Ask The Stroke Doc

If you would like more information about stroke rehabilitation, stroke research, or stroke outcomes, questions can be directed to the email address: askthestrokedoc@ric.org.

While we will attempt to answer each question individually, answers to selected questions that are of general interest to stroke survivors and their families will be posted on this page. Your name or email address will not be used.

Ask the Stroke Doc Answers and Questions

Disclaimer
"Ask the Stroke Doc" is an informational program provided by the Rehabilitation Research and Training Center on Technology Promoting Integration for Stroke Survivors: Overcoming Societal Barriers. All information posted on the "Ask the Stroke Doc" site is provided exclusively for informational and educational purposes. The information provided is not intended for diagnosis or treatment of any medical condition and should not be interpreted as medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition.

Question:

Are there any exercises that I as a caregiver can do with a stroke survivor to enhance their therapy?

Answer:

It is very valuable for caregivers to assist and participate in a regular home exercise program with a stroke survivor. Your enthusiasm and encouragement can be very motivating. It is difficult to recommend any specific therapy without knowing the specifics of the stroke survivor's condition, but if she is still in therapy, a physical therapist or occupational therapist could show you some exercises. Just attend a session sometime if you haven't already.

One particular area that is often difficult for a stroke survivor to exercise on their own is the shoulder on the weak side. Caregivers can be very valuable in helping with this, and again, the physical and occupational therapist can show you what to do.

Question:

My elderly father recently had a stroke. After being evaluated it was suggested that he go to a subacute rehabilitation center. I thought if he could handle it physically, he would get better rehabilitation in an acute rehabilitation facility. Can you tell me what the difference is between the two?

Answer:

Both subacute and acute rehabilitation programs share the common approach of being team-driven, interdisciplinary, physician-directed, and focused on functional improvement. This means that in both types of programs, many therapies are provided in a coordinated fashion to promote independent functioning. The difference is in the amount of therapy that is typically provided: In acute rehabilitation, usually 3 to 6 hours of therapy services are provided per day on average, while in subacute rehabilitation, usually 1 or 2 hours of therapy per day are provided. The decision regarding which program to choose is usually based on how much therapy a patient can tolerate. If the patient is able to sit up and participate in an exercise program for 3 hours or more, then it is likely that Acute Rehabilitation may be the better choice. Sometimes, patients start in one of those programs, and move to the other. However, programs, patients, and situations vary, and the specific decision should be based on your particular circumstances.

Question:

I would appreciate information on stroke related dementia. My mother has a stroke four years ago. She is now experiencing increased agitation and short term memory loss.

Answer:

The most common syndrome related to stroke that is associated with a dementia-like presentation is that of multi-infarct dementia. Simply put, this is repeated small strokes that cumulatively result in dementia. Multi-infarct dementia can affect several cognitive and behavioral functions with individual variation depending upon the areas of the brain being damaged. Multi-infarct dementias usually progress in a "step-wise" fashion, meaning a person may have rather distinct points of decline correlated with the occurrence of another small stroke. Depending upon any underlying conditions that might increase risk of stroke, an individual can stabilize and not get worse for some time. Multi-infarct dementias are managed much in the same way as stroke prevention is described. An individual's risk factors for stroke should be assessed and monitored to decrease progression, such as use of anti-coagulant therapy.