Stroke Rehabilitation Team

Stroke rehabilitation requires a multidisciplinary approach involving therapists, doctors, psychologists, and social workers. Physical therapists work to restore range of motion to limbs while speech therapists tackle communication problems. Medical doctors provide prevention and treatment strategies.

Family members are also critical to the rehabilitation team: they provide emotional support, encouragement, and assistance with learning new skills, such as using a walker, and performing exercises at home. Social workers, psychologists, and other specialists round out the team. But perhaps the most important member of the team is the stroke patient — without the patient’s active participation in the process, rehabilitation cannot succeed.

Doctors and Rehabilitation Nurses

Doctors and nurses perform initial rehabilitation. The physician’s goals are to stabilize medical conditions and prevent future strokes. Doctors work with patients to modify stroke risk factors and guide preventive lifestyle choices.

Rehabilitation nurses begin working with the patient soon after the stroke stabilizes. They often begin by exercising paralyzed or weakened limbs in an attempt to restore or maintain range of motion. Nurses also help educate the stroke survivor and family members, teaching them how to deal with daily activities and challenges.

Physical Therapists: Restoring Range of Motion and Balance

Without the patient's active participation in the process, rehabilitation cannot succeed.The goal of a physical therapist is to restore range of motion to disabled limbs and joints. The physical therapist also helps the patient regain a sense of balance and provides physical exercises designed to reduce physical disability. If a limb is paralyzed, exercise takes the form of passive range of motion: the physical therapist moves the limb to prevent the joint from “freezing” in place. Weakened limbs benefit from active range of motion exercise. The physical therapist teaches strength-building exercises that the patient can perform without assistance.

Because strokes may affect balance, injuries from falls are more likely after a stroke. Restoring balance is of vital importance. If walking alone is not possible, the therapist may recommend that the patient use a cane or walker. Learning to balance using a walker or a cane takes time and practice. Many patients initially refuse to use a cane or walker because these devices are often associated with the elderly or infirm. However, a walker can provide independence and mobility if balance is compromised. For those with severely impaired balance a wheelchair may be necessary.

Speech Therapists

Speech therapists work to restore communication to stroke survivors. This may include teaching new ways of communicating or providing exercises to strengthen the throat and mouth muscles. Speech therapists also help family members learn to communicate with the stroke survivor.

Social Workers

A stroke impacts a person’s physical and emotional well being. Disabilities from a stroke can even impact a patient’s career, causing financial hardship. In the event of financial difficulties, social workers direct stroke patients and their families towards resources that can provide assistance. A social worker also provides support and advice for practical, day-to-day life after a stroke. And finally, social workers can provide family and individual counseling to those affected by stroke.

Other Team Members

In addition to physical therapists, speech therapists, and social workers, many other specialists may be involved in stroke rehabilitation:

  • Occupational therapists teach the patient daily living skills and how to use living aids such as walkers or bathroom grab bars.
  • Recreation therapists help the patient return to social andrecreational activities.
  • Urologists treat urinary incontinence or bladder disorders.
  • Dietitians assist with creating a nutritionally balanced diet for the patient. Dietary changes are sometimes required for patients with difficulty swallowing or for those who want to change lifestyle habits that contribute to stroke.
  • Vocational therapists counsel working stroke survivors on their return to the workforce, especially patients who need to change careers.
  • Psychologists provide emotional counseling, treat depression, and may help treat memory loss or cognitive disabilities.

Resource

U.S. Agency for Healthcare Research and Quality. (1995, May). Recovering after stroke: A patient and family guide [AHCPR Publication No. 95-0664]. Retrieved February 18, 2004, from www.strokecenter.org/pat/ras.pdf.