Ischemic Stroke Recovery Guide

 A stroke can be a devastating experience for anyone involved. Not only does a survivor have to deal with the initial attack, but also the major life changes that are sure to follow. During the recovery process, the survivor of an ischemic stroke will certainly be faced with many challenges, but this guide is meant to ensure that you, as a loved one, are prepared to provide the best possible support moving forward.

Understanding the Problems

According to the Centers for Disease Control and Prevention (CDC), there are three main types of stroke that can occur:

• Ischemic Stroke: the result of a blood clot preventing blood flow to the brain for an extended period of time
• Hemorrhagic Stroke: the result of a blood vessel within the brain rupturing and causing internal bleeding
• Transient Ischemic Attack (TIA) or Mini Stroke: the result of a momentary blood clot disrupting blood flow to the brain for a brief period of time (no more than 5 minutes)

Ischemic Stroke

The most common type of stroke, the American Heart Association (AHA) reports that nearly 87% of strokes are ischemic. They are caused by when a fatty substance called plaque collects in the  arteries and narrows them. This is called atherosclerosis, and it slows the flow of blood. As it pools, blood can clump and form clots -- and the artery gets blocked. Ischemic strokes can be either embolic or thrombotic;

• Thrombotic: a blood clot forms inside one of the brain’s arteries, which then blocks blood flow to that part of the brain.
• Embolic: a blood clot forms elsewhere, breaks loose and travels to the brain via the bloodstream. Once lodged in an artery, it blocks the blood flow to the brain.

Understanding the reasons why a stroke occurs is important, but a survivor will be susceptible to many other difficulties after the attack subsides.

What Are the Main Disabilities that Ischemic Stroke Survivors Face?

It’s important to remember that a stroke has the potential to harm a subject in several ways. Not only are there many possible physical side effects, but mental and emotional complications can also surface because of an attack. However, the seriousness of these issues is determined by the severity of the stroke itself, and the nature of the issues may vary depending on what parts of the brain are affected.

Here are some common impairments that one may encounter:

• Paralysis or motor control: After a stroke, survivors can find the side of the body opposite the damaged side of the brain seriously affected. This can happen with the arm, leg, corresponding side of the face, or the entire side of the body. Weakness on one side of the body is known as hemiparesis and paralysis on one side of the body is known as hemiplegia. Stroke survivors suffering from hemiparesis or hemiplegia often struggle performing everyday functions comfortably.
• Sensory disturbances: Survivors of stroke may experience significant sensory deficits after stroke. The ability to feel touch, pain, temperature, or position can be hindered, causing survivors to struggle with recognizing objects they are holding or touching.
• Aphasia: Defined as the ability to speak or understanding speech, at least one-fourth of all stroke survivors experience linguistic impairments. The two primary types of aphasia are receptive and expressive. Receptive aphasia is when the individual has trouble understanding what is being said and expressive aphasia is when the individual is having difficulty expressing what they want to say.
• Problems with thinking and memory: A stroke event is traumatic to the brain and it is common to experience significant issues with memory and cognition afterward. Issues with problem solving or attention span are common, depending on whether short- or long-term memory capabilities have been impacted.
• Emotional disturbances: Many stroke survivors struggle with significant emotional changes after stroke. Fear, anxiety, frustration, anger, and depression are all understandable responses to a stroke, for a survivor. It is important for survivors to seek help with unmanageable negative feelings, from their support system and medical professionals.

Keep in mind that stroke survivors are also susceptible to mental and emotional disorders — depression, memory loss, pseudobulbar affect (PBA), dementia — that can be stifling throughout their stages of recovery. There are, however, numerous things you can do to help.

Putting Ischemic Stroke Survivors in a Position to Succeed — Ways to Help

As a family member, caregiver, or stroke patient, you need to be ready to deal with all possible outcomes of an attack. To ensure that a successful recovery is within reach, here are a few things to consider:

1.   Recognizing Stroke Symptoms and Preventing a Second Stroke

Up to 25% of stroke survivors can experience a second stroke during the course of their recovery, it is imperative to recognize the warning signs of an impending attack. After all, seeking immediate treatment is the best way to increase one’s chances of a full recovery later down the road. If you suspect that a loved one is experiencing a stroke, it’s time for you to act FAST:

 

F: Face Drooping

A: Arm Weakness

S: Speech Difficulty

T: Time to Call 911

This acronym is a great tool for identifying an attack, and it can help prevent a loved one from experiencing any further damage to their development.

2.   Regaining Mobility and Battling Foot Drop

In many cases, someone who experiences a stroke will battle with limited mobility. Essentially, this means they will have issues walking, or may have instances of foot drop. Foot drop is a condition caused by weakness or paralysis of the muscles involved in flexing the ankle and toes. This condition causes a person to drag the toe of the shoe on the ground or slap the foot on the floor while walking. Whatever the case may be, survivors who wear a brace like the SaeboStep or Ankle-Foot Orthoses (AFO) have shown tremendous improvements to their mobility. In addition, creating a routine of leg exercises can strengthen limbs and ward off issues with spasticity and curled toes.

3.   Counteracting Learned Non-Use

When a lack of mobility occurs due to weak limbs, the effect can sometimes be self-perpetuating. Learned Non-Use refers to the process by which a patient may come to rely on a stronger limb to carry out tasks, leaving the weaker limb to lose muscle mass. Instances of this can be seen when a survivor experiences hand paralysis or a lack of arm function. To fight against this problem, one must find a way to keep the affected extremities moving on a daily basis. One method that has proven successful is a treatment known as Constraint-Induced Movement Therapy (CIMT). In CIMT, the unaffected limb is prevented from moving while the patient attempts to exercise the impaired one. Although the outcomes can be successful, there are limitations to CIMT. In order to participate in CIMT, a stroke survivor must have some movement in the affected limb and it requires a considerable time investment, sometimes as much as 7 hours a day.

4.   Promoting a Healthy Lifestyle

One of the best ways to promote your loved one’s speedy and full recovery is to encourage them to make healthy lifestyle choices. Aside from bringing them to appointments and making sure they complete their treatments, you can also help keep them active at home by encouraging some sort of physical activity for at least 30 minutes every day, and offering healthy meal options to provide good nutrition. If your loved one happens to be a smoker, you can help them quit their habit to lessen their chances of a second stroke. The same applies to limiting their intake of alcoholic beverages.

Overall, patients who make healthier decisions have a better chance of regaining independence. However, these chances become even greater when the rehabilitation process is undergone immediately.

5.   Choosing the Most Effective Setting for the Stroke Survivor

Seeking rehabilitation treatment is a vital step toward a survivor’s recovery because it represents progress. It represents the first move that will set the pace for all others, so it is important to consider needs, insurance and convenience when choosing a stroke rehab setting.

Stroke rehabilitation options include:

• Inpatient rehabilitation units: These units can be independent or as part of a larger hospital or clinic. Intensive programs at these facilities can require two or three weeks of inpatient stay.
• Outpatient units: Often part of a hospital or clinic, these require visiting the facility on an appointment basis a few days a week.
• Skilled nursing facilities: The type of care offered at nursing facilities varies widely; some specialize in rehabilitation, while others offer less intense programs.
• Home-based programs: Insurance can make home-based programs tricky, as they are strict about who qualifies for them. Additionally, more complex (and expensive) rehabilitation equipment is often only found in specialized rehab environments. Here at Saebo, we pride ourselves on offering affordable and advanced products for stroke rehabilitation that can be used at rehab or at home, with or without a therapist.

Don’t forget to consult with your medical team and support system when choosing a rehabilitation plan.

6. Setting Recovery Goals with Your Therapist

It’s hard to get anywhere without a plan, which is why setting recovery goals can make a huge difference when gauging a survivor’s headway. By working with a therapist and establishing realistic checkpoints, one can feel a greater sense of accomplishment in the recovery process. Also, small accomplishments will eventually lead to major breakthroughs.

7. Help To Keep the Stroke Survivor Motivated

Your loved one is fighting a difficult battle; so don’t let them forget that they’re not alone! Throughout the rehabilitation process, you can find fun and interesting ways to incorporate personal motivation into your loved one’s routine. This could be something as simple as giving them a special photo to take with them every morning, or planning a fun trip after they’ve completed a huge milestone. Supporting them with love and understanding will go a long way, so do whatever you can to help them go the distance.

Other Things to Be Prepared for After an Ischemic Stroke

Just to make sure that you’re not hit with any surprises along the way, here are some other things to watch out for as your loved one recovers:

Difficulty Speaking and Communicating

Commonly known as aphasia — an inability to create or understand speech — this side effect occurs within an estimated 25-40% of stroke patients.

There are two forms of aphasia that can surface: receptive and expressive. Receptive aphasia refers to a survivor not being able to comprehend what is being said to them, whereas expressive aphasia refers to the survivor not being able to communicate what they want to say.

To mediate this issue between yourself and a loved one, be sure to use simple words and phrases, while also staying patient. If you become flustered or agitated during conversations, it can only make matters worse for both parties.

If interacting through speech doesn’t seem to be working, you can also try using different tools to communicate ideas, such as photos, word books, and symbols.

Coping with PTSD after a Stroke

Post-Traumatic Stress Disorder (PTSD) is normally associated with veterans and survivors of assault, but studies have shown that nearly 25% of stroke survivors will also experience PTSD at some point throughout their recovery. These episodes can surface in several forms, such as the survivor replaying the moment of their attack repeatedly in their thoughts or within a recurring nightmare.

Reasons for this can often be traced back to overwhelming anxiety or misplaced guilt surrounding their condition, but thankfully, there are treatment options available that can help with episodes. The most common treatment options for PTSD consist of medication — including antidepressants or anti-anxiety medication — or psychotherapy. A survivor should talk to their doctor and support system about best options.

Dealing with Fatigue

Anywhere from 40-70% of stroke survivors experience fatigue, which can make the recovery process more challenging for everyone involved.

If your loved one is dealing with extreme bouts of weakness or lethargy, it may be a good idea to consult with a doctor to make sure there aren’t any underlying problems causing the disruptions. Beyond that, counteracting fatigue with a positive support system can help encourage a loved one to resume normal activity.

Battling the Recovery Plateau Stage After Rehab is Completed

Once a survivor begins to see a decrease in their recovery progress, they may reach a state referred to as the recovery plateau stage. This means that a patient may begin to lose interest in their treatment programs because results may be harder to obtain.

The best thing you can do for a loved one who has reached this point in their rehabilitation is to provide constant motivation and support. Although it may not be apparent during this phase, if the patient continues to follow through with their routine, further recovery is highly possible. If some time has passed and there is a change in a stroke survivor’s ability, good or bad, it may be prudent to discuss with their physician the possibility of getting back into therapy. There are also many devices that can facilitate a more progressive home program.

Helping Stroke Survivors Help Themselves

Regardless of where a loved one is in their rehabilitation process, dealing with the effects of an ischemic stroke will always be challenging. Whether the task is finding a reliable therapist or trying to get dressed in the morning, challenges are sure to follow, but negativity cannot win out.

Although it can be extremely frustrating and complicated, upholding a positive outlook is crucial. Your support and understanding will mean the world to a survivor, so stay informed and prepared — your role in their recovery is vital.

Here at Saebo, we are committed to stroke support and recovery for all survivors and their families. Saebo offers a wide range of products that combine cutting-edge technology with evidence-based rehabilitation techniques. Our offerings and network of Saebo-trained therapists can help you or a loved one to obtain all the necessary tools to maximize stroke recovery.

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All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.