How long does it take to recover after a stroke: timing, prognosis

Currently, a huge problem is not only mortality from strokes, but also a high percentage of disability. Rehabilitation for people who have suffered a stroke is very important, as it can reduce this percentage, as well as reduce the depth of neurological deficit.

Rehabilitation measures can reduce the patient’s dependence on outsiders, which improves his quality of life and is also important for his relatives.

In this article we will look at what exactly the consequences of a stroke may be, and what opportunities exist for their correction. You will become aware of the benefits of undergoing rehabilitation measures in a hospital, as well as what contraindications exist for this and what you can do at home.

Neuroplasticity or why you can recover after a stroke

The goal of neurorehabilitation is restoration or, in the absence of the possibility of complete recovery, partial compensation of impaired functions of the nervous system.

This is based on complex mechanisms of neuroplasticity. Neuroplasticity is the ability of nervous tissue to undergo restructuring following damage.

It should be remembered that the area of the brain that was damaged as a result of an ischemic or hemorrhagic stroke is not restored. Those nerve cells that have died will not recover. New neurons also do not appear. Therefore, restoration is possible only due to the fact that other neurons take over the function of the lost ones. This occurs due to those neurons located near the lesion in which irreversible changes have not occurred. This process is long, during which time various changes occur both at the structural and biochemical levels. It is also necessary to take into account that in case of severe damage to the brain, complete recovery should not be expected, since the capabilities of neurons for neuroplasticity are not unlimited.

It is believed that these processes can continue throughout the year after a stroke, most actively in the first months. Therefore, rehabilitation measures should begin as early as possible, even in the acute period of a stroke, already in the first days, as far as the patient’s condition allows.

The speed and limits of a patient’s recovery after a stroke

Often close people responsible for rehabilitation really want to hear clear deadlines: how long will it take for the patient to recover to a certain level?

Of course, this question is naive and is mainly dictated by the great stress that people experience. Clear deadlines seem to them like a lifeline that they can grab onto in such a situation that unexpectedly falls on their shoulders.

No doctor can answer this question. The timing is so individual that sometimes it is impossible to say until the last minute whether a person has approached the possible limit of recovery. Or there is still a long difficult work ahead.

However, a large sample of medical histories makes it possible to statistically compile estimates of average recovery rates. The type of stroke and the resulting damage (lost capabilities) of the patient are taken as a guideline.

In case of ischemic stroke, as a result of which the consequences can be attributed to very mild, minimal, expressed in minor impairments of neurological functions (for example, mild tremor of the limbs, slight paralysis of some muscles, mild visual impairment), the expected time frame for the first visible results after one month is indicated treatment, and full recovery can be expected within three to four months.
In any stroke, as a result of which the patient receives severe damage in terms of neurology, for example, paralysis of some muscles or limbs, loss of coordination in a pronounced form, and others, this implies the possibility of a very moderate, partial restoration of some functions. It is possible to restore the patient to self-care, but full recovery should not be expected. This happens, but these cases are very rare and unpredictable.
Severe strokes of any kind do not imply full recovery. The patient usually receives complete paralysis of one part of the body (left or right). On average, it takes about two years for the patient to learn to sit again, perhaps to develop some paralyzed limbs, but complete recovery is not possible.

This table is not the ultimate truth, but it allows us to roughly estimate the scale of the disaster. It should be separately noted: you can hope for the best, but prepare yourself for the worst, then, regardless of the results, neither the patient nor his loved ones will experience deep depression about the unattained result. Which, unfortunately, is not uncommon with such serious and unexpected illnesses.

Often patients are so disappointed in the results that conventional therapy gives that they begin to resort to various not very scientific methods. Is it possible to refuse those methods offered by conventional doctors? It is reliably known that, for example, recovery after a stroke using folk remedies without the use of modern medications sometimes occurs in practice.

In fact, the stated recovery periods are wrong. Once people have suffered a stroke, they are forced to engage in rehabilitation for life, which is very difficult.

Restoring lost functions

The consequences of acute cerebrovascular accident can be different, depending on where the focus of the brain lesion is localized. If the centers responsible for movement are affected, the ability to move the limbs on the side opposite to the lesion will be completely or partially lost. If the speech center is damaged, speech will be impaired or may be completely absent. The same principle can be used to correlate all other neurological disorders that appear as a result of a stroke. Next, we will take a more specific look at possible neurological syndromes.

Hemiparesis or hemiplegia is a disorder of motor function.
Hemiparesis is a partial loss of strength in the limbs on one side (only on the right or only on the left).
Hemiplegia is a complete loss of the ability to move the limbs on one side.

Impaired motor function may manifest as muscle weakness, leading to limited range of motion up to complete immobility in the affected limbs. In mild cases, impaired motor function may be manifested by awkwardness of movements and rapid fatigue.

Muscle atrophy may often develop in the affected limbs. This is due to the fact that the muscles of these limbs do not have the necessary load, as a result of which they atrophy, which complicates the rehabilitation process. Therefore, from the first weeks it is necessary to carry out active or passive gymnastics, if it is impossible to carry out active gymnastics due to deep paresis, cognitive impairment or impaired level of consciousness. The best option for carrying out such gymnastics is a physical therapy doctor.

Spasticity is also a motor dysfunction. This is an increase in muscle tone in the affected limbs. This aspect also requires attention, as it has a negative impact on the implementation of movements, restoration of walking and self-care.

With severe spasticity, the usual pathological position of the limb is formed. With increased muscle tone, it is difficult to straighten a limb or, for example, fingers. This also threatens the appearance of flexion contactures—limitation of passive movements in the joint. If this problem is identified, regular therapeutic exercises are necessary to prevent the formation of the usual position of the limb, for example, if, due to spasticity, the fingers of the hand are constantly bent, it is necessary to straighten them with a healthy hand or with the help of an outsider and fix them in this position. The use of orthoses is also effective.

In some cases, the attending physician may prescribe certain medications that help temporarily reduce increased muscle tone, but this will be ineffective or not effective at all if contractures have formed.

Most often, with a hemispheric stroke, restoration of movements occurs first in the lower limb, then in the upper, and most recently in the hand, this is due to the peculiarities of the blood supply to the brain. But this pattern is not 100 percent. Everything can be individual. Restoration of movements can begin already in the first days after a stroke. However, if there is no dynamics for a month, then the prognosis for further restoration of movements is very doubtful. The most effective time for motor rehabilitation is the first 3-6 months from the onset of a stroke.

Rehabilitation after a second stroke

The main restoration of all functions that were present in the patient before the repeated vascular accident occurs in the first two to three months - they are considered peak for neurological recovery. At this time, half of the main functions are restored, then until the end of the year - the second half. Assessment of the quality of recovery includes indicators characterizing the return of self-care skills, motor and cognitive functions.

Often, a consequence of a second stroke is a disorder of motor functions, so the activation of a post-stroke patient begins in the hospital as soon as his condition has stabilized. Basically, the ability to move in paralyzed limbs is restored in the first six months.

To prevent muscle contracture in the joints of paralyzed limbs, the patient, who is still on bed rest, begins to be activated - to do static exercises, i.e. give the arms and legs positions that the patient himself is not yet able to assume. For example, they extend the arm at the elbow joint, placing it on a chair placed next to the bed, while opening the hand and extending the fingers as much as possible. The leg is bent at the knee joint at an acute angle, the foot is flexed. The limbs are fixed in the desired position using bolsters, pillows, towels, and sandbags for at least two hours every day.

Additionally, passive gymnastics is performed with paralyzed limbs. First, the exercises are performed by a physical therapy specialist. At the same time, the patient’s relatives are present, who, having studied the sequence of exercises, will continue to do them independently after discharge. Passive gymnastics is complemented by breathing exercises. The pace and number of exercises performed gradually increases.

Physical recovery of a post-stroke patient begins with giving him a semi-sitting position under the supervision of medical staff, measuring pulse and blood pressure, and assessing the subjective sensations of the patient, who gradually learns to sit, then stand and move with support around the ward. The patient is supported on the paralyzed side, placing the shoulder under the paretic limb. Next, the patient begins to use the support of special devices - walkers. At the same time, they are restoring everyday skills - they offer to grasp objects with a paralyzed hand, dress without assistance, button up, tie shoelaces, and the like.

In addition to physical therapy, the patient is prescribed massage. It should be performed by a specialist familiar with the specifics of performing this procedure for post-stroke patients, since lack of qualifications can lead to complications after massage in the form of muscle spasms and contractures. In case of severe muscle spasms, the patient is prescribed muscle relaxants, the treatment regimen for which is prescribed by the doctor in each specific case. Acupressure, physiotherapeutic procedures, and acupuncture prevent the occurrence of movement restrictions in the joint.

A special activating massage is also used for decreased muscle tone in paralyzed arms and legs; drugs that activate muscle contractions and physical methods are prescribed.

If relatives have the opportunity to place a post-stroke patient in a specialized rehabilitation center, then qualified specialists there will quickly restore all functions that need to be restored.

Speech disorders are most effectively corrected through systematic sessions with a speech therapist-aphasiologist. At first, these classes are short in time, no more than a quarter of an hour. Over time, loved ones can actively take part in restoring speech, writing, and reading skills by working with the patient at home. Typically, the patient is prescribed nootropics that help restore speech and other cognitive functions.

The diet must contain plant foods, cereals, cereals, lean meat and fish. Fatty, fried foods, smoked foods, pickles, cakes, pastries, and pastries should be excluded. The dishes are under-salted. The daily calorie intake should be 2000-2500 kcal. Food is taken in small portions, 5-6 times a day.

Basic methods of motor rehabilitation

Physiotherapy

Therapeutic gymnastics includes physical exercises aimed at general training of the body, training tolerance to physical activity, as well as special exercises aimed at restoring lost functions.

A set of physical exercises performed by a physical therapy doctor is selected individually based on the motor deficit of a particular patient. The exercises are aimed at increasing muscle strength, increasing range of motion in joints, reducing muscle tone, improving coordination, learning to stand and walk.

Restoration of walking takes place in several stages: imitation of walking while lying down, sitting, learning to stand and maintain balance, learning to walk with a 4-support cane within the ward, learning to walk on stairs, walking outdoors. During the restoration of walking, an important point is the correct positioning of the foot. Often, as a result of a stroke, the ability to walk is lost; in this case, it is necessary to control the position of the foot, knee and hip joints. Physiotherapy doctors know how to do this correctly.

You should not expect that a person with profound impairment of motor functions will be able to walk immediately. This requires a long time, the work of specialists and the work of the patient himself. Restoring walking function is not always possible; it depends on many factors - from the motivation of the patient himself to the extent of brain damage. It is not uncommon to meet a person who, years later, still walks poorly after a stroke; often the deficit can persist for life. But rehabilitation helps reduce this deficit to the minimum possible.

Verticalization

Verticalization involves bringing the patient into an upright position as far as the motor deficit allows. The minimum level of verticalization is considered to be raising the head end of the bed. Next is a half-sitting position in bed, then a sitting position in bed, then sitting in a bed or chair with legs down. It is necessary to begin verticalization from the first days and continue it continuously if the general condition of the patient allows this.

The importance of these events is difficult to overestimate. When staying in a horizontal position for a long time, the muscles of the back and limbs do not work, the tone of the blood vessels changes, and the longer the patient is only in a horizontal position, the more difficult it will be in the future to teach him to sit and “accustom” his vessels to a vertical position.

Orthosis therapy

Orthosis therapy is the use of special fixing functional devices. They are necessary for temporary immobilization of individual segments of the musculoskeletal system. Effective in the treatment of contractures and to facilitate the restoration of movement and provide stability while improving gait function, for example to protect the knee or ankle joint. The need to use this method is determined by the physical therapy doctor.

Massage

Massage can help combat spasticity in the limbs, as well as improve tissue trophism. But this method is only auxiliary. Since it has been proven that those methods used in rehabilitation in which the patient does not actively participate have practically no effect.

Physiotherapy

Physiotherapy includes electrical stimulation. This method is used to prevent atrophy and reduce spasticity. Provides a training effect. This method will not teach muscles to contract voluntarily; it only prevents muscle tissue atrophy. This should not be assumed to restore movement.

Full or partial restoration of motor functions is possible with the joint work of the patient, physical therapy doctor and neurologist.

Features of recovery after an ischemic attack

How to recover quickly?

Medications

The purpose of medications is to stop the negative consequences of an attack and help the patient quickly restore lost functions.

After a stroke, 4 groups of drugs are prescribed: muscle relaxants, anticonvulsants, antiplatelet agents and antidepressants.

Muscle relaxants. Reduce muscle hypertonicity that appears by the third month after the attack. Examples of muscle relaxants:
Tizanidin-teva. The average price in Moscow is 173 rubles, in St. Petersburg – 121 rubles.
Anticonvulsants. Prevents seizures. Examples of anticonvulsants:
Carbamazepine. The average price in Moscow is 69 rubles, in St. Petersburg – 55.
Antiplatelet agents. Prevents the formation of blood clots. Examples of antiplatelet agents:
Thrombopol. The average price in Moscow is 56, in St. Petersburg – 44 rubles.
Antidepressants. Up to 80% of people affected by a stroke are depressed, and it is very difficult to get out of it without pharmaceutical support. Examples of antidepressants:
Azafen. The average price in Moscow is 215, in St. Petersburg – 198 rubles.

If you have a stroke, you cannot self-medicate, so all medications must be prescribed by your doctor.

You will find detailed information about the treatment of ischemic stroke in the hospital and at home here.

Exercise therapy

Therapeutic physical education is the basis of post-stroke rehabilitation.

During the early recovery period, various exercises from therapeutic gymnastics are used, the task of which is to restore the normal motor ability of the main muscle groups.
At the later stages of the patient’s rehabilitation, elements of ergotherapy, a system aimed at adapting the patient to everyday motor activities, are included.

Classes are conducted under the supervision of an instructor , who draws up an individual physical activity plan for each patient, which consists of exercises with one’s own weight and using special exercise equipment.
It can take from 3 to 12 months for a patient to recover with exercise therapy. If you refuse therapeutic exercises, a person’s condition can only worsen.

Massage

Massage is an important addition to therapy, especially if paralysis, severe muscle spasms or regular seizures have developed after a stroke.

You can only trust a massage to an experienced specialist with a medical education.

Objectives of the procedure:

Improving blood flow, lymph flow and metabolic processes.
Reducing spasms.
Returning muscles to normal tone.

The purpose of massage sessions is to restore lost body functions and improve overall health. Depending on the severity of the consequences of the attack, a course of massage will help the patient recover within 3-6 months.

Physiotherapy

Physiotherapeutic procedures affect the body using artificially created natural factors, which helps eliminate various abnormalities caused by a stroke. This type of therapy is prescribed individually, based on the patient’s condition and the appropriateness of using certain types of procedures.

The most effective type of physiotherapy is magnetic therapy , this procedure:

improves the functioning of the endocrine and nervous systems;
stimulates brain function, which improves the general condition of the patient.

When undergoing a full course of magnetic therapy, the patient recovers in 1.5-4 months instead of 6-12.

Despite its effectiveness, magnetic therapy is quite painful and difficult to tolerate for some patients.

Social and psychological assistance

If a stroke affects the right hemisphere of the brain, this can lead to a change in the person's character, making him more capricious and aggressive. In addition, patients who have suffered a stroke often suffer from depression caused by disruption of the usual rhythm of life and the inability to care for themselves. Therefore, working with a psychotherapist is necessary.

A specialist helps a person control his actions and behavior in society and reduce depression.

It would be useful to use antidepressants and sedatives , but only a psychotherapist should prescribe them.

Rehabilitation at home

By the time the patient returns home, relatives should prepare for the fact that his lifestyle may now change dramatically. This also applies to eating habits.

Nutrition and diet rules

It is necessary to adhere to the rules of the rehabilitation diet:

The food served should not be too hot and not too cold. The optimal temperature is 36-38 degrees.
Almost all food that the patient eats should be fairly soft or pureed.
Calorie intake should not exceed 2500 Kcal per day.
Most foods must be boiled or stewed. Frying and baking are not allowed.

Mode

Since digestive function is impaired during a stroke, the patient should not overload the gastrointestinal tract. To do this, you need a fractional diet - many meals (4-7) in small portions throughout the day.

Specialized centers

Having contacted a rehabilitation center, the patient receives a primary diagnosis. After this, the doctor selects the necessary techniques and draws up an individual rehabilitation course, which may include the following activities:

exercise therapy;
massage;
physiotherapy;
drug treatment.

The need to create a dietary menu is also decided by the doctor individually. Among all rehabilitation centers, the following are considered the best:

"Rejuvenating apple" The center is located in Moscow. The average cost for a full course is 35,000 rubles. For more information, call +7 (495) 227-84-36.
Nikolaevskaya hospital. Located in St. Petersburg. The full course lasts 3-4 weeks and costs from 200 to 230 thousand rubles. For more information, call 8-981-133-57-28.
Rehabilitation center of the Russian Ministry of Health. Located in Moscow. The average cost for one day of stay in the center is 5,000 rubles. For more information, call 8 (495) 730-98-89.
Central Clinical Hospital for Rehabilitation in Goluboye. Located in the Moscow region. The price per day spent in the hospital varies from 3 to 12 thousand rubles. For more information, call 8 (495) 536-09-22.

Recovery from a stroke is not an easy process, regardless of the severity of the consequences of the attack. The more attentive the patient and his relatives are to rehabilitation, the greater the chance of completely restoring lost body functions.

Hypoesthesia - loss of sensitivity

When the area of the brain responsible for sensitivity is damaged, hypoesthesia develops - a decrease in sensitivity. Its decrease will manifest itself in the limbs opposite to the side of the lesion.

Sensitivity, as a rule, takes longer to recover than movements in the limbs, this is due to the structural features of sensitive nerve fibers.

To restore sensitivity, tactile stimulation can be used - irritation with cold temperature, vibration, pressure. Therapeutic gymnastics also plays a certain role, promoting awareness of the position of the limb in space.

Coordination problems

When the cerebellum is damaged, coordination disorders develop - accuracy and consistency of movements. They can manifest themselves in different ways: impaired stability when standing or walking, impaired coordination of movements, tremor. A number of patients experience severe impairment of walking function due to damage to the cerebellum. In this case, the strength in the limbs can be completely preserved, the range of movements is full, but when performing purposeful actions (walking, standing up, trying to independently bring a spoon to the mouth), significant impairments are revealed.

Rehabilitation of such patients consists of motor activation, balance training, motor skills training, and fine motor skills training. A large role in solving this problem is given to therapeutic exercises. A special set of exercises is used aimed at:

Increased precision of movements
Improved coordination of movements
Balance training and walking training
Training fine motor skills and various hand grips

For concomitant dizziness, drug therapy is used to improve blood circulation in the brain and suppress the excitability of the vestibular centers. The drug, dose and dosage regimen are prescribed exclusively by a doctor.

Speech disorders

It is often possible to encounter the fact that a person does not speak after a stroke; speech disorders appear in most patients, to one degree or another. Speech disorders occur when the speech areas of the cerebral cortex, subcortical structures or pathways are damaged.

There are different types of such violations:

Aphasia is a systemic disorder of speech activity that occurs when the speech center of the left hemisphere is damaged in right-handers and the right hemisphere in left-handers. Aphasia is often accompanied by impairments in writing (agraphia) and reading (alexia). Aphasias are also divided into several types; this article will indicate only the main, most common ones:
Motor aphasia is a violation of speech activity, manifested in the difficulty or impossibility of pronouncing sounds, syllables, and words. Secondarily, it may be accompanied by a violation of understanding the speech of another person.
Sensory aphasia is manifested by a violation of the discrimination of specific speech sounds, and, accordingly, is manifested by a lack of understanding of the speech of others. As a result, the patient answers the questions posed incorrectly, speech is disorganized, and consists of a set of unrelated words.
Amnestic aphasia is a violation of the naming of objects; a person can describe why a given object exists, but does not remember its name.
Dysarthria is a violation of the pronunciation of words due to insufficient innervation of the speech apparatus. The speech system does not collapse, but the clarity of sound pronunciation, articulation, phonation and intonation coloring of speech suffers. The disturbances can be severe to the point that others cannot understand the patient’s speech.

The rehabilitation of such patients should only be carried out by a professionally trained speech therapist. Specialists conduct correctional classes with such patients, selecting exercises individually based on the type of speech disorder. In some cases, “disinhibiting” and stimulation techniques are necessary, in others, on the contrary, it is necessary to slow down some processes. In parallel with speech restoration classes, reading and writing restoration exercises are also carried out. A speech therapist teaches correct articulation and speech understanding.

Gymnastics of the muscles of the pharynx and pharynx, articulatory muscles, massage of these muscles, and training in the coordination of respiratory movements can also be performed.

Rehabilitation measures to correct speech must begin as early as possible, even in the acute stage of the disease. This promotes faster speech recovery. You should be prepared for the fact that in case of severe violations, the restoration of speech function is a long process. If the patient does not speak after a stroke, then a lot of time will be required; recovery will not be limited to the time spent in the hospital, but will also require the involvement of specialists at the outpatient stage. Classes are possible at home or in a clinic with a frequency of at least 2-3 times a week.

Recovering a person after a stroke - How to restore speech and movement

Stroke - recovery stories from the newspaper “Herald of Healthy Lifestyle”

It is possible to recover from a stroke even in the most hopeless cases, as evidenced by the stories given here of people who suffered a stroke with severe consequences.

Full recovery after a stroke.

Examples of recovery in old age.

How to treat a stroke - personal experience.

Is it possible to recover after a stroke?

It is possible to recover after a stroke! The human body has a powerful ability to recover. Even if the damaged area of the brain cannot be restored, the functions of the damaged cells are taken over by others.

A person’s recovery after a stroke, the speed and completeness of rehabilitation depend on the size of the brain damage. In some patients, movement and speech are completely restored in the first weeks or months, in others they remain difficult, and in others they are almost never restored. The process of restoration of lost functions occurs most quickly in the first year after a stroke. Then the patient comes to terms with his situation, adapts to the existing defects, and progress in rehabilitation stops.

To recover from a stroke , you need to start rehabilitation as quickly as possible, even the next day after the attack, start while still in the hospital, and then continue recovery at home.

Often a paralyzed person after a stroke becomes depressed and indifferent to his condition, does not want to do rehabilitation exercises, and does not try to restore speech. In such patients, even mild impairments of motor and speech functions are poorly restored. Often this happens not even because of laziness and depression, but because of damage to certain areas of the brain. Such patients need to be properly stimulated in order to quickly overcome the consequences of brain damage.

The process of a person’s recovery after a stroke occurs at a slow pace, often progress is almost unnoticeable. This can cause a person to feel despair and helplessness. It is important not to lose motivation, remember that it is possible to recover from a stroke even in the most severe cases.

Below are reviews from those who recovered from a stroke, including those who recovered from severe brain damage, when doctors predicted complete immobility for the rest of their lives. Stories of people’s recovery are taken from the newspaper “Vestnik ZOZH” under the heading “Life after a stroke.”

We also advise you to read the article “STROKE - SYMPTOMS, FIRST AID AND PREVENTION”

An example of recovery after an ischemic stroke at home.

The men suffered a massive stroke, most of the brain was damaged, half of the body was paralyzed, and vision and speech were lost. His wife was told that there was little hope, and if he did not die within the next week, he would be paralyzed for life. But determination, perseverance, willpower and self-confidence helped the person recover, get back on his feet and take care of himself, although many of the consequences still remain.

It is believed that the remaining part of the intact brain can take over the functions of the damaged part and transmit impulses to the paralyzed parts of the body. But this is only possible with the help of training. It was very difficult for a man to learn to swallow, eat food, and control his bladder. But he decided not to give up, but to fight hourly for his health. The main thing is not to get used to the state you are in, but to move forward every day. The part of the brain that controls speech and language understanding recovered after performing special exercises that were recommended at the hospital. He performed these exercises every day for 1 year after the stroke, and then for another five years in cases where his face began to warp.

After he learned to sit in a place that he could not feel, the patient began to think about how he would learn to stand and move. But he didn’t have enough strength for this - he swallowed food with difficulty, so he ate little. He spent most of the day sitting in a stroller, learned to tie himself to it with one good hand, and push off the floor with his good leg to move the stroller. Life immediately became more interesting. Then he learned to dress and undress on his own. Although five years later his arm and leg remained paralyzed, the man learned to walk with the help of a stick and go down the stairs using the railing backwards. Before a paralyzed person is going to get to his feet, he needs to fix what position his leg is in, otherwise he may fall - the paralyzed leg, while rising from a chair or bed, is not able to support the weight of the body and seems to bend. It takes time to learn to lean on the paralyzed leg and maintain body balance. It is very helpful to stretch the paralyzed hand and each finger on it several times a day, but care must be taken not to damage the joints due to lack of sensation in the hand. If the pressure is normal, then the following exercise is useful: holding onto a stationary support with your healthy hand, try to do squats, starting from three times, up to 10 (2-3 times a day) 4 years after the stroke, a paralyzed man walks on his own, in a wheelchair sits down only if he feels tired or loses balance, undresses and dresses himself, including shoes, prepares food, tries with all his might to become independent (HLS 2003, No. 10, pp. 14-15, 2003, No. 21, p. .24)

How to recover after a stroke at home - right side.

Correct motivation and belief in success helped me recover from a stroke. A 53-year-old woman suffered a stroke, although she was never considered hypertensive, her blood pressure was always 120/80. However, on the day of the attack, when the ambulance doctor measured the blood pressure, it turned out to be 240/70. For three months she lay at home without moving, depressed. The right side was paralyzed. My arm and leg hung like a whip, my speech was impaired. The patient was completely discouraged, but the nurse convinced her that the consequences could be overcome. Then the woman began to fight for her health: she massaged her right side with her left hand, read aloud to restore her speech, and did exercises. When my right leg began to function, I began to walk around the room for a long time. Her hand also did not rise above her waist, then she began to draw marks on the wall with her left hand and tried to reach them with her right hand. Gradually, my arms and legs began to function normally. Daily exercise helped with this. 12 years have passed since then, and all that remains is the noise in my head. (HLS 2000, No. 11, p. 7)

Restoring walking after a stroke.

The woman suffered an ischemic stroke in September 2002, leaving her right side paralyzed. In the hospital where she was admitted, the doctors infected her with optimism and promised that she would be running by the New Year. More than a year has passed. The consequences of a cerebral stroke are slowly receding. The past year after a stroke can be divided into five stages of rehabilitation.

1st stage. (October-December 2002) The patient can only lie down and cry a lot. In October, 10 massage procedures were performed. In November - 30 injections (Cerebrolysin, piracetam). In December, I started doing therapeutic exercises with a trainer. I learned to sit on pillows, after which I was able to watch TV, read, and do crossword puzzles. 2nd stage. (January - March 2003) In January, my blood pressure began to rise in the mornings, and I took a course of injections. In February, I took a massage course and continued to do therapeutic exercises with a trainer. In February, I learned to sit up in bed on my own with the help of a rope attached to the legs of the sofa on which I was lying. While sitting, I learned to iron and sew. Since she was left-handed from birth, and her right hand was paralyzed, she was good at this work. 3rd stage. (April – July) Started learning to walk in April. Restoring walking was difficult; I had a crutch in my left hand and a daughter and granddaughter on both sides. My daughter supported me on the right paralyzed side, my granddaughter and a crutch on the left. The patient walked 10 steps from the sofa to the window and back. This counted as 1 time. With each lesson the number of times was increased. There was hope that he would learn to walk. By that time, six months had already passed since the stroke, the 4th stage of rehabilitation (August). In August, the woman was transported to the dacha, she really liked it there - fresh fruit, air. She began to move more. And the restoration of walking went better - on one side there was now only a crutch, and on the right there was still a daughter or granddaughter.

5th stage of rehabilitation (September – November, a year has passed since the stroke). In September, they began to take the woman out for walks, while the patient herself learned to work while sitting and help harvest the crops from the dacha - peeling vegetables for canning, crushing grapes for wine. Her right hand did not work; she only pressed down vegetables with it. On November 10, she began to walk around the house only with a cane, without the support of her family: she moves from the sofa to a chair, then to another chair, which stands next to the table. Holding onto the table, he gets to his feet and, leaning on a crutch, walks through the apartment to the front door and back. This is 15 meters. At first I made 2-3 flights a day, by the end of November there were already 40 flights. It took at least 2 hours a day to walk. At the end of November I completed a course of injections and massage. (HLS 2004, No. 2, p. 11)

Massage, cupping and walking helped to recover from a stroke: A 57-year-old man suffered a cerebral stroke. Before this event, he had not even thought about a healthy lifestyle, he tried to eat tastier and move less. The illness forced him to reconsider his attitude towards life. As a result, a year later, he lost 28 kg of excess weight, blood pressure was 115/70, blood biochemistry was normal. In his letter, he talks about the stages of rehabilitation after a brain stroke. Immediately after being transferred from intensive care to a regular ward, the patient’s wife decided not to limit herself to the prescribed treatment, but to engage in rehabilitation on her own. After all, the first hours and days after a stroke are the most important for maximum restoration of lost functions. Having read that cervical osteochondrosis contributes to cerebral circulation disorders, much attention was paid to massage. While the patient was still unable to sit, his wife massaged his earlobes, popliteal fossae, feet, and spine. The massage was carried out both with fingers and with massage balls 2-3 times a day. After two weeks, the left leg “moved away”, after a month – the arm, after a month and a half the patient learned to speak individual words clearly. As soon as the paralyzed patient was allowed to sit, his wife began to massage his collar area, first carefully, then more and more intensely. She alternated regular massage with honey massage, and a month later she also added cupping, which she placed along the spine in 2 rows. 2 months after the stroke, the patient was transported to a sanatorium, where physiotherapy, massage, and walks were prescribed. At first, the man could walk 300 m in a day; after a month he was already walking 3 km. I did all this through “I can’t”, sacrificing sleep, TV and other sanatorium temptations. In my diet I gave preference to vegetable and fruit dishes, avoiding fatty, sweet, salt and eggs. The blood test still showed high cholesterol levels, so they began to develop a nutrition strategy more thoroughly, eliminating all harmful foods. After the sanatorium, the man still followed a diet and walked a lot - 1 hour in the morning and in the evening in any weather. At first he walked slowly, then faster and faster, and then began to jog at times. I adjusted the loads according to my heart rate, raised and lowered them slowly - after an energetic walk I didn’t plop down on the sofa, but took a contrast shower, then did relaxation exercises. (HLS 2004, No. 7, p. 16)

Recovery after a hemorrhagic stroke at home.

The man suffered a hemorrhagic stroke . After that, he lay motionless for 2 years, his left side was paralyzed. His wife and relatives looked after him. He would have continued to lie there if an army comrade had not come to visit and put him to shame: “How can you lie there and keep the “service personnel” around you? If the right side is not paralyzed, then we need to work on ourselves.” The comrade tied belts to the legs of the sofa on which the patient was lying and demanded that he try to lift his body and sit down. It was very difficult at first. His head hurt and he was dizzy, but the patient continued to constantly exercise: he would either get up, or work on his left leg and arm with his right hand, and for this reason he even stopped sleeping during the day. From a “log” he began to turn into a person. Finally, he began to turn over on his own and sit up. Then I learned to lower my legs from the sofa to the floor. At first I sat for 5-10 seconds, gradually increasing this time. Then, with the help of his wife, and then the chair, he began to stand on the floor. He stood for 2-3 seconds and sat down. A year after the start of training, he began to walk around the apartment on his own. The same friend brought the book “The Miracle of Fasting” by Paul Bragg. The man fasted for 24 hours a week for two years, then switched to a 36-hour fast, and again fasted for 3-4 days once a month. The result of such rehabilitation (5 years have passed, of which 3 years of exercise and fasting): 1. clarity in the head, 2. pressure dropped from 160/120-130 to 140/100, 3. pills are no longer needed. 4. All joints rotate freely, although the left side is still “dead”. But the man learned to control it. You can overcome the consequences of a brain stroke yourself. To do this, you need to use your willpower and perseverance; there is labor-intensive work ahead. Get a hold of yourself. If you don't do this yourself, no healers will help you. Only independent daily exercises give positive results. (HLS 2006, No. 1, p. 18)

Restoring speech in a person after a stroke at home.

After a stroke, the patient suffers from a speech disorder for a long time. The time it takes for a person to recover speech after a stroke is closely related to the area of damage to the nerve cells in the cerebral cortex that are responsible for speech. For any form of speech disorder, you need to regularly communicate and practice with the sick person. This will help restore speech after a stroke. Often, relatives of patients make the mistake of believing that since a person does not understand them, they can not talk to him, but only worry about cleanliness and taking medications. Then unclaimed functions are completely lost.

How we managed to restore speech after a stroke. A 54-year-old man was admitted to the hospital with a right-sided stroke. The doctors considered him hopeless and did not carry out any treatment. A few hours later I woke up in a regular ward, not in intensive care. The wife persuaded the doctors not to write the patient off, but to fight for his life. As a result, life was saved, but life expectancy at discharge was assigned to 3-4 years. Recovery proceeded very slowly, the patient had to relearn how to walk, talk, read - the meaning of what he read constantly eluded him, only six months later the ability to think logically returned. To restore speech, the speech therapist recommended reading newspapers out loud and pronouncing difficult words several times. But it was pretty boring. At that time, everyone was reading the novels of Valentin Pikul. And the patient began to read the first volume aloud, his wife being the listener. He pronounced the words diligently, trying to achieve the correct pronunciation. I read for a long time because the novel was captivating. After the first volume, speech became much clearer, almost all words were pronounced correctly. After the second volume, the old voice and its coloring returned, the man spoke as before, before his illness. I was unable to restore my right hand, so I started writing with my left hand. At first, the result was scribbles, but after two years of training, the handwriting was completely restored and became similar to the handwriting of the right hand, but the speed of writing dropped. The recovery was not as smooth as this description might suggest. These small victories occurred against a background of pain, including hypertension, angina, spasms in the arm and leg, and worries about being useless. The patient, who had previously been engaged in mental work, did not want to leave his brain unloaded, so he began to write a story on a typewriter - memories of his friend, a front-line poet, which the local newspaper then began to publish, and read books by philosophers. Almost 20 years have passed since the stroke, and the death sentence has not taken place. (HLS 2001, No. 15, p. 15)

Restoring speech after a stroke - doctor's advice. A 56-year-old woman suffered two strokes; after the first, her right side was paralyzed, and after the second, she lost speech. My daughter contacted the newspaper asking how to restore her speech. Answered by the head of the neurological department of the Scientific Center of Neurology of the Russian Academy of Medical Sciences, Professor, Doctor of Medical Sciences A. S. Kadykov. Restoration of speech and movements does not always occur simultaneously; speech returns more slowly. Even with the most severe speech disorders, intelligence, as a rule, does not suffer. Therefore, do not treat the patient as an unreasonable child. The most important thing is to communicate more with the patient; there should be no speech isolation. First you need to speak, naming objects in the nominative case “Fridge, plate, cheese,” which means take a plate of cheese out of the refrigerator. In the future, make speech lessons more difficult. Encourage the patient to make his own statements and ask questions more often. Be patient and do not rush the patient to answer. Try to say each word slowly and clearly. Stop speech restoration exercises when you see that the patient is tired; do not cause irritation by forcing him to work for the allotted time. If you feel well, classes can last 30-60 minutes. Do them 1-3 times a day, you can do shorter sessions, but increase their number to 5-6 times. In order for home exercises to restore speech in a paralyzed patient to be more effective, it is necessary to obtain a preliminary consultation with a speech therapist. (HLS 2010, No. 13, p. 25)

How to restore speech after a stroke - folk remedies. To restore your speech, try using these folk remedies:

Onion juice. Mix half a glass of honey and half a glass of onion juice. Store the mixture in the refrigerator. There is no need to infuse the composition; the fresher it is, the better. Take the mixture 1 tbsp. l. three times a day 20 minutes before meals. When the portion runs out, make a new one. The course of treatment is 1 week. Then take a break for 7 days, and then take a second course - a copy of the first. (HLS 2004, No. 7, p. 21)
Radish. This is an affordable and proven folk remedy for speech restoration. Place grated or thinly sliced radish under and on your tongue. Keep it in your mouth. The patient should feel a cold burning and tingling sensation. If the gastrointestinal tract is sick, then the accumulated saliva should be spat out. Do the procedure 3-4 times a day. (HLS, p. 38, 2012, No. 6)

Frolov simulator for recovery after a stroke.

The man suffered a brain stroke. After that, I took a lot of medications, but my condition remained very deplorable. A chance helped - there was a medical exhibition, and one doctor advised him to buy a Frolov TDI-1 simulator for recovery after a stroke. Two-month courses on using this simulator were also held here. The patient took courses and mastered endogenous breathing using a simulator. Started with 5 minutes. The classes were very difficult for him; he had to mobilize all his willpower and energy so as not to abandon them. As a result, the man brought the classes to two hours. I achieved tangible success - I began to do without medications, my blood pressure dropped from 230/150 to 130-140/90. She feels well, the noise in her head has disappeared, and she has almost completely recovered from the brain stroke. The paralyzed arm and leg are gradually being restored. (HLS 2003, No. 22, p. 19)

Full recovery of a person after a stroke.

After severe stress, a woman suffered from a stroke, although she had always led a healthy lifestyle. I was depressed for a long time, thinking that my life was over. But one day, after reading “Healthy Lifestyle,” I thought that many people are struggling with their illness in even more difficult conditions than she did. After these thoughts, with great effort, I rolled off the sofa, and in order to give myself physical exercise, I began to roll from side to side. Then the doctors who visited her every day came and helped her return to the sofa. This was the beginning, little by little the former bedridden patient began to crawl on her right side and walk with crutches. This lasted for six months until she was taken to live in a village house. There she crawled through the grass and was glad that she could move on her own, although her coordination of movements was impaired. All these efforts were not in vain. I managed to fully recover from the stroke. Now she is 63 years old, she gets up early in the morning, does exercises, and runs every morning along forest paths. She saws and chops wood for the stove herself, and works in the garden in the summer. (HLS 2003, No. 9, p. 8, )

Recovery after a stroke at home for an elderly person.

A 78-year-old man suffered a stroke. The daughter read about the healing power of eggs, that fresh village eggs help to recover, and sent her sick father to the village to see her sister. There he ate 2 eggs in the morning and in the evening. A month after treatment, he came back to life - he began to walk, his speech and memory were restored. All the neighbors were amazed; no one thought that he would be able to get out of bed. The man lived in the village all summer, gained weight and now feels well. (HLS 2002, No. 23, p. 19)

Reviews about recovery after a stroke at 80 years old. Three-time world speed skating champion Maria Isakova suffered a stroke at the age of 80. The left side was paralyzed. But the former champion told herself, “I have to get up no matter what.” In the very first days, the patient, overcoming dizziness, weakness and the doctors’ warnings, began to sit up in bed. In bed, I tried to move as best I could: I lifted my healthy arm and leg, then with my healthy arm I lifted the sick one. When her daughter came to the hospital to take care of her, she forced her to put 2 chairs next to each other, and, leaning on them, tried to do the exercises she did every morning. The result, of course, was similar to what had happened before, but the patient forced herself not to retreat: she turned, bent over, forced herself to slightly raise her knees, pretending to walk, and even tried to squat. The doctors were surprised at her persistence. After some time, she became stronger and was able to walk with a cane and the support of her daughter. When I returned home from the hospital, I also did not allow myself to relax. Every morning he forces himself to get out of bed, does exercises, because he doesn’t want to change his usual lifestyle, then washes his face and makes himself coffee. Everything is going very slowly. Then she starts crocheting, which she picked up after the hospital; she had never knitted before. He knits 20 loops, then makes himself walk around the apartment, when he gets tired, he sits down to knit again. 7 years have passed, the whole apartment is now decorated with knitted rugs, napkins, capes, and he gives them to relatives. It is very important to deal with a sick person, to be needed by someone and to enjoy what you do. Seeing the result of a case is like medicine. (Review from the newspaper “Vestnik ZOZH” 2005, No. 24, pp. 16-17)

How we managed to recover after a brain stroke - the left side. A 68-year-old man suffered a stroke. I lay unconscious in the bathhouse for 16 hours, because I lived alone. The left side was completely paralyzed. From the very first days there was a great desire to fully recover. 4 years have passed, until everything works out completely, but the determination does not go away. Here are his results to date: The patient gets up at 6 am, does exercises in bed, then 100-150 squats, 50-70 push-ups. Developing his left hand, he lifts the brick 30 times, pushes it away from himself and pulls it 20 times. For breakfast, he eats oatmeal steamed with boiling water, adding dried apricots, prunes, raisins, fresh or frozen berries, walnuts, and grated carrots. To improve the health of blood vessels, she drinks a mixture of lemons, garlic and honey 3 times a day. For dinner he eats 3 tbsp. l. buckwheat soaked in kefir with the addition of honey. An hour after dinner - a glass of kefir (HLS 2010, No. 6, p. 9)

How to cope with the consequences of a brain stroke. The woman is 81 years old. She has already suffered 3 strokes. An infusion of herbs, the recipe of which was recommended by a neurologist, helps her overcome its consequences, especially dizziness. 1 tbsp. l. rose hips, 1 tbsp. l. hawthorn fruit. 1 tbsp. l. pour motherwort into a thermos with 1 liter of boiling water. Drink 1 glass 3 times a day. The course of treatment is 3 months. (HLS 2004, No. 10, p. 26)

Recovery of walking and memory after stroke.

Writes from a woman who suffered a stroke. She sees the way out of her illness by searching for joy, even if it’s small, but joy. Joy for her is to achieve her goal. Immediately after the stroke, she suffered a terrible period of despair, when all thoughts were only about the disease. This incident helped her overcome this condition. When she was sitting on a chair at the entrance, a woman she knew came up to her, having learned what had happened, the friend said that this was an insidious disease, and now everything would depend on the patient herself, which of them would win. These words sank into my soul; the patient really wanted to return to her old life, when she went to the dacha and skied. I realized that if you just wait for everything to go away on its own, lie down and feel sorry for yourself, then this is a dead end. We must fight and overcome our illness. Before this conversation, she could only walk around the room, after the conversation she began to restore her walking skills, adding steps, rejoicing that the number of steps was increasing. I did exercises lying down for 30 minutes, then walking again, the day was spent working on myself. Excitement appeared, interest in life returned. New victories bring new joys. To restore my memory before going to bed, I tried to retell the texts I read during the day. I took the text of the fables with me on walks and learned them. There are exacerbations and bad moods, but my wife does not let them run wild, she immediately mentally switches to something pleasant in order to distract herself. (HLS 2010, No. 18, pp. 9-10)

How to treat headaches after a stroke - doctor's advice.

A woman suffered a stroke 2 years ago and contacted the newspaper with a complaint that headaches, dizziness, and a feeling of fear did not go away. She is answered by the head of the neurological department of the Scientific Center of Neurology of the Russian Academy of Medical Sciences, Professor, Doctor of Medical Sciences A. S. Kadykov. Headaches could have existed before the illness. A stroke itself very rarely leads to headaches. Therefore, if they appeared recently, it is necessary to find out the reason for their occurrence. It happens that headaches appear when the intensity of rehabilitation exercises is too high. When you have a headache, use folk remedies - apply mustard plaster to your feet, or prepare an infusion from a mixture of herbs: oregano, mint, St. John's wort in equal proportions. 1 tbsp. l. collection for 1 glass of boiling water - drink in 3 doses during the day. course of treatment – 2-3 weeks. This remedy helps well with neurological headaches. Dizziness after a stroke may be due to vegetative-vascular dystonia. Relanium and seduxen will relieve the feeling of fear, but first try herbal folk remedies - tinctures or infusions of motherwort, valerian. (HLS 2010, No. 4, p. 28, )

Swallowing disorders

Dysphagia is a violation of the act of swallowing, accompanied by choking when taking liquid or solid food.

This problem is very relevant for patients who have suffered a stroke, but it is not always given enough attention. A condition when a patient does not swallow after a stroke or swallows with difficulty is dangerous with a number of complications, which will be discussed below.

When the swallowing center is damaged, dysphagia of varying degrees occurs and requires different measures to correct the disorder and ensure patient safety.

Swallowing assessment should be performed in every stroke patient. In difficult cases, endoscopic techniques can be used to diagnose dysphagia.

In case of choking or any discomfort that occurs while drinking or eating, it is necessary to consult a specialist and select an individual diet.

The diet consists of a certain consistency of food suitable for a particular patient. When choking on the thickest food, a nasogastric tube is installed and feeding occurs only with its help. Special food mixtures are used. In this case, you should not take anything by mouth! The patient receives all food and drink only through a tube. In the absence of correction of the disorder, surgical techniques are used for a long time, and a gastrostomy tube is installed.

For moderate or mild swallowing disorders, the consistency of food and drink is selected and strictly observed. Soups can be in the form of cream or puree, drink in the form of jelly, if this consistency is suitable according to the results of an examination by a specialist. If necessary, special thickeners can be added to food to create a thicker consistency.

If you have dysphagia, you should never give regular liquid (water, tea, juice) without a thickener!

The great importance of this issue is associated with the possibility of drink and food getting into the respiratory tract - aspiration. Choking indicates aspiration.

Complications associated with dysphagia include:

Tracheobronchitis
Pneumonia
Empyema of the lung
Breathing problems
Exhaustion, dehydration
Sinusitis

In conditions of multiple stroke, especially if the patient’s condition does not allow him to actively move independently, the likelihood of inflammatory complications occurring is very high. That is why great attention should be paid to the nutrition of such patients. Cooking food for them should take into account the degree of dysphagia and be selected by a specialist.

Rehabilitation of patients with dysphagia does not have many possibilities. These include:

Individual selection of food and liquid consistency.
Exercises aimed at training the muscles of the pharynx, mouth, and larynx, which should be carried out by a specialist.
Physiotherapy – electrical stimulation of the muscles involved in the act of swallowing.

The possibility of changing the consistency of food consumed is determined by the doctor or swallowing specialist, and not by the patient or his relatives!

Cognitive impairment

One of the consequences of a stroke is impaired cognitive function. The frequency and depth of such disorders correlates with the age of the patient. If a cerebrovascular accident occurs against the background of an existing cognitive deficit, then there will be a worsening of existing symptoms and, probably, the appearance of new ones.

Impaired cognitive functions include:

Attention deficit, impaired ability to quickly orientate in a changing environment.
Decreased memory, often short-term.
Rapid exhaustion of mental processes.
Slowness of thinking.
Narrowing the range of interests.

There are 3 degrees of cognitive impairment:

Mild degree – minimal cognitive deficit, the patient follows instructions, is oriented in place and space, controls his behavior, but there are disturbances in concentration, memorization of new material, and decreased mental performance.
Moderate degree - orientation in place and space may be impaired, moderate decrease in working memory, errors in following two-step instructions.
Severe degree - dementia. Severe impairments of memory, intelligence, attention, social maladjustment.

A neuropsychologist examines such patients more thoroughly and selects the necessary exercises to train memory and thinking for a particular patient. If necessary, anti-dementia drugs that require long-term use may be prescribed.

Estimated terms of rehabilitation

As it becomes clear, the time frame for complete recovery is different for each patient. For some patients, a couple of months is enough, but in most cases, patients require a significant amount of time. It’s hard to say how long - sometimes the rehabilitation period stretches for several years.

The fundamental factor is the early start of measures to regain lost skills and the patient’s focus on results - without the patient’s internal desire to recover, the effect of the exercises will be low and the prognosis will be unfavorable.

Any treatment after a stroke should be carried out under the supervision of a specialist - only he can make changes to the rehabilitation program, regulate the level of physical activity and prescribe medications. The patient's recovery period does not end with discharge from the hospital. Performing prescribed exercise daily over a long period of time will help reduce the likelihood of having another attack of cerebrovascular accident.

Emotional-volitional disorders - post-stroke depression

Depression is often one of the consequences of a stroke. Many relatives of patients consider this problem to be insignificant or deny its existence altogether; for them it is much more important that movements and speech are restored. But such an attitude to this problem entails consequences. Very often, against the background of depression, restoration of lost functions is slow, and exercises become ineffective. With depression, motivation decreases to the point of its complete absence, existing cognitive impairment intensifies, the patient cannot and does not want to understand tasks and instructions. The patient becomes adynamic and inhibited. With the passive participation of the patient, the effectiveness of rehabilitation is minimal.

Appetite may also decrease, but if the patient does not eat after a stroke, this leads to nutritional deficiency, which also complicates the rehabilitation process.

The cause of post-stroke depression can be either damage to certain areas of the brain or awareness of the depth of the problem with preserved criticism.

In this situation, not only the help of a psychologist is required, but also the use of antidepressants. The course of treatment should last at least 6 months.

Restoring speech in older people after a stroke

The most intensive restoration of speech functions in elderly people is observed in the first 6 months after a stroke; in the case of extensive lesions or late treatment, it can last 2–3 years.

Depending on which areas of the brain were affected by the stroke, patients experience a motor or sensory form of speech impairment (aphasia). With the motor type, the patient:

perceives speech by ear;
understands what is being said to him;
responds to requests;
cannot formulate thoughts and pronounce phrases;
does not want to read and write, as these processes are difficult for him.

With sensory aphasia, the patient does not perceive the words of others, he himself speaks incoherently, without controlling the speech flow. Such a patient can read, but will not understand the meaning of sentences; writing skills are completely lost. The speech of older people after a stroke is not meaningful enough and is accompanied by gestures. Patients try to explain what they want to say to others, but they do not understand them, and as a result they become irritated and offended.

In this case, you need to understand that even long exercises to restore speech after a stroke (lasting several months or even years) may not give a positive effect. In 30–35% of cases, speech functions return spontaneously and not gradually.

In order for older people to start speaking after a stroke, they need to constantly hear sounds, words, and expanded speech.

During rehabilitation, it is necessary to follow the principle of the sequence of stages. You can start classes by practicing the pronunciation of individual sounds, then you can move on to syllables, simple and complex words, and then to small poems and sentences. When working with older people after a stroke, you can help them a little - pronounce the initial part of the word, and they will finish the ending themselves.

Also, to restore speech, older people are recommended to listen to music and sing. Often, patients after a stroke cannot speak normally, but retain the ability to sing. In this case, you should definitely try to sing - this will activate speech restoration.

Exercises to rehabilitate facial muscles are best done in front of a mirror. Such classes are especially indicated in cases where an elderly person has a distorted face after a stroke. To do this you need to do the following:

bare teeth;
curl and protrude your lips into a “tube”;
opening your mouth, push your tongue forward as much as possible;
alternately bite your upper and lower lips;
lick your lips with your tongue in a circle, first in one direction, then in the other direction;
pull the corners of your mouth up, as if smiling.

During speech rehabilitation classes with older people, you can use the following:

showing the patient cards on which letters, syllables and words are written, asking him to compose a sentence from them and read it;
encourage the patient to communicate: ask questions, sing together, recite poetry;
listen to your favorite audiobooks with the patient and retell their contents;
look at the pictures and then ask them to describe them.

If relatives conduct classes with a patient who has suffered a stroke at home, it is important to be kind to even the slightest attempts by the patient to pronounce words, to encourage him, and not to correct mistakes. To help older people overcome their speech impediment, you need to be persistent and constantly communicate with them.

Occupational therapy

Ergotherapy is an area of physical rehabilitation that helps a person adapt to environmental conditions, as well as restore movements in the upper limbs, by working with special exercise equipment and game tasks (constructors, mosaics, “laces”). Also, the task of the occupational therapist is to teach lost everyday skills.

A person who has suffered a stroke and has insufficient strength and range of motion in the hand is limited in everyday activities, which negatively affects the quality of his life. Therefore, restoring the functions of the upper limb, and especially the hand, is one of the most important tasks.

The ergotherapist teaches the skill of dressing independently; this is possible even with complete absence of movement in one hand. She also teaches how to eat; cutlery and dishes are adapted for such patients. They learn everyday hygiene skills - washing, shaving, brushing teeth. Using familiar objects also requires attention - a mobile phone, a pen (learning to write, practicing handwriting), an iron, a remote control. Training is carried out taking into account the capabilities of each patient. Occupational therapy allows the patient to adapt to environmental conditions, taking into account the existing neurological deficit, which reduces dependence on others and improves the quality of life.

Pain syndrome

Sometimes you may encounter a complaint that after a stroke a paralyzed arm hurts or a paralyzed leg hurts. Pain can be either central in origin or due to the formation of contractures. If in the first case only certain types of drugs prescribed by a doctor can help, then the formation of contractures can be prevented by early initiation of exercise therapy. If contractures begin to form, then it is necessary to continue physical therapy or begin, if for some reason, exercise therapy was not started earlier. In free time from exercise, the patient himself or his relatives can passively make movements in the joints where the contracture is formed, this will help get rid of it more quickly.