REHABILITATION
Exercises, cognitive and perceptual stimulation, speech related activities, psychological counselling, lectures on topics related to stroke and social activities are offered by the Helderberg Stroke Support Group. This generally takes place in a group setting. Occupational therapists, physiotherapists, psychologists, speech therapists and other health professionals give input at the rehabilitation groups. Trained assistants and volunteers help at the groups.
TRAINING
This is done by rehabilitation therapists with a special interest and experience in stroke rehabilitation and is directed at home based carers, nursing staff and volunteers who are interested in assisting stroke survivors in their communities. The following aspects are covered: General information on stroke, risk factors, stroke prevention, speech impairments, mobility, cognitive and perceptual impairments and home care.
THERAPY
Rehabilitation usually starts in the first few days after a stroke when the stroke survivor is generally still hospitalised. Recovery depends on the brain's ability to reorganize its undamaged cells and make up for what has been lost. This is called neuroplasticity.
Rehabilitation potential is influenced by the severity of the stroke and the extent of the resulting impairments. Everyone experiences different problems depending on the areas of the brain which have been affected. People also recover at different rates.
Rehabilitation is a slow process and much repetition of exercises /movements is required in order to create new pathways in the brain. It is important to take every opportunity to exercise and repeat new skills until they become automatic.
Depending on their needs, the involvement of the following team members may be required in the rehabilitation of a stroke survivor: doctors, nurses, physiotherapists, occupational therapists, speech and language therapists, audiologists, psychologists, social workers, dieticians, prosthetics and orthoptists. See more info below:
One of the many devastating effects of a stroke or “brain attack” is the loss of speech & language, because it means a loss of the ability to maintain human relationships, convey wants and needs and live as a dignified, self-reliant, connected person. This leads to loneliness, frustration & depression. Speech Therapists can assist in the following areas:
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Help the stroke survivor to comprehend and communicate more effectively and ultimately to function better in his / her environment. Exercises and brain stimulation tasks can help to improve function.
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Strategies can be taught to compensate for lost function.
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The speech therapist may recommend alternate means of communication, such as pictures, alphabet charts or electronic devices.
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The speech therapist can assist with problems with swallowing, by providing information about posture and head positions and changes in texture of food and liquids which can enhance the ability to swallow.
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Exercises can be done to improve swallowing and make it safer.
Occupational Therapists use meaningful activities to assist stroke survivors to maximise their functioning and empower them to be as independent as possible.
The Occupational Therapist (OT) assists in the following areas:
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Evaluation and treatment of physical, sensory, cognitive, perceptual and visual impairments.
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Activities of daily living: (e.g. Dressing, bathing, personal care). The therapist will evaluate and assist the stroke survivor to do as many activities as they can independently. This might involve adapting how the activity is done or suggesting appropriate assistive devices to enhance abilities.
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Work. The OT plays an important role in determining the person’s ability to return to work and where possible, facilitating the process in consultation with the stroke survivor, employer and relevant role players.
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Hobbies and Leisure activities: The therapist will assist in adapting, altering or suggesting alternative leisure tasks after stroke.
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Driving: The OT plays an important role in determining the person’s ability to drive safely after the stroke and in making recommendations in terms of adaptations which may be necessary.
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Assistive devices. The OT will make recommendations with regard to assistive devices required to improve mobility and independence. (e.g. Wheelchairs /bath aids.)
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Home Modification: The OT will make recommendations on adaptations to make the home safe and accessible (e.g. Ramps /grab rails etc.)
The role of the physiotherapist is to promote the return of normal function, so that the stroke survivor can continue to participate in meaningful activities. The physiotherapist is there to guide the person through the correct positions and exercises which will promote optimal recovery.Rehabilitation may include:
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Helping the stroke survivor to perform basic movements, such as rolling over, getting out of bed, and walking.
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Specific exercises to strengthen weak muscles.
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Balance re-education.
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Instruction on how to use walking aids safely.
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Teaching the stroke survivor new ways to complete tasks.
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Gentle massage and exposing the skin to different textures and temperatures to promote sensory function
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Correct positioning and specific stretching to inhibit spasticity and prevent shortening and tightness of the soft tissues.
Dieticians play an important role in educating stroke survivors and their families on appropriate diet which can assist in the prevention and management of illness.
They can play an important role in the modification of risk factors for stroke –advising on the correct diet for weight loss, lowering cholesterol, reducing salt intake, appropriate meals for diabetics etc.
They can evaluate the nutritional needs of stroke survivors and implement appropriate diet plans accordingly.
They collaborate with other health professionals in evaluating and managing swallowing disorders.
Psychologists can assist the stroke survivor and his/her family adjust to the changes brought on by stroke.
They can assess behaviour, thought , memory and other aspects of brain functioning, which can help the stroke survivor and his /her loved ones better understand what has changed in the person and why. They can also provide important information with regard to day –to- day living, assess whether the person is able to continue to work and/or to drive a car and whether he/she can take care of him - or herself.
