Each year, more than 10,000 people are admitted to Singapore hospitals for stroke. It is the number 4 killer after cancer, heart diseases and pneumonia.

 What is post-stroke rehabilitation?

An estimated two-thirds of these individuals survive the stroke and require rehabilitation. The goals of rehabilitation are to help survivors become as independent as possible and to attain the best possible quality of life. Although rehabilitation cannot reverse brain damage of stroke patients, it can substantially help them achieve the best possible long-term outcome.

Rehabilitation helps stroke survivors relearn skills that are lost when part of the brain is damaged. For example, these skills can include coordinating leg movements in order to walk or carrying out the steps involved in any complex activity. Rehabilitation also teaches survivors new ways of performing tasks to circumvent or compensate for any residual disabilities. Patients may need to learn how to bathe and dress using only one hand, or how to communicate effectively when their ability to use language has been compromised.

When will rehabilitation begin?

Rehabilitative therapy begins in the hospital after the patient's medical condition has been stabilized, often within 24 to 48 hours after the stroke. The first steps involve promoting independent movement because many patients are paralyzed or seriously weakened. Patients are prompted to change positions frequently while lying in bed and to engage in passive or active range-of-motion exercises to strengthen their stroke-impaired limbs. Patients progress from sitting up and transferring between the bed and a chair to standing, bearing their own weight, and walking, with or without assistance. Rehabilitation nurses and therapists help patients perform progressively more complex and demanding tasks, such as bathing, dressing, and using a toilet, and they encourage patients to begin using their stroke-impaired limbs while engaging in those tasks.

For some stroke survivors, rehabilitation will be an ongoing process to maintain and refine skills and could involve working with specialists for months or years after the stroke.

What disabilities can result from a stroke?

The types and degrees of disability that follow a stroke depend upon which area of the brain is damaged. Generally, stroke can cause five types of disabilities: paralysis or problems controlling movement; sensory disturbances including pain; problems using or understanding language; problems with thinking and memory; and emotional disturbances.

Paralysis is one of the most common disabilities resulting from stroke. The paralysis is usually on the side of the body opposite the side of the brain damaged by stroke, and may affect the face, an arm, a leg, or the entire side of the body. These patients may have difficulty with everyday activities such as walking or grasping objects. Others may have problems with swallowing or the ability to coordinate movement, leading to problems with body posture, walking, and balance.

Stroke patients may lose the ability to feel touch, pain, temperature, or position. Sensory deficits may also hinder the ability to recognize objects that patients are holding and can even be severe enough to cause loss of recognition of one's own limb. Some stroke patients experience pain, numbness or odd sensations of tingling or prickling in paralyzed or weakened limbs.

Stroke survivors frequently have a variety of chronic pain syndromes resulting from stroke-induced damage to the nervous system (neuropathic pain). Patients who have a seriously weakened or paralyzed arm commonly experience moderate to severe pain that radiates outward from the shoulder.

The loss of urinary continence is fairly common immediately after a stroke and often results from a combination of sensory and motor deficits. Stroke survivors may lose the ability to sense the need to urinate or the ability to control muscles of the bladder. Some may lack enough mobility to reach a toilet in time. Loss of bowel control or constipation may also occur.

Where can a stroke patient get rehabilitation?

Patients may sign up for stroke rehabilitation programs at rehabilitation centres at community hospitals, polyclinics or specialized rehabilitation centres. They typically spend several hours, often 3 to 5 days each week, at the facility taking part in coordinated therapy sessions and return home in the evening. Rehabilitative services are also available at nursing facilities where residential care is emphasized.

Home rehabilitation is also an alternative. Stroke survivors may participate in an intensive level of therapy several hours per week or follow a less demanding regimen. These arrangements are often best suited for people who lack transportation or require treatment by only one type of rehabilitation therapist. Undergoing treatment at home gives people the advantage of practicing skills and developing compensatory strategies in the context of their own living environment.

What rehabilitation programs does UniQue Hydrotherapy offer?

UniQue hydrotherapy has been used extensively for the rehabilitation of stroke patients. The treatment is excellent for patients who suffer partial immobility. The massaging effects of bubbles, together with deep penetration of far infrared rays and ultrasound, promotes blood circulation. This rehabilitation process is automatic and the intensity of the massage can be tuned according to the patients' conditions. For any patient, the frequency of treatments matters, it determines the time taken for recovery. We provide two options for the convenience of our clients:

·         Treatment at our centre. Patients sign up for a stroke recovery package and come for treatments regularly at our centre.

·         Treatment at home. Patients rent or purchase UniQue hydrotherapy equipment so that they can perform the treatments in the comfort of their own homes.

Talk with us and we shall recommend the program that is most suitable to your needs.

We work with GPs and clinics to jointly monitor the recovery of stroke patients. GPs who send their patients to us for hydrotherapy treatments are encouraged to perform their independent assessments of their patients after certain duration of hydrotherapy treatments.

Additional Resources

National Stroke Association
http://www.stroke.org

American Stroke Association: A Division of American Heart Association
http://www.strokeassociation.org