Arm and Hand Recovery
Arm and hand recovery continues to be a major problem following neurological injury. According to scientific data, fifty-percent of stroke survivors are likely to regain some functional use of the upper limb (Broeks JG et al. Disabl and Rehabil, 1999). Forty-one percent of all patients had limited hand use at 3 months and 45% at 18 months after stroke (Welmer AK et al. J Rehabil Med, 2008). At 6 months post stroke, some dexterity was found in 38% and complete functional recovery was seen in 11.6% of patients (Kwakkel G et al. Stroke, 2003).
The latest research shows that the brain is capable of rewiring and adapting after stroke. To improve function in the upper limb, the client must be willing to incorporate the affected side purposefully, functionally, and repeatedly. In addition to functional training, other evidence-based strategies include strength training, mental imagery, robotics, and gravity compensation.
Leg and Mobility Recovery
One of the most common impairments resulting from a neurological injury is paralysis, which can affect a portion or the entire side of the body. Problems with body posture, walking, and balance can be significant. Two thirds of the patients are unable to walk without assistance in the first week after stroke (Jorgensen HS et al. Arch Phys Med Rehabil, 1995). Approximately 35% of survivors with initial paralysis of the leg do not regain useful walking function (Hendricks HT et al. Arch Phys Med Rehabil, 2002).
Although 65% to 85% of stroke survivors learn to walk independently by 6 months post stroke, gait abnormalities and poor endurance persists through the chronic stages of the condition (Wade DT et al. Scand J Rehabil Med, 1987). It is true that recovering from a neurological injury will be an uphill battle for many, however, it is also accurate that the latest research findings regarding neuro recovery are more promising than ever before.
According to the research as many as two-thirds of patients experience cognitive impairment or decline following stroke. (Canadian Study of Health and Aging – CSHA). In addition, over 63% of stroke survivors display abnormalities in cognition (Nature Neuroscience, 2000). When it comes to difficulty with speaking, studies show that aphasia is present in 21 – 38% of acute stroke patients (Pederson PM. Ann Neurol, 1995). New technology and evidence-based treatment makes it possible for clients suffering from cognitive or communication impairments to live an independent and fulfilling life.
Approximately 30% of all stroke patients suffer from post-stroke visual impairment (Sand KM. Acta Neurol Scand Suppl. 2013). Following a stroke or other neurological injury, various types of vision deficits can occur including the inability to recognize objects, color vision deficits and difficulty with perceiving various types of motion. Approximately 20% of patients experience permanent visual deficits (Romano JG. J of Neurol Sci. 2008).
According to the National Stroke Association, homonymous hemianopia, which is the loss of one half of the visual field in each eye, is the most common visual disorder. Most people who have vision loss after a stroke do not fully recover their vision. Thankfully, some recovery is possible. Treatment and outcomes will depend on the type of vision impairment and its cause.
Approximately 23% to 50% of acute stroke patients are dysphasic (Daniels SK. Arch Phys Med Rehabil 2008). The presence of dysphagia has been associated with an increased risk for pulmonary complications and even mortality (Marik PE. Chest. 2003). Upon admission, there is an association between dysphagia and poor overall outcomes for 6 months following stroke (Smithard DG. Stroke 1996).
Evidence-based treatments such as Electrical Stimulation and EMG-Triggered Stimulation may be a beneficial treatment intervention for dysphagia. In addition, dysphagia diets, consisting of texture-modified solid foods and partially thickened fluids may help to reduce the incidence of aspiration pneumonia.