Every year in the United States, more than 700,000 people have a stroke. We spoke with rehabilitation physician Edward S. Claflin, M.D., about the types of rehabilitation offered through U-M’s Stroke Rehabilitation Program and what to expect if you or a loved one need these services.
When should a patient begin stroke rehabilitation?
There is no fixed timeline, but starting rehabilitation within several days after a stroke usually gives patients the best chance to maximize their recovery.
The medical or surgical team will ask for rehabilitation assessments by therapists as soon as it is deemed to be safe, and these therapists will continue to see patients in the hospital until they move to the next level of rehab.
How does stroke rehabilitation benefit patients?
Stroke patients will have some natural recovery without rehab, but there is much evidence that formal rehabilitation helps patients recover faster and better than they would otherwise. Our goal is to help patients achieve their best level of function after the stroke.
Does every patient need stroke rehabilitation?
Every patient will have a unique experience, and our staff develops an individualized rehabilitation plans for each person.
Some patients see a quick resolution of their symptoms and need very little or no rehab, while others may need many months of rehabilitation to reach their best level of function.
There is increasing evidence that people can continue to improve up to and beyond a year after suffering a stroke. Our individualized rehabilitation plans provide therapy throughout this critical period of recovery.
What are the different levels of stroke rehabilitation?
Acute rehabilitation, which often begins shortly after the stroke occurs, is for patients who have significant disabilities. The patient is evaluated by a number of rehabilitation providers, such as physicians, a physical therapist, a speech therapist, and so on, depending upon needs. The patient typically participates in 3 to 4 hours of therapy per day, 6 or so days per week, for 2 to 3 weeks. This team then develops specific rehab goals and a timeline for transitioning to another rehab setting or back home.
We typically encourage people to bring clothes from home so they can practice dressing. We will sometimes even go out to the person’s home before discharge to make sure they’ll be well prepared.
The next level, subacute rehabilitation, is usually provided in community facilities such as nursing homes, which offer 1-2 hours of therapy per day.
If patients are home bound and meet the criteria for a home health program, rehabilitation services can be provided in their homes by providers who usually visit patients 2 to 3 times per week.
If patients are more mobile, they can go to an outpatient rehabilitation program 2 to 3 times a week where they will have the benefit of newer, better equipment than they would have at home.
Patients who are out of the hospital can visit their doctor in clinic to collaboratively develop an individualized rehabilitation program.
What types of stroke rehabilitation does U-M offer?
At the U-M Acute Stroke Rehabilitation Program, we offer all levels of programs through a variety of services, including daily physician visits, occupational therapy (for daily living skills such as dressing, eating and bathing), physical therapy, speech-language therapy (for cognition, language skills and swallowing) recreational therapy, rehabilitation psychology, orthotics (for bracing) and social work services.
Our physicians are also active in going to subacute rehab facilities in the region to assist in meeting the needs of those patients. And we have a wonderful outpatient multidisciplinary stroke program that incorporates all the types of providers I’ve mentioned for patients well enough to travel from home.
What are your final words about stroke rehabilitation?
Stroke rehabilitation is not a “one-size-fits-all” kind of program. Just as every patient is different, every stroke is different. We match patients’ tolerance for rehabilitation and their rate of improvement with the amount of therapy they receive through our extremely comprehensive program. No matter what type or level of disability they experience after a stroke, we are able to address their needs.
While not every patient will have a complete recovery, our ultimate goal is to get stroke survivors back home and living happy, healthy lives.
- Learn more about U-M’s Acute Stroke Rehabilitation Program
- Learn more about U-M’s Comprehensive Stroke Program
Edward S. Claflin, M.D., is a clinical lecturer in Physical Medicine & Rehabilitation and specializes in neurologic rehabilitation. Dr. Claflin is passionate about treating stroke patients with the latest and best rehabilitation, resources and care. His research interests include stroke rehabilitation, electromyography (EMG) and resident education.
The University of Michigan Health System’s Comprehensive Stroke Program holds the official certification of Comprehensive Stroke Center, granted by the Joint Commission accrediting organization and recognized by the American Heart Association and American Stroke Association. Fewer than 100 other hospitals in the country have achieved this elite status.