It is widely accepted that physiotherapy following a stroke can significantly improve function and mobility (ability to walk), and research confirms this (Pollock et al., 2014). But what does research have to say about the duration of therapy – for what length of time should one undergo therapy and still see improvements? The following article seeks to shed some light on this subject.
Stroke is defined as “…A neurological deficit attributed to an acute focal injury of the central nervous system (CNS) by a vascular cause…) (Ralph, L. et al. 2013). This can result in various impairments in functional activities, mobility, speech and cognition.
The (British) National Clinical Guidelines for Stroke (1016) is an evidence-based and comprehensive overview on appropriate management of stroke. This resource notes that stroke affects individuals differently, and while some may recover fully in a short period of time, others can experience impairments in daily activities for months or years, and symptoms can worsen as time goes on due to changes in priorities.
A key recommendation with regards to rehabilitation, is that those living with stroke should receive 45 minutes of therapy appropriate to their needs every day at a rate which facilitates reaching their functional goals for as long as they are willing and able to participate, and continue to show a benefit from treatment. There is often a big focus on rehabilitation in the first few months when a stroke occurs, however long term rehabilitation is often insufficient, and does not meet the needs of those living with stroke. As time goes on, the focus of rehabilitation may change, but should not end just because there appears to be a plateau in natural recovery. (Intercollegiate Stroke Working Party, 2016).
The overall evidence available suggests that rehabilitation remains beneficial for long term stroke survivors, and that physical activity programs have a positive effect on overall disability, particularly for those who are able to walk (English C and Hillier SL 2010; Saunders et al, 2016).
If you are interested in finding out more about rehabilitation following a stroke, or would like to make a booking, you can make contact with us with the following details.
Email: info@wellspringcentre.co.za
Contact number:(+27) 21 785 7200
Website: www.aptherapists.co.za
References
Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, Pomeroy VM, Langhorne P. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database of Systematic Reviews 2014, Issue 4. Art. No.: CD001920. DOI: 10.1002/14651858.CD001920.pub3.
Ralph L. Sacco, Scott E. Kasner, Joseph P. Broderick, Louis R. Caplan, J.J. Connors, Mitchell S.V. Elkind, Mary G. George, Allen D. Hamdan, Randall T. Higashida, Brian L. Hoh, L. Scott Janis, Carlos S. Kase, Dawn O. Kleindorfer, Jin-Moo Lee, Michael E. Moseley, Eric D. Peterson, Tanya N. Turan, Amy L. Valderrama and Harry V. Vinters. An Updated Definition of Stroke for the 21stCentury (2013).
Intercollegiate Stroke Working Party National clinical guideline for stroke. 5th. London:: Royal College of Physicians; 2016.
Saunders DH, Sanderson M, Hayes, Kilrane, M. Greig, CA., Brazelli, M, Mead GE. Physical Fitness Training for Stroke Patients. Conchrane Database Systematic Reviews 2016 Mar 24;3:CD003316. doi: 10.1002/14651858.CD003316.pub6.
English C, Hillier SL. Circuit Class Therapy for Improving Mobility after Stroke. Cochrane Database Systematic Reviews 2010 Jul 7;(7):CD007513. doi: 10.1002/14651858.CD007513.pub2.
n Neuroscience Education. ACT is based on the idea that pain in life is inevitable and instead of explaining, changing or reframing pain, willingness is the way to make peace with and detach from pain.
