Thursday, November 8, 2012

Therapy is upside down.

When a survivor first has their stroke the brain is very vulnerable. And because it's vulnerable the survivor shouldn't do very much. The first few days after stroke is a time to convalesce. There is a time to add intensity to the recovery effort. But during the first few days, generally referred to as the acute phase, is not when intensity should be attempted. There are more important things to do. Like saving as much brain is possible (the domain of medical doctors).
So what do therapists do during acute phase? Most therapists involved in acute care will tell you the same thing: "We do whatever they can." That is, whatever the patient is physically able to do is encouraged. But there is often not very much the stroke survivor can do. Yet therapy immediately after stroke is generous. There is often hours per day slated for acute care therapy. But that's not when hours are needed. Hours are needed during the subacute phase.

The subacute phase is usually defined as "seven days to three months." But this is actually a misrepresentation. The fact is, like anything with stroke, it's different for every survivor. Each phase, in fact, happens in a different time for each individual survivor. In any case, it's the subacute phase when intensive efforts towards recovery should begin. Yet for many stroke survivors there's actually a reduction in the number of hours of therapy during the subacute phase as compared to the acute phase. In this way, therapy for stroke survivors is upside down.

By: "stroke recovery blog" "stroke blog"


Bert R said...

Very good points-I totally agree. I would go on to say, that more intense therapy after the healing-once the person has recovered from the shock of the loss and realizes he/she has years of life ahead -is very beneficial-much beyond the "what you get back in 6 months is it" idea. People work when they believe they have something to work for.

Tamara said...

I feel I made most progress in the second and third year after my stroke. At first I was too shocked that all of a sudden I wasn't sexy anymore, but disabled. I was so ashamed when I returned to work. My job was too stressful for me to return to, so I left, very quietly and for a while I chose to hide, but now I'm ready to get my life back and I work harder to recover. Fortunately it pays off. Good to read that every recovery is different. Therapists have told me so many times that what I don't have back within a year most likely will be lost forever. But thanks to your book I know this isn't true, so I keep reminding myself that I'm a super survivor who doesn't give up.

Anonymous said...

I wish more insurance providers would learn your lesson! I am amazed at how long I continued -and still continue to this day- to make improvements. There is one priceless thing not offered during most phases: Hope. Thanks for sharing with people that regardless of the acute or sub-acute phase there is still progress that can be made!

SerenityFarmNM said...

I am posting here in desperation. I am 20 months post stroke @ age 39 & I've made little/no recovery. I am sure I am not going to be able to continue to fake "emotional" recovery. I'm ready to give up. I need help finding online support group or something.

Peter G Levine said...

SerenityFarmNM, please feel free to email me at: strongerafterstroke (at)


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