How to recover after a stroke - returning basic functions. The Four Phases of Stroke Recovery—And What to Do During Each Respiratory Assessment

When faced with the consequences of a stroke in loved ones, we are often unable to immediately appreciate how important it is not to give up and to fight to bring the moment when our loved one will return to normal life again. But in order for rehabilitation to be successful, you need to understand what needs to be done and, most importantly, when. We will try to delve into the problems associated with recovery after a stroke in this article.

Consequences of a stroke

There are two main types of stroke - ischemic and hemorrhagic, each of them is caused by specific causes and has specific consequences.

Man after hemorrhagic stroke

This type of stroke is considered to be the most dangerous, because it is associated with hemorrhage in the brain, which means that the affected area can have a significant area. Patients who have suffered a hemorrhagic stroke experience serious problems with movement, speech, memory and clarity of consciousness. Partial paralysis is one of the most common consequences; it affects the right or left side of the body (face, arm, leg) depending on the location of the brain lesion. There is a complete or partial loss of motor activity, a change in muscle tone and sensitivity. In addition, behavior and psychological state change: speech after a stroke becomes slurred, incoherent, with obvious violations of the sequence of words or sounds. There are problems with memory, symbol recognition, as well as depression and apathy.

Man after ischemic stroke

The consequences of this type of stroke may be less severe; in the mildest cases, after a short period of time, full recovery body functions. Nevertheless, doctors do not give positive forecasts very often - problems with blood circulation in the brain rarely go away without leaving a trace. After an ischemic stroke, problems with swallowing, speech, motor function, information processing and behavior occur. Often a stroke of this type is accompanied by subsequent pain syndromes that have no physiological basis, but are caused by neurological problems.

Throughout the recovery period after a stroke, you need to carefully monitor the upper limit of the patient’s blood pressure in order to take timely measures in case of a dangerous increase. Normal indicator is 120–160 mmHg. Art.

If the result of a stroke is paralysis, then the patient needs bed rest. In this case, the patient’s body position should be changed every 2–3 hours to avoid the formation of bedsores. It is necessary to monitor the regularity and quality of discharge, change underwear in a timely manner, and monitor any changes. skin and mucous membranes. At later stages, one should practice first passive and then active gymnastics, massage, and it is necessary to restore the patient’s motor functions, if possible. During this period, psychological and emotional support from family and friends is very important.

Methods of restorative therapy and assessment of their effectiveness

Methods to speed up rehabilitation after a stroke are regularly improved, which helps patients partially or completely restore lost functions and return to their previous standard of living.

Drug treatment

The main task of medications during this period is to restore normal blood flow in the brain and prevent re-formation of a blood clot. Therefore, doctors prescribe medications to patients that reduce blood clotting, improve cerebral circulation, lower blood pressure, and also neuroprotectors to protect cells. Only a professional doctor can prescribe specific medications and monitor the course of treatment.

Botox therapy

Spasticity is a medical term meaning a condition when individual muscles or their groups are in constant tone. This phenomenon is typical for patients who have recently suffered a stroke. To combat spasms, Botox injections are used in the problem area, muscle relaxants reduce muscle tension or even completely eliminate it.

Exercise therapy

This is one of the simplest but effective ways restore mobility to arms and legs after a stroke. The main task of physical therapy is to “wake up” living nerve fibers that have fallen into biochemical stress, to create new chains of connections between them so that the patient can return to normal life or make do with minimal help from outsiders.

Massage

After a stroke, muscles need to be restored, and for this, doctors recommend using a special therapeutic massage. This procedure improves blood circulation, reduces spastic conditions, removes fluids from tissues and has a positive effect on the functioning of the central nervous system.

Physiotherapy

Methods based on various physical influences. They can be very effective for restoring blood circulation, reducing pain syndromes, and improving the functioning of various organs. The abundance of methods allows you to choose suitable option for each specific case or develop a whole range of measures aimed at the rehabilitation of body systems. Physiotherapeutic procedures include electrical muscle stimulation, laser therapy, electrophoresis, vibration massage and others.

Reflexology

Impact on acupuncture or biologically active points of the body helps to activate its vital forces, essentially being an effective additional method of treatment. Acupuncture and injections reduce muscle tone in spastic conditions, regulate the functioning of the nervous system and improve the condition of the musculoskeletal system.

Kinesthetics

One of the most modern methods restoring the patient's independence after a stroke. It consists of gradually learning to perform movements that do not cause pain. For example, for bedridden patients, one of the main tasks of kinesthetics is the ability to independently regularly change body position in order to prevent the formation of bedsores.

Bobath therapy

This is a whole set of measures based on the ability of healthy areas of the brain to take on responsibilities that were previously the prerogative of damaged ones. Day after day, the patient re-learns to accept and adequately perceive the correct body positions in space. Throughout the entire therapy process, a doctor is next to the patient, who prevents the occurrence of pathological motor reactions of the body and helps to carry out useful movements.

Diet and herbal medicine

In a post-stroke state, the patient needs proper nutrition with a minimum content of fatty foods - the main source of bad cholesterol. The basis of the menu is most often fresh vegetables and fruits, lean meat, and whole grains. It is best if the diet is prescribed by a doctor, based on the characteristics of a particular case. Treatment is used as phytotherapeutic methods essential oils(rosemary, tea tree, sage), as well as the use of decoctions and tinctures (rose hips, St. John's wort, oregano).

Psychotherapy

After a stroke, any patient needs psychological help, preferably provided by a professional. In addition to the fact that depressive states can be caused by disorders of the brain, the patient experiences constant stress due to his helplessness. A sudden change in social status can have a negative impact on psychological state patient and even slow down the overall recovery process.

Occupational therapy

Behavioral reactions also most often change during the recovery period, so the patient needs to relearn the simplest things - how to handle household appliances, using transport, reading, writing, building social connections. The main goal of occupational therapy is to return the patient to normal life and restore ability to work.

Some time after your first stroke, the likelihood of having a second increases by 4–14%. The most dangerous period are the first 2 years after the attack.

Duration of rehabilitation after a stroke

It is necessary to take measures to restore each lost body function after a stroke as soon as the patient’s condition has stabilized. At integrated approach to this task physical activity returns to the patient within 6 months, and speech skills within 2–3 years. Of course, the period depends on the degree of brain damage, the quality of the procedures performed and even on the wishes of the patient himself, but if you approach the problem with full responsibility, the first results will not take long to appear.

The more sudden a stroke occurs, the more shocking the consequences become. Just yesterday your close relative was healthy and cheerful, but today he cannot cope without outside help. It is necessary to understand that in this situation a lot depends on those people who are next to him. And it’s not just about the degree of professionalism (although this is an important factor), but also about simple human care and understanding.

Ainura.

Good afternoon, Ainura! It is known that a sudden disruption of cerebral circulation leads to a stroke. Complications after cerebrovascular pathology can be very different, from violation speech apparatus until the body is completely paralyzed. Memory loss (amnesia) is one of the most common complications.

The brain consists of two hemispheres, each of which is responsible and controls certain functional purposes. The left hemisphere is responsible for the right side of the brain. Logical thinking, obtaining information data, sequence of actions, and so on. All this is the work of the left side.

The right hemisphere, on the contrary, controls the left side. This side controls emotional condition, processes the received data, details the information received. A healthy circulatory system ensures synchronous brain function. If any areas are damaged, neurological abnormalities occur. Memory loss is one such problem.

Memory restoration is a complex and long-term process that requires great patience and perseverance from those around the sick person.

All measures to restore memory should be comfortable for the patient himself. There should be no irritation or feelings of intrusiveness. First of all, start training visual memory. Shift various objects from one place to another, focusing the patient’s attention on this.

After some time, remind him of this; it is advisable that the objects he is looking for are in his field of vision. Then make the task more and more difficult. Be sure to consult a psychotherapist.

A necessary condition when working with a patient is constant monitoring of blood pressure.

Under no circumstances should you make him worry or overexert himself. Everything should be natural and relaxed.

An interesting method of memory restoration after a stroke was proposed by the National Polytechnic Institute in Mexico. The patient is offered background music in a natural form, composed of his previously favorite compositions. The result is amazing. Of the 500 patients tested, 438 people, after some time, began to remember their favorite melodies and hum them. A gradual method of memory restoration, through music, family photographs, simple poems and phrases, will help restore lost memory to a person.

History of rehabilitation after a stroke

My name is Natalya Efratova. In the summer of 2017, my husband had a left-sided stroke. Almost completely paralyzed. He spent a month in the city hospital. Then, with great difficulty, we transferred him to a rehabilitation center, where he simply lay for a month, and there was no talk of any full-fledged rehabilitation. A month later we were discharged in the same condition in which we were admitted. Sergei didn’t even learn to sit normally.

After such treatment, we decided to throw all our energy into recovery and decided to go to a private center. I looked through a lot of information on the Internet and the Evexia center caught my eye. From the very first contact, I felt a desire to help us cope with our problem.

We originally came here for two weeks, but stayed for a month and a half. My husband began to walk. We are not very confident yet and we have not yet achieved the desired result in our hand, but we were told that it will take time. But Sergei is already walking and this is already a big victory for us.

We have already partially touched on this issue above, when we talked about restoring motor abilities. After all, in the human psyche everything is interconnected: in the process of learning to walk and all other movements, down to the smallest and most precise, all mental functions will inevitably be restored and developed. But, of course, special exercises are also required aimed at developing each specific area of the psyche.

The scope of our book does not allow us to dwell on this problem in detail, but there is a truly boundless sea of literature that will certainly be useful to you. And first of all, you need to pay attention to all kinds of “educational” books for children preschool age. There you will find a considerable number of tasks, training methods aimed at developing thinking, attention and memory. We have already said that you should not neglect all kinds of “children’s” activities, such as modeling from plasticine or drawing. To this you can add many other “entertainments”. The so-called " finger games": you probably know at least one of them - the famous "Thieving Magpie". In this way, you can “act out” almost any poem, accompanying their reading with various finger movements (you can clench your fingers into fists, clap your hands, click them, and so on With frequent repetition, the patient memorizes the poem with you (an exercise for memory), tries to correctly repeat all the gestures in accordance with the spoken words (trains attention), and all the manipulations that you perform with his fingers (alternately bending them, like in the same “The Thieving Magpie”, light stroking or rubbing) have a strong stimulating effect on speech restoration (it is known that there are points directly connected to the speech centers of the brain on the fingers).

Many exercises aimed at restoring intellectual abilities can be carried out with the patient “on the job”: while cleaning his room, while eating, in the bathroom, you can, for example, play “words” with him. There are a great many variations of this game; the one that I remember from my own early childhood was called “loading the ship.” The rules are simple: you “load the steamer” with all the items that come to your mind, the names of which begin with the letter “A” (or “D”, or “U”...). The winner is the one who “loads his ship” with a large number of items. Another well-known option is the “city game”: you say one name, your partner must remember a city whose name begins with the same letter with which the name of the first ended (that is, together you build a chain like “Armavir - Rzhev - Washington” and etc). As you go along, the task can be complicated: for example, name the cities of only one country or continent.

You can play synonyms or antonyms (that is, select words with similar or opposite meanings), write short poems (a line for you, a line for your partner). However, the enumeration of all possible activities of this kind can be continued indefinitely; the general idea is probably clear to you. The main thing is to try to fill every free minute of the patient with a variety of “mental” exercises.

L. Obraztsova

"Restoring intelligence, memory, attention after a stroke" article from the section

Mental disorders after a stroke (acute cerebrovascular accident) include dementia - acquired dementia, which results in a gradual loss of previously acquired skills and knowledge, and it also becomes difficult to master new information and skills.

After a stroke, mental disorders such as changes in speech, writing, and other cognitive or neurological functions appear. To correct the consequences of a stroke, in addition to drug treatment, psychological rehabilitation is carried out, which helps the patient cope with disorders after a stroke.

Danger of dementia

Dementia is a common and rapidly progressive disease. Thus, in 2009, there were about 35 million people with dementia, and as of 2015 there were already more than 46 million.

Scientists predict an increase in the number of patients with this disease by 2050. mental disorder up to 131 million people. More often than not, a mental disorder cannot be treated, so it is important to promptly diagnose and treat acute cerebrovascular accident and other diseases that provoke the development of pathology.

Types of dementia

Depending on the affected area, the following types of dementia are distinguished:

cortical;
subcortical;
cortical-subcortical;
multifocal.

Cortical dementia develops due to abuse alcoholic drinks, as well as for Alzheimer's and. In cortical dementia, the affected area is the cerebral cortex.

The cause of subcortical dementia is hemorrhage into the white matter, as well as Huntington's. The affected areas are the subcortical structures of the brain.

During a stroke, the cortical and subcortical areas of the brain are most damaged (cortical-subcortical dementia). Multifocal dementia develops due to a pathological process in different parts of the central nervous system.

Why does vascular type dementia develop?

The cause of the development of pathology is an acute or chronic disturbance of cerebral blood flow. Due to the fact that the tissues partially or completely do not receive the required volume of blood, neuronal necrosis is observed. An acute disorder can be triggered by ischemic (acute cerebrovascular accident due to blockage of cerebral arteries) or hemorrhagic (acute cerebral circulatory disorder developing due to rupture of intracerebral vessels) strokes.

Factors that can provoke an ischemic or hemorrhagic stroke include:

arterial hypertension (high blood pressure);
heart diseases;
diabetes mellitus (atrial fibrillation);
taking narcotic substances;
elderly age;
overweight.

Stroke also develops in the following ways: psychological reasons like availability severe stress and prolonged emotional stress.

Chronic circulatory disorders usually go unnoticed. Dementia develops gradually as a result of blockage of small vessels due to atherosclerosis or insufficient volume of blood delivered due to cardiovascular failure. Due to the presence of compensatory mechanisms in the initial stages of dementia, it is almost impossible to identify it.

Signs of vascular dementia

Vascular dementia combines cognitive and neurological disorders. Cognitive impairment occurs within one month after a stroke attack. In the case of many small strokes, symptoms of cognitive impairment appear within six months. Symptoms and their degree of manifestation depend on which part of the brain and how severely it is damaged. Typical symptoms of vascular dementia are:

reduction in the number of human interests;
depression of mental functions (thinking, perception);
deterioration in flexibility of thinking.

Negative changes in a person’s memory appear already at the beginning, but more mildly in comparison with their manifestation in Alzheimer’s. A person forgets some episodes and has difficulty learning new material. However, passive memory comes easily to him. Difficulties arise when a person tries to remember certain things (active memory). People in the early stages of dementia have difficulty speaking and writing. They forget some words or do not understand their meaning. During a conversation, they may make mistakes in spoken words because they do not understand their meaning.

As they progress, mental disorders after a stroke worsen. A person cannot remember how to use things that are familiar to him. It becomes difficult for him to navigate in space, especially in places where he has never been before. It is difficult for such a person to make a purchase on his own and draw up documents. People with late stage dementia need constant care, since without outside help they are not able to feed and clothe themselves.

Vascular dementia is characterized by a wave-like progression. The patient may experience inexplicable rage, irritability, and mistrust, but after a while these emotions disappear without any reason. It is also possible to develop after a stroke depressive state or psychosis.

Diagnosis of vascular dementia

In order to identify dementia, the doctor takes a medical history. It is also based on signs indicating the presence of dementia:

There is evidence of the patient's memory impairment. The doctor finds out this information by interviewing the patient and his relatives.
There are signs (errors in oral speech), agnosia (difficulty perceiving surrounding information), apraxia (movement disturbance).
Violation of interaction with the social environment, the emergence of bad relationships in the patient’s family.
No symptoms of delirium (mental disorder) were detected.
Brain defect recorded using tests (EEG, magnetic resonance and computed tomography of the brain, rheoencephalography, ultrasound).

How to cure a mental disorder

Medicines are prescribed by the doctor depending on the course of the disease. The goals of therapy are to eliminate cerebrovascular accidents, maintain normal blood flow to the brain, and also to eliminate disorders caused by dementia. To eliminate cognitive impairment, the doctor prescribes medications such as:

antioxidants;
neuropeptides;
nootropic drugs;
neurotrophic drugs;
antidepressants;
membrane-stimulating drugs;
sedatives;
neuroleptics.

To restore their psyche after a stroke, people are prescribed a special diet and measures are taken to normalize blood pressure. Since a paradoxical effect may occur when taking medications, it is important to monitor the patient’s somatic and mental state, and if there is no therapeutic effect of the drug or the patient’s well-being worsens, immediately replace the medication.

Important! Drugs that depress cognitive function are used only when necessary and in small doses.

Features of caring for patients with dementia

People with a mental disorder need appropriate care in addition to drug therapy. Patients are indicated for occupational and group therapy. They need comfortable and safe conditions residence. Sometimes the keys to the apartment are taken away from the patient, and access to the gas stove is removed in order to protect his life.

During a stroke, blood circulation in one area of the brain is disrupted, and the supply of oxygen to cells may completely stop for a certain period.

This phenomenon is commonly called oxygen starvation. The situation is fraught with the death of brain cells. Stroke is a condition requiring emergency medical care.

The doctor will prescribe medication and physical therapy. He will also give advice on how to quickly recover after a stroke. This is possible due to the ability of brain cells to regenerate.

The success of the rehabilitation process after a stroke depends on a number of internal and external factors.

The main ones are:

number of affected brain cells;
localization of the damaged area;
general health of the patient;
help from relatives;
timing of the start of rehabilitation.

The sooner recovery activities begin, the sooner the patient can return to a full life. The rehabilitation process should begin as soon as the patient is able to move. Until this point, all restoration measures should be carried out by the patient’s relatives or an invited medical professional.

A person who has suffered a stroke will return to normal life much faster if he is given massage and forced exercises.

This manipulation involves flexion and extension of immobilized limbs.

It is better if the very first restoration measures are started in the first week after the stroke, when the patient’s condition becomes stable.

You should not postpone rehabilitation for a long time. This is fraught with irreversible changes.

What happens during the recovery process?

A stroke is a serious disorder of the body that affects vital organs. Recovery is always a complex and lengthy process. Sometimes patients are forced to relearn how to walk, talk and take care of themselves. It may take additional time to restore the patient's vision and memory.

All rehabilitation techniques are aimed at restoring brain functions. His area, which was starved of oxygen, stops working properly.

Accordingly, motor activity is disrupted and sensitivity is lost in those areas that were subordinate to the damaged area of the brain.

The most important thing in the rehabilitation process is to establish the transmission of nerve impulses. Passive gymnastics will send a signal about a change in body position from muscle receptors to the brain. Gradually, this system will restore its operation in the opposite direction. Due to this, connections are formed between brain cells. New neurons are actively beginning to form.

The importance of passive gymnastics is difficult to overestimate. It not only restores neural connections, but also prevents muscle atrophy.

Rehabilitation after ischemic stroke

Ischemic stroke leaves a serious impact on human health. Rehabilitation after it is aimed at restoring:

speeches;
motor activity of the limbs;
self-care skills.

Patients often require the help of a psychologist. Against the background of a serious condition, there may be a lack of interest in life and a desire to recover.

The doctor observing the patient will definitely prescribe neuroprotectors. These medications promote rapid recovery of brain cells. Taking them will protect neurons from negative factors and also normalize metabolism.

Rehabilitation will be slower if the patient’s body is weakened by chronic diseases. The recovery process is especially difficult for older people.

Rehabilitation after hemorrhagic stroke

Recovery of patients who have suffered a hemorrhagic stroke is aimed at preventing relapses and possible complications. After a cerebral hemorrhage, it is important to help the patient restore previous skills and abilities. The key importance of rehabilitation is the patient’s adaptation to the new condition. He should have a desire to return to normal life.

In a hospital setting, drug treatment is started.

The patient needs nootropics, glutamic acid and B vitamins.

Gradually, rehabilitation programs will be launched, including therapeutic exercises, wearing special suits, speech therapy and various techniques physiotherapy.

Fast and complete recovery after hemorrhagic stroke impossible. In most cases it lasts for the rest of your life.

Not everyone knows how to identify the first signs of a stroke, but such knowledge can save a person’s life. - everyone should know this.

Let's look at the features of caring for patients after a stroke at home.

And in this topic we will consider the consequences of right-sided ischemic stroke.

Restoration of motor functions

Chiropractors and therapeutic exercise instructors are involved in restoring the functioning of the musculoskeletal system. A set of special exercises is aimed at working all muscle groups. If you have hypertension, massage is indicated. Thanks to this, blood circulation throughout the body improves.

In some cases, it is necessary to restore the movements of the hands. It is necessary to perform flexion and extension of the fingers. After returning to normal mobility, you can move on to more complex exercises that involve the whole body.

Therapeutic gymnastics can be performed lying down, sitting or standing. The choice of exercises depends on the patient's condition. In the first stages, the patient will need the help of relatives.

A set of exercises for hands

Gymnastics should only be performed under the supervision of a physician. He will determine which exercises will be most effective.

Vision restoration

Loss of vision is a rare consequence of stroke. The success of recovery depends on the location of the damage. If the cells of the cerebral cortex in the occipital lobe are destroyed, then it is impossible to restore vision.

If the visual center of the brain has not undergone pathological changes, the patient is recommended special gymnastics for the eyes.

The exercise cycle includes:

closing your eyes;
squeezing the bridge of the nose with your fingers;
gentle pressure on the eyeballs;
light pressure on the eyelids.

Additionally, the doctor prescribes appropriate drug therapy. Complex treatment will restore visual function in the shortest possible time.

Speech restoration

Speech disorders are often a consequence of a stroke. Its restoration will take from 3 months to several years. Regular sessions with a speech therapist are required.

It is necessary to maintain the activity of the facial muscles at the proper level.

To do this, you can follow simple steps, for example:

folding lips into a tube;
tongue sticking out;
licking lips;
lip biting.

Communication between relatives and the patient also plays an important role. They should communicate with him as much as possible, showing patience in case of misunderstanding. You need to ask questions that require monosyllabic answers. Words must be spoken slowly so that the patient has time to hear and understand them.

In severe cases with extensive brain damage, complete restoration of speech is impossible. Learning an audiological language may be required.

Memory recovery

Is memory restored after a stroke? To fully restore memory functions, only the patient’s efforts are not enough.

A special role in this process is given to his relationships with loved ones.

The most effective way counts finger gymnastics with learning simple quatrains.

You need to communicate a lot with the patient, remembering the positive moments. During the conversation, you should not talk about unpleasant moments for the patient associated with his condition.

Positive results are observed if you ask the patient simple questions and play basic word games. The effect will be pronounced if such classes are conducted on a regular basis.

How to recover after a stroke at home?

The first rehabilitation period takes place in a medical facility. When the patient’s condition has stabilized and the first progress in recovery is noticeable, he will be discharged home. It is important to continue the rehabilitation process.

You can perform therapeutic exercises at home. The exercises are aimed at improving blood circulation and removing excess muscle tone.

If it is not possible to use special simulators in rehabilitation centers, then you can perform simple limb bends and leg lifts. It is recommended to hang a towel over the bed, fix the patient’s hand in it and perform various movements.

Proper nutrition also plays an important role. Foods high in animal fats are prohibited. Due to the presence of cholesterol, such a diet can provoke a second stroke.

Folk remedies

Application traditional medicine helps restore damaged brain vessels and reduce blood viscosity.

The following remedies are effective:

pollen;
horse chestnut infusion;
celandine decoction;
peony root tincture;
mumiyo with aloe juice.

These substances are recommended to be taken orally. Your doctor will help you calculate the exact dosage. You can wipe immobilized areas with a decoction of bay leaves, and in case of speech problems, place thin slices of black radish in the oral cavity.

Traditional recipes will not provide complete recovery. They are purely auxiliary tools.