Motor Learning/Motor Control
There are advances in stroke rehabilitation that significantly assist stroke patients in gaining mobility and independence.
According to the American Heart Association, a stroke occurs when a blood vessel that carries oxygen and nutrients to the brain cannot get the blood and oxygen it needs, so it starts to die.
When a person suffers a stroke, it usually means altered facial expressions and loss of function on one side of the body and sometimes speech impairment, depending on the area of the brain that is affected.
Until recently, it was believed that once the brain was injured, as in the case of a stroke, the damage was permanent. However, recent studies have demonstrated the plasticity of the brain and its ability to "rewire" itself after injury.
Most of the studies have determined that this "rewiring" of the brain comes as a result of re learning the lost functions through increased and repetitive use.
The involved extremities in a stroke are "flaccid" or very weak, or show "spasticity", an abnormally increased muscle tone, or a mixture of both. In any case, the patient will have a difficult time using the involved side's arm and leg to perform any of their daily activities.
Undergoing physical, occupational, and speech therapy helps restore these lost functions. However, rehabilitation focuses on making the patient functional, this means teaching the patient to walk, get in and out of bed, feed, and dress themselves, even if it requires having to compensate with the uninvolved side to do most of the work.
Depending on the severity of the stroke, patients can fully recover their ability to perform their daily activities independently as in the case of a mild stroke, or they may become disabled in varying degrees as in the case of a more severe stroke.
Initially after the stroke, therapy is usually given for a few hours daily for 4 to 8 weeks as an inpatient either at the hospital or rehabilitation facility. Once the patient goes home therapy is given for one to two hours two to three days a week for a few months to a year. The current treatment methodologies do not emphasize the constant engagement of the affected side in the therapy, mainly because time restrictions and insurance reimbursement issues which focus on functional gains.