The Centers for Disease Control and Prevention states that more than 795,000 people in the United States suffer a stroke every year. A stroke happens when something blocks the supply of blood to a part of the brain or when a blood vessel in the brain bursts.
If you’ve had a stroke, knowing what to expect from the recovery process is vital. Learn about the potential recovery timeline.
Day 1: Beginning Your Recovery
The first step is always to confirm that you did have a stroke. This should happen as soon as possible because the treatment process is most effective when it begins right after the stroke.
When you arrive at the hospital, you’ll be taken to an imaging room for a CT scan, which will help identify the stroke. The type of stroke you had will determine the treatment you receive. Your team will go through the entire process with you and your loved ones to ensure you understand what it involves.
Week 1: The Next Steps
Most stroke patients can go home after about four to seven days. This will vary depending on your overall health, the severity of the stroke, and how the recovery is progressing.
Physical therapy involves mobility training, motor-skill exercises, range-of-motion activities, and anything else that helps you regain motor skills.
Speech therapy focuses on helping you regain any lost speaking abilities, as well as helping you with swallowing.
Another type of therapy is occupational therapy, where an occupational therapist will help you with any issues with vision and cognitive skills.
Because stroke rehabilitation needs to focus on treating the whole patient and not just the symptoms, the treatment plan has to include cognitive and emotional activities with a mental health specialist. This type of therapy helps you express what you’ve been feeling after the stroke.
The Three Months After the Stroke
You will continue your rehabilitation either as home-based care, which involves the therapists coming to you at your home, or as outpatient therapy at a stroke rehabilitation center.
Some people can also benefit from specialized short-term or long-term care. One of these options is skilled nursing care. Many nursing facilities have experience helping people who have had strokes and need more intensive care. The average stay at these nursing facilities is about a month.
Inpatient stroke rehabilitation is another option. It usually involves spending two or three weeks at an inpatient facility for people who’ve had strokes. You will likely have therapy five days a week for at least three hours a day. This can be a good option if you need 24/7 medical care but can still handle intensive therapies.
Nursing home care is a long-term option. It is a good choice if you need non-medical care and help with things like bathing, eating, and mobility. You can still receive certain therapies, but for the most part, nursing home care focuses on helping you manage everyday life.
You can also combine these options, with some people moving from one option to the next as they start improving.
Some people experience a spontaneous recovery during the first three months after a stroke. This is when a skill or ability that you thought you had lost returns completely. Spontaneous recovery occurs because the brain finds new ways of performing a particular task.
Six Months After the Stroke
Within six months, most people who have had strokes have completed at least one rehabilitation program and may be continuing care at home.
Just because you’ve returned home doesn’t mean you don’t still need therapy, however. It’s crucial to focus on preventing another stroke as well, so you should establish relationships with specialty and primary doctors who will be there to provide ongoing care.
You should have a mental health professional helping you through this stage of recovery. Having a stroke is a major event in your life, and you may not have yet processed it emotionally. A mental health professional helps you find ways of dealing with depression, anxiety, or any other mental health concerns you’re struggling with.
Another important member of your team is the vascular neurologist. They specialize in strokes as well as other brain diseases. They’re the ones who can identify a stroke when you go to the hospital, and they also provide post-stroke care.
Your primary care doctor is another crucial team member. They help monitor your health and are even able to gauge your risks of having another stroke.
One Year After a Stroke
After a year, you will likely have completed one or more rehabilitation programs. You may still be struggling with limitations or may have experienced a full recovery. However, it’s important to know that stroke recovery is an ongoing process.
You also want to continue dealing with the emotional toll a stroke can take, so reaching out to support groups for people who’ve had strokes is a good option. This will allow you to speak with others who have gone through a similar process.
Setbacks can happen in the months after a stroke. Setbacks can include a second stroke, pneumonia, and other health issues. Although these events take a significant toll on your body, they often take a heavier one on your mental state. That’s why having a mental health professional helping you is vital.
Your care team will have to adjust your recovery timeline if these setbacks occur and prepare new therapies that can address any issues that may have arisen.
Outlook After a Stroke
A full recovery after a stroke is often possible. It’s also possible to experience lasting issues that affect your daily life and require long-term adjustments. Perhaps the most important thing, however, is to prevent another stroke.
By working closely with your recovery team and having medical professionals you trust helping you, you can pursue the various therapy options available.
One such option is regenerative medicine, also known as stem cell therapy, which uses your body’s natural healing abilities to work where you need them most. Stem cell therapy is a promising treatment to help people manage their condition and help the healing process after a stroke. Speak with your doctor about these options.
The Centers for Disease Control and Prevention states that as many as 795,000 people in the United States suffer a stroke each year. A stroke is a serious condition that can range in severity but that requires some patience throughout the recovery process. Learn more about what a stroke is and the recovery tips that can help you improve faster.
What Is a Stroke?
You can think of a stroke as the brain’s equivalent of a heart attack. It occurs when a part of your brain doesn’t receive enough blood flow, either because you have a blocked artery or because you were bleeding into your brain. If something blocks blood flow to your brain, the organ doesn’t receive the oxygen it needs.
Anyone can have a stroke, including children. That said, you may have a higher risk than others if you are older than 65 or if you have high blood pressure, Type 2 diabetes, high cholesterol, or irregular heart rhythms.
The warning signs of a stroke are:
Sudden vision loss in one or both eyes
Loss of balance
Muscle weakness on one side of the body
Most strokes are ischemic, which means that blood clots have blocked the blood vessels to the brain. Plaque can also cause such a blockage. Hemorrhagic strokes occur when an artery in the brain breaks open or leaks blood into the brain. This blood puts a lot of pressure on brain cells.
Stroke Recovery Tips
If you’ve suffered a stroke, take the time to make the necessary changes to your lifestyle so that you can recover faster and perhaps even prevent future strokes.
Rest When Your Body Asks for It
The stroke and the recovery process both put a lot of stress on your body, and you need to listen to what it tells you. If fatigue becomes overwhelming, allow yourself to rest. As you recover, your brain needs sleep. Sleep helps improve movement recovery after a stroke, making it as vital as your rehabilitation exercises.
Good Nutrition Is Key
Your body needs all the right nutrients to heal more efficiently. This means sticking to a diet that is rich in vegetables, fruits, lean proteins, and whole grains. Some vitamins are also essential for stroke recovery, including vitamin D, which you get from the sun but also from egg yolks, fatty fish, and cheese.
Vitamin B3, present in turkey, salmon, and chicken, is also crucial because it helps with neuroplasticity. Another excellent option is vitamin B12 because it can boost the function of nerve and brain cells. Eggs, poultry, and milk are also great sources. And If cholesterol is a concern, fish is a better option.
An additional vitamin to consider adding to your diet is vitamin C. You can find it in citrus fruits, as well as broccoli and bell peppers.
If you have dietary restrictions, consult your doctor about whether taking vitamin supplements is a good option for you. As you recover from a stroke, avoid alcohol and an excess amount of sugary foods and drinks, as well as foods rich in saturated fat.
Use the Affected Side of Your Body
Your brain focuses on efficiency. If you don’t use an affected limb or entire side of your body, your brain forgets how. For instance, if you spend days not using your right hand, it will assume it’s not an important part of the body and de-prioritize it.
As you recover, all movement is important. Even if you don’t fully control the limb or if you experience paralysis after the stroke, you can help by moving that part of your body with your hands.
Schedule Regular Visits to Your Doctor
Your doctor is one of your most powerful allies as you start healing from a stroke. They will be able to guide you through all of the stages of your recovery, offering advice and reassurance. They have experience treating strokes and can give you the right perspective on how your recovery is going. Speaking often and honestly with them is key.
Don’t Get Discouraged
Progress after a stroke tends to be slow, which can be discouraging. You may not see the kinds of huge improvements you may have expected, but that doesn’t mean that you aren’t improving at all.
One of the toughest moments in the stroke recovery process is the “plateau” that occurs after about three months. You may notice that recovery is slowing down. It doesn’t have to stop, however, if you continue with your rehabilitation programs.
To rewire itself, your brain needs constant stimulation. Speak with your doctor about finding the right therapies to perform at home so that you can continue making progress even after months after experiencing the stroke.
Communicate What You Feel
Another important aspect of recovering from a stroke is healing emotionally. Going through a serious issue like a stroke leaves you feeling vulnerable or like you’re alone with your worries.
Communicate with your loved ones and let them know what you’re feeling. If that’s not an option, reach out to support groups. Support groups allow you to meet others who have gone through similar situations and who have a good understanding of the challenges you face. For some people, turning to a therapist can be helpful, too.
Physical activity, even simply walking around a room, helps minimize high blood pressure. This means it can also assist in preventing future strokes. Exercise additionally boosts your mood by releasing endorphins.
Ask your doctor what exercise options are suitable for your needs. Never begin a regimen without the recommendation of your doctor.
Managing Life After a Stroke
Lingering stroke symptoms can be frustrating. They may leave you thinking that there’s nothing you can really do about them. That’s not necessarily true. Lately, the field of regenerative medicine has been turning to stem cell therapy options to help people manage better after a stroke.
Regenerative medicine, also known as stem cell therapy, has the potential to replace damaged brain cells and restore some lost functions for post-stroke patients. MSCs (Mesenchymal Stem Cells) can potentially help post-stroke by reducing inflammation, promoting neuroprotection, and stimulating tissue repair in the damaged brain.
As with every treatment you’re considering, speak with your doctor to find out whether it might be a good choice for your needs.
Recent advances in medical accessibility, technology, and treatment have increased the average human life expectancy, while at the same time, increasing the risk for neurodegenerative diseases and other disorders – including stroke.
According to the CDC, nearly 800,000 people in the United States suffer a stroke each year, with 87% of these strokes being ischemic strokes. An ischemic stroke is a medical emergency that occurs when the blood supply to part of the brain is reduced or interrupted. Without the ability to deliver oxygen or nutrients, brain cells begin to die in a matter of minutes.
Even when identified and treated early, the lasting, long-term effects associated with stroke result in economic and social costs for patients, their families, and society in general. As an example, the CDC estimates that stroke-related costs, including those associated with healthcare and missed days of work, exceed $50 billion dollars in the U.S. each year.
While medical research continues to search for ways to prevent stroke by addressing underlying causes, primary stroke treatment continues to focus on managing stroke progression while also treating related symptoms.
Recently regenerative medicine, also known as stem cell therapy, along with rehabilitation therapy has been presented as an effective stroke treatment. In this review, Berlet, et al. explore the potential synergistic outcomes of stroke treatment observed when combining current advances in stem cell research with known stroke rehabilitation strategies. The authors also review research while considering the advantages and disadvantages of using the combination of stem cell transplantation and rehabilitation as a way to mitigate the devastating effects of stroke.
Combining stem cell treatment with rehabilitation therapy and outside strategies, such as an enriched environment (EE) may enhance functional stroke recovery and allow for an ideal long-term therapy for stroke patients. With the goal of enhanced brain plasticity, these therapies aim to introduce intrinsic or extrinsic stimuli to assist with the reorganization of the brain’s structure, functions, and connections.
The human brain has been demonstrated to be more plastic after experiencing an injury. With EE promoting improved stem cell survival and migration, and stem cell therapy creating the potential for an extended window of treatment, the combination is viewed as a potentially effective therapy when combined.
Preclinical experimentation has demonstrated stem cell therapies to be effective days after an ischemic stroke occurs, providing a very important window of time for critical stroke treatment to occur. While this is certainly promising information, the authors also point out that there has been a disappointing and frustrating disconnect between these preclinical findings and what is observed in clinical experimentation.
Considering this, the authors identify determining the optimal clinical stem cell route of administration, dosage, and timing as key areas of study to better understand – and maximize – the therapeutic potential of stem cells in the treatment of ischemic stroke.
While Berlet et al. calls for additional research into the ideal route of stem cell administration, type dosage, and timing to further confirm the efficacy of stem cell transplantation for the treatment of ischemic stroke, the authors conclude that the addition of stem cell therapy to rehabilitation has significant potential to create a conducive host microenvironment to facilitate the repair process.
With nearly 15 million people affected worldwide each year, stroke continues to be the most prevalent cerebrovascular disease. Responsible for over 5 million deaths and another 5 million individuals suffering long-term disabilities, stroke also is the leading cause of mortality and morbidity worldwide.
Although there have been significant advances in both pharmacological and surgical therapies designed to treat the effects of stroke, effective therapy remains limited and primarily focused on managing the symptoms associated with a stroke rather than treating the causing factors or preventing the stroke at the onset.
Recently regenerative medicine, also known as stem cell therapy, and specifically mesenchymal stem cell (MSC)-based therapy has been identified as a potentially effective strategy for a wide range of diseases and health conditions, including stroke.
In this review, Li et al. examine current preclinical and clinical data from trials using MSCs in the treatment of stroke, the mechanisms underlying MSC-based therapy for stroke, and the challenges associated with the timing and delivery of MSCs.
Initial preclinical studies of the application of MSCs in the treatment of stroke demonstrated that transplantation of MSCs following ischemic stroke promoted improvement of cerebral function protected the ischemic neurons, and repaired brain damage. However, these studies were conducted in young and healthy subjects and failed to factor in the presence of comorbidities, such as diabetes and hypertension, more commonly observed in ischemic stroke patients.
Considering that 75% of strokes occur in the elderly and/or those with the previously mentioned comorbidities, the authors of this review focused their review on studies that incorporated these two factors into their trials.
While these preclinical studies of MSC-based therapy for stroke demonstrated promising results, including improved blood-brain barrier integrity, increased white matter remodeling, and improved neural repair, the authors point out that there has been a limited number of preclinical studies conducted and call for additional preclinical studies specifically utilizing the comorbidity model.
Although treatment of stroke using MSCs has been established to be safe and feasible in phase I and II clinical trials, there have been mixed findings as to the therapy’s efficacy. As a result of these varied findings, the overall efficacy in the treatment of ischemic stroke remains controversial. The authors consider several reasons for the inconsistency of results observed in these trials, including the varied number of patients, doses, and type of cell delivery, the timing of the cell therapy, and the treatment modalities used in these trials; the authors also call attention to the different locations, extent, and severity of lesions used in these trials.
As a result of the inconclusive results surrounding the effectiveness of MSC-based therapy for the treatment of stroke in these clinical trials, the authors call for more optimized and well-designed large-sample multicenter studies to evaluate the therapeutic efficacy of MSCs more thoroughly in ischemic stroke.
While the underlying mechanisms of MSC-based therapy for stroke have not been fully explained or understood, a review of several studies has demonstrated that MSCs protect against stroke through multiple mechanisms, including direct differentiation, paracrine effects, and mitochondrial transfer.
Before MSCs can be widely applied in clinical practice, Li et al. highlight several challenges that need to first be considered. These challenges include determining the optimal time for MSC administration during the acute stroke stages, further understanding the best treatment, conditions, and strategies to maximize the regenerative potential of MSCs, identifying the simplest and safest route of MSC delivery, and identifying the best source of MSCs for stroke treatment.
The authors conclude this review by recommending future preclinical and clinical studies that consider the adoption of a well-designed randomized controlled study design and method rigor and intervention measures to determine the effect of MSC therapy in the treatment of stroke.
Even with considering the above recommendations, MSCs continue to demonstrate exciting potential as a means to protect neurons and improve outcomes and overall quality of life for stroke patients.
Gait refers to a person’s manner of walking or moving on foot. After a stroke, gait can be significantly impacted due to the damage caused to the brain and nervous system. Stroke can affect gait in several ways, including:
Muscle weakness: A stroke can cause weakness or paralysis on one side of the body, which can affect the ability to lift and move the leg and foot during walking.
Spasticity: Spasticity is a condition that causes muscle stiffness and spasms, which can make it difficult to move the leg and foot smoothly during walking.
Balance and coordination: Stroke can affect the brain’s ability to control balance and coordination, making it harder to maintain a steady gait.
Foot drop: Foot drop is a condition where the foot drops down when walking, due to weakness or paralysis of the muscles that lift the foot. This can cause stumbling or tripping while walking.
Cognitive and perceptual changes: Stroke can also affect cognitive and perceptual functions, such as perception of depth and distance, which can affect a person’s ability to walk safely and confidently.
Gait training exercises can help stroke patients improve their gait by addressing these issues through strength training, coordination exercises, balance training, and other targeted interventions. Working with a physical therapist can also help stroke patients to customize their exercise program to their specific needs and abilities.
To regain your strength and improve your ability to walk after a stroke, you can practice gait training exercises like the ones below.
Flamingo stands are one of the easiest gait training exercises to perform. You can stand freely in the middle of the room or with one hand against a wall for added support. Bend one leg up and backward into a flamingo position and remain standing on the other leg. Do this for about 30 seconds and then switch legs. Repeat ten times for each leg.
Seated marching is a basic gait training exercise that can be performed from any seated position. You start by sitting with both feet placed on the floor in front of you and then lifting one leg up into your chest and placing it back down onto the floor. Repeat this with the other leg and then alternate between legs for ten repetitions.
Side Leg Raises
To perform a side leg raise, begin in a standing position. You can hold on to a chair for increased stability. Lift one leg outward to your side about 45 degrees. Hold this pose for several seconds before bringing your foot back down to the floor. Do 15 repetitions and then repeat with the other leg.
For a knee extension gait exercise, you will start in a seated position. Extend one leg out in front of you and hold it parallel to the floor. Make sure to contract your thigh muscles and then slowly lower your foot back down toward the floor. Alternate back and forth between each leg for ten repetitions while maintaining a straight posture with your back.
It’s important to note that stroke patients should always consult with their healthcare provider before starting any new exercise program. Additionally, exercises should be tailored to the individual’s specific needs and abilities.
According to the CDC, stroke continues to be a major cause of serious disability for adults. It is also estimated that nearly 800,000 people in the United States have a stroke each year. While 80% of those experiencing a stroke survive for at least one year following the event, more than 70% will continue to experience long-term disabilities.
Stroke is divided into three distinct phases: acute, subacute, and chronic phases. The acute phase of stroke occurs within 24 hours of the actual ischemic event. The subacute phase starts at 24 hours and lasts up to 3 months. The chronic phase of stroke, by definition, starts at 3 months.
While stroke patients tend to see some response to rehabilitation efforts occurring in the chronic phase, they tend to quickly plateau, leaving many with serious chronic neurological and functional disabilities. To date, there are no approved treatments for the chronic phase of stroke.
For the purposes of this study, Steinberg et al. report the two-year outcomes of their phase 1/2a study examining chronic stroke patients after implantation of mesenchymal stem cells (MSCs). This study specifically examined the outcomes of 18 patients who were at least 6 months post-stroke onset and had chronic motor deficits secondary to the nonhemorrhagic stroke.
At the 1-year point of this study, the authors reported the implantation of bone marrow-derived MSCs (BMD MSCs) was generally safe, well-tolerated, and associated with significant improvement in clinical outcomes.
There were no correlations between improvement in clinical outcomes and cell dose, baseline patient age, or baseline stroke severity. However, two years after implantation of MSCs, those enrolled in this study experienced significant improvement in motor impairment scales as indicated by a number of scores, including the ESS, NIHSS, F-M total, and FMMS scores.
Although all enrolled patients experienced at least one Treatment-Emergent Adverse Event (TEAE), with headache and nausea being the most common, 94.4% of the TEAEs were determined to be unrelated and no one withdrew from the study.
Interestingly, the authors reported that there also appears to be a significant correlation between the size of newly appearing transient lesions primarily in or adjacent to the premotor cortex – a finding that remained consistent at month 12 and month 24 of this study.
While Steinberg et al.’s reported findings are encouraging, the authors point out that the small scale and uncontrolled study design mean the findings should also be interpreted with caution.
Steinberg et al conclude that their findings associated with this completed, open-label, single-arm phase 1/2a study was consistent with the data at the 1-year point and indicated that treatment of chronic stroke with BMD MSCs after 2 years continued to be safe and was associated with sustained and significant improvements in clinical outcomes.
Given the findings of this study, the authors highlight the potential of MCSs, and specifically SB623 cells used in this study, as a potential treatment for patients with chronic ischemic stroke.
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