome and consequences of the disease depend on patience, perseverance and desire for recovery not only on the part of the patient, but also on the part of his relatives. The main thing is to believe in a successful outcome, then a positive result will not be long in coming.

Video: how to restore movement after a stroke? Healthy Living Program