Written by Leah Oswald, January 2018
The Australian National Clinical Guidelines for Stroke Management have recently been updated. The guideline provides an overview of the best treatment currently available, to help us as clinicians provide you with the best quality care we can. Let’s explore what this could mean for you and your rehabilitation after surviving a stroke.
The importance of early rehabilitation
The key in the early phases of rehabilitation is to start to get moving again, the guidelines want you to start within the first 24-48 hours! Hospitals can be a hive of activity and you would have had lots of different clinicians coming to help you with your therapy. Often Physiotherapists and
Occupational Therapists work closely together to help you improve your mobility and function of everyday tasks – the guideline suggests that a minimum of 3 hours a day should be spent on these activities. That may sound like a lot, but it doesn’t have to be done all in one session. Fatigue has an affect on the quality of your therapy and you should try and do your therapy in times throughout the day where you feel more alert.
Take charge of your own health
We don’t want your progress to stop once you’re ready to come home. Your therapy schedule may look and feel different, but it is important to keep building on everything you have achieved so far. As much as we would love to see you every day, it is your turn to take a more pro-active role in completing your therapy. Part of how we, the clinicians, can assist you with this is to empower you by providing you with the information and education you need to help understand your stroke and the factors affecting your journey.
Set your goals clearly and adjust them as life goes
Setting goals for your recovery helps. You and your therapist should take the time to discuss what matters to you and develop clear goals that we can work towards together. You may find it helpful to involve your family members or carers especially if they are able to assist you with your daily therapy. The goals you choose to set should be well-defined, specific and challenging.
Don’t forget that as your rehabilitation progresses and changes, so will your goals – we should be regularly reviewing and updating them along the way. It’s also a nice way to see your progress as it’s sometimes easy to miss the little things or see how far you’ve come! There is no one recipe to follow when it comes to therapy for stroke survivors – strokes affect people in different ways so it is important your therapy is individualised to you.
Repetition and practice with graded difficulty and variety
Your clinician will be able to work with you ensuring your therapy is specific to your needs and goals. The guideline emphasises the importance of repetition or part practice of tasks that you are finding difficult. This could mean working on your sitting balance, perfecting your walking or practicing the elements that make up these tasks.
Therapy can also target specific impairments that are making it hard for you to master the tasks we are working. Common impairments include weakness, changes in sensation, changes in your spatial awareness or difficulty executing movements. The guideline expands on these topics to give therapist the latest evidence to assist treating these impairments. Cardiovascular fitness also plays a vital role within your rehabilitation and it is shown to have carry over effects on your overall ability and improves walking. Additionally, it is one of the elements in secondary prevention – other preventative measures the guideline recommends include life modifications around smoking, diet, weight and alcohol.
If you would like to know more, you can find the guidelines here, or feel free to speak to one of us.
The National Stroke Foundation Clinical Guidelines, 2017, Available here https://informme.org.au/Guidelines/Clinical-Guidelines-for-Stroke-Management-2017