Hope and rehabilitation: Life after a stroke

Actor Mithun Chakraborty recently suffered a stroke shining a light upon a medical condition that is a major cause of mortality and morbidity. Studies indicate that 70% of strokes occur in low and middle-income countries (LMICs). In India, stroke ranks among the top five reasons for disability as well as death. According to a Lancet study, India recorded 13 lakh cases of stroke in 2019. This is the highest in any Southeast Asian country. 

Dr Gaurish Kenkre, General Manager and Center Head, Atharv Ability- a Mumbai based neurological rehabilitation centre speaks to us about the impacts of stroke. 

What are the reasons for a growing number of strokes? 

An increase in sedentary lifestyle, unhealthy eating habits, inadequate exercise and sleep, and high stress levels are among the top contributing factors for stroke. Stroke is a life-changing event not only for the patient but also for their near and dear ones. 

What are the major impacts of a stroke? 

The debilitating effects of stroke depend on the severity of the stroke episode and the organs affected. Some of the most common long-term effects include: cognitive symptoms like memory problems and trouble in speaking; physical symptoms such as weakness, paralysis, and difficulty in swallowing; emotional symptoms like depression and impulsivity; heavy fatigue and trouble sleeping. Stroke can affect activities of daily living in multiple ways, including impairment of mobility, speech, memory and concentration. Patients may require adjustments to perform even the most simple routine activities, such as dressing, eating, brushing hair, and communicating.

Do strokes impact the quality of life permanently? 

Modern-day advancements in stroke treatment and innovative technology-driven rehabilitation therapies have shown significant improvements in patient outcomes and the quality of life for survivors. Hence, it is important for patients to believe that a stroke episode is not the end of life. Stroke episodes demand immediate medical attention. Delay in treatment can lead to more severe disabilities and in some cases, even death. Rehabilitation and therapy can help patients regain function and adapt routines to work around the challenges. 

How long is the road to recovery? 

This is a unique journey for each patient and one that depends on factors such as the severity of the stroke, the affected area, and the availability of medical intervention and rehabilitation facilities. Once a patient is out of hospital care, the recovery journey often requires a combination of physical therapy and occupational therapy. In addition, various neurological rehabilitation therapy approaches including robotics, aqua therapy, speech therapy, and pain management have demonstrated great results in accelerating patient recovery. These interventions aim to help stroke survivors regain cognitive functions like balance, coordination, strength, mobility, and achieving communication effectiveness. Additionally, stroke patients typically experience limited mobility, which is why it is beneficial for them to receive neuro rehabilitation at centers that offer all therapies under one roof. Rehabilitation can have a positive impact on a patient’s self-perception and attitude towards their condition. It also reduces dependence on family members or caretakers, increases functional independence, and prevents complications such as stiffness in the shoulder, wrist pain, or instability in the ankle and knee. After a stroke, patients should focus on rehabilitation and finding ways to regain independence, while cherishing moments of progress and improvements. 

The rehabilitation part of life after a stroke can be compared to learning a new dance, where every move is different, and each move requires practice. With adequate practice and adoption of the latest rehabilitation methods, there is a high chance for patients to lead a normal lifestyle – however, patience is the key. 

What are the major roadblocks experienced on the path to recovery?

Stroke patients and their families often expect accelerated recovery and feel overwhelmed in the face of setbacks. Coping with the sudden changes in physical abilities and lifestyle can be emotionally overwhelming, and setbacks such as depression and lack of family support can have an even more detrimental impact on a patient’s health. Many stroke survivors experience feelings of sadness, hopelessness, anxiety and a low sense of self. The transition from an independent, active life to one with limitations can lead to feelings of loss and frustration. Stroke survivors may withdraw due to embarrassment or fear of judgment. Hence, it is necessary to focus equally on the mental health of patients to further improve the effectiveness of rehabilitation efforts. Also, practicing functional activities in therapy sessions is important to stimulate interest in these patients. In conclusion, stroke recovery is a multifaceted journey. It requires resilience, patience, and a strong support system.