Rehabilitation for Every Kind of Stroke
A stroke is a life-changing medical condition that can bring many challenges to your life. At University of Utah Health, our Stroke Rehabilitation Program will give you or your loved one a personalized rehabilitation plan to help build the foundation for a meaningful recovery. Our highly trained stroke specialists understand the obstacles that you are up against and will support you every step of the way. We give our patients the best available therapies and treatments to adapt to this new normal on their journey towards rehabilitation.
Two Types of Strokes
We divide the term stroke into two general categories: ischemic and hemorrhagic.
An ischemic stroke is a clot-based stroke that forms in the brain or elsewhere in the body and blocks an artery. Ischemic strokes are caused by two types of clots — a thrombus (a clot that forms inside the brain) and an embolus (a clot that forms outside the brain and enters the brain through your bloodstream). Ischemic strokes represent about 85 percent of all stroke cases.
When an artery bursts within the brain, a hemorrhagic stroke can occur. Arteries can burst one of two ways:
- Due to risk factors such as hypertension (high blood pressure) or
- burst spontaneously and hemorrhage (bleeding).
This type of stroke is less common and accounts for 15 percent of stroke cases.
Effects of Stroke
Each person is affected differently by a stroke. This largely depends on where the stroke took place. Strokes most often effect four main regions of the brain, which include the:
Left Hemisphere Stroke
Damage to the left hemisphere will often affect a person’s speech, language, and can also paralyze the right side of his or her body. A left hemisphere stroke may lead to expressive aphasia or receptive aphasia. When language abilities are lost but cognition remains intact, this is called expressive aphasia. Contrarily, people with receptive aphasia will have problems such as:
- difficulty reading or speaking,
- producing nonsense speech, and
- a poor understanding of their language problems.
Right Hemisphere Stroke
For strokes that affect the brain’s right hemisphere, a person may be paralyzed on the left side of the body or have impaired cognitive abilities such as a lack of impulse control and judgement. For example, a person may not know how to avoid falls and injuries. These deficits can be subtle, but they are significant both to the stroke survivor and their family and friends. However, a high quality of life can still be achieved with treatment from your rehabilitation team.
Subcortical strokes affect the small vessels deep in the brain, and typically cause motor hemiparesis (one-sided weakness of the body) affecting the face, arms, and legs. Nearly 30 percent of all ischemic strokes are subcortical, and include lacunar infarcts (strokes caused by blocked arteries in a deeper part of the brain), which have the best prognosis.
Patients with brainstem strokes typically retain their cognitive skills. However, this type of stroke will often result in the following symptoms:
- one-sided weakness (hemiparesis),
- swallowing problems (dysphagia),
- double vision (diplopia),
- poor coordination (ataxia), and
- dizziness (vertigo), which could lead to severe nausea.
Our Stroke Quiz
How much do you know about stroke? Learn to recognize stroke signs and symptoms.
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Learn More About the Patient Experience For Stroke Recovery
Stroke In Young Adults
Young stroke survivors often face challenges unique to a younger population because of their stage of life. While their symptoms do not differ despite their age, they frequently cope with higher demands placed upon them to due to an expectation of greater resiliency and vitality. We take this into consideration in all areas of the rehabilitation program when working with younger populations.
Stroke Complications That Effect Your Health
Dysphagia (swallowing problems) is common after stroke, as the event damages a person’s ability to coordinate movement in the throat. Swallowing food or liquid down the “wrong pipe” (the trachea that leads to the lung) is known as aspiration and can lead to aspiration pneumonia. Silent aspiration means the stroke patient does not cough, gag, choke, or have any other outward signs of difficulty. Much of this can be addressed durring speech language therapy and utilizing swallowing technology like FEES (flexible endoscopic evaluation of swallowing).
Infections, like bladder infections and IV line infections (when the bloodstream is infected with germs that enter the body through an intravenous tube), are also common, though usually quite simple to treat with antibiotics. A urinary tract infection (UTI) is the most common type of infection.
Most people worry about having another stroke but the probability of a second stroke is about 10 percent within three years. However, stroke risk does increase with age.
Deep Vein Thrombosis & Pulmonary Emboli
When one or more body parts is paralyzed due to inactivity of the limb, blood is more likely to start pooling inside the veins and form clots called deep vein thrombosis. If deep vein thrombosis occurs, the clots can break off, travel through the bloodstream, and get caught in the lungs, which is called a pulmonary embolism. This is rare but may be life-threatening.
This occurs when your brain interprets normal everyday sensations as pain without any injury to the skin. Neuropathic pain can feel like a numb, tingly sensation, similar to a wire brush touching the skin, or, in extreme cases, broken glass rubbing on the skin.
Most people who experience neuropathic pain begin to feel mild sensory changes about two to four weeks after a stroke. The good news is medications and methods exist for alleviating this pain.
The shoulder on the weak, hemiplegic (one-sided paralysis) side typically experiences this type of pain. Most people avoid using their weak arm because their shoulder is in too much pain. This can limit participation in rehabilitative activities and impair function.
Shoulder subluxation (dropping) is initially present because the whole shoulder is weakened by the stroke. A few weeks later, spasticity (muscle over-activity) develops and overtightened muscles may further limit normal movement.
Ideally, management should begin with careful efforts to prevent shoulder pain from occurring in the first place. Poor handling of the affected limb is thought to play a role in contributing to later shoulder pain. Care should be taken in transferring (from bed to chair, etc.) and handling the weak arm and shoulder.
Treatment options to alleviate this shoulder pain and increase range of motion include:
- over-the-counter pain medications,
- joint injections with corticosteroids,
- botulinum toxin injections to relax tight, spastic muscles,
- neuromuscular electrical stimulation of the shoulder muscles, and
- stretching and strengthening program with a physical therapist.
It is important to recognize and monitor your mood and emotions. If needed, seek help from your family, friends, or doctor. Effective treatment typically includes:
- exercise, and
- support groups.
Spasticity & Hypertonia
The muscles on the weak, hemiplegic (one-sided paralysis) side may start to get tight around two to four weeks after a stroke. If you don’t address symptoms of spasticity (muscle over-activity) or hypertonia (too much muscle tone that makes it stiff or difficult to move) with your rehabilitation team, your muscles will continue to tighten up and further restrict your ease of movement.
At U of U Health, we offer a spasticity management program with an array of treatment options to explore.
Meet with One of Our Stroke Specialists
We accept self-referrals and referrals from family members to be admitted to our program. A doctor referral is not necessary. Please call our referral line at 801-646-8000 to be seen by one of our stroke specialists. Our administrative staff will work with your current provider to obtain necessary medical records and verify your insurance benefits for coverage.