Neurology and Neurosurgery

Rehabilitation from a stroke, your questions answered

Female nurse assisting a senior man walk using parallel bars in a rehabilitation center after recovering from a stroke


Rehab specialists answer common questions about recovering from a stroke


If you or someone you care about has had a stroke, you might be wondering what to expect after overcoming this medical emergency. After you have had initial stroke treatment at a hospital, your stroke care team might recommend rehabilitation if the stroke caused problems with your ability to move or talk.


Here are tips from rehabilitation specialists about recovering from a stroke.



What is a stroke?

There are two types of stroke. The most common stroke is an ischemic stroke, which occurs when something blocks oxygen-rich blood from flowing to the brain. A hemorrhagic stroke happens when a blood vessel bursts and causes bleeding in the brain. A stroke can cause brain damage, permanent disability or death if it is not treated quickly.



What happens after a stroke?

The after effects of a stroke depend on a number of factors and can vary from few to no side effects to side effects that greatly affect someone’s quality of life. After effects of a stroke depend on how quickly you had treatment, your age and overall health. A stroke can affect someone’s speech, mobility or both depending on the location in your brain.


How rehabilitation help common side effects from a stroke

Spatial awareness: Changes to your vision and body caused by a stroke can affect your spatial awareness. Spatial awareness is how we perceive our body in the space around us. Stroke can cause visual changes such as double vision or visual field cuts. Field cuts happen when you can only see half of what is in the visual field. If a stroke causes lasting paralysis, it can affect where and how you move your body. A physical therapist can develop movement training for you to relearn how to move with the changes in your body. 


Cognition: A stroke may impact your cognition, depending on the parts of the brain affected the stroke. This might change your ability to recall information, multitask or stay on task. An occupational therapist or speech therapist can help you improve your cognition with brain-stimulating activities such as memory games. They can also offer strategies for reducing frustration and ways to compensate for cognitive changes after a stroke.


Personality: A stroke may change your personality, depending on the parts of the brain affected the stroke. Some stroke survivors have a flat affect, varying mood changes, or may not be able to assess their abilities well post-stroke. A physical therapist can help you and your family and friends understand these changes and encourage acceptance and understanding.



Physical therapy after a stroke

Many people who have mobility difficulties after a stroke ask when they will be able to move their arm or leg again, or when they will be able to walk again if the stroke greatly affected their balance, coordination and strength. 


“Some people may need only a few sessions of PT and some people need many weeks, months or even years of PT. How much PT you might need and the mobility you will get back depends on the severity of the stroke, its location in the brain, and how quickly treatment was initiated,” says Erika Chason, licensed physical therapist, Nuvance Health. “It also depends on your age, and how active you were and what other medical conditions you had before the stroke.”


“While we have data to suggest long-term stroke outcomes, we never discount the power of a positive mindset. We have many inspiring patients who have beat the odds because of their commitment, determination and optimism,” says Erika.


“On the other hand, post-stroke depression affects about one-third of stroke survivors and can impact recovery as well. It often goes unnoticed, so please consult with your care team if you are feeling down or depressed even months after a stroke,” says Erika.


Occupational therapy after a stroke

Occupational therapy (OT) after a stroke may help you perform daily activities to your best ability, including showering, getting dressed and making meals.


“In OT, you can learn different type of interventions to help you in areas that may be weak from the stroke. For example, your therapist may help you learn how to use a device to move independently,” says Megan Grabowski, licensed occupational therapist, Nuvance Health.



How long you might need to use interventions depends on what the stroke affected. Interventions may include:

  • Physical support, such as a cane or leg brace

  • Adaptive skills so you can maintain your independence, such as assistive devices to help close buttons, zip zippers or put on shoes

  • Occupational support such as how to safely and successfully return to work



What are good signs after a stroke?

Many people ask, “When will I be able to return to normal?” after having a stroke. The progress you make in rehab after having a stroke will depend on your unique circumstances. 


“Recovery time after a stroke varies quite a bit depending on the individual. In general, some patients can experience ‘spontaneous recovery’ of function within three months after a stroke. This means that an ability or skill that was affected by the stroke returns suddenly because the brain finds new ways to perform these functions,” explains Megan. “It is also estimated that most patients will regain functional independence.”


If you or someone you know has side effects from a stroke, there are reasons to be optimistic about long-term recovery.


“More and more research is debunking the notion that people stop making functional gains after six months from having a stroke. We have seen patients make progress a year after having a stroke!” says Megan.


The bottom line: Post-stroke life might look different after recovering from this medical emergency. If a stroke affected your ability to walk, talk or move and complete daily tasks, physical therapy and occupational therapy may help you to gain strength, confidence and skills and maintain your independence.