Stroke Recovery: The Basics o... Video Transcript

Participants

David Alexander MD, David R. Marks MD, Richard D. Zorowitz MD

Summary

Stroke is a devastating condition that often results in serious long-term complications. Among the most common and most challenging are mobility difficulties. These can range from trouble doing normal household chores to a total inability to walk. Fortunately, many therapies are available to help restore physical abilities. Join our panel of experts as they discuss rehabilitation therapy and how it works.

Webcast Transcript

DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Stroke is a devastating condition that often results in a number of serious long-term complications. Among the most common and most challenging are difficulties moving. This can range from trouble doing normal activity, such as cooking and cleaning, to a total inability to walk. But the situation is not hopeless. Many therapies are available to help you regain your physical abilities.

Joining us today to discuss how rehabilitation therapy works are two experts. First is Dr. Richard Zorowitz. He's director of stroke rehabilitation at the University of Pennsylvania. Thanks for being here.

RICHARD ZOROWITZ, MD: Thank you.

DAVID R. MARKS, MD: And also with us is Dr. David Alexander. He's the medical director of the Daniel Freeman Rehabilitation Center in LA. Welcome.

DAVID ALEXANDER, MD: Thanks

DAVID R. MARKS, MD: Dr. Zorowitz, what is going on in the brain to cause these problems with motion?

RICHARD ZOROWITZ, MD: Stroke is brain damage. The blood vessels get clotted and blood flow cannot get to part of the brain, and as a result the brain cells die, causing damage and problems with movement that are associated with that.

DAVID R. MARKS, MD: Is there a range in the difficulty, or is it all or nothing?

RICHARD ZOROWITZ, MD: There can be a range of difficulty that can occur. It can occur with problems with walking or using the arm. It can go all the way to not being able to use the arm or the leg at all.

DAVID R. MARKS, MD: So there is a broad range. Everybody's an individual, I guess, when it comes to stroke.

RICHARD ZOROWITZ, MD: Yes. There is quite a broad range.

DAVID R. MARKS, MD: Dr. Alexander, let's talk about rehabilitation therapy. When should this start for the best outcome for the patient?

DAVID ALEXANDER, MD: We think that rehabilitation therapy should start almost immediately after a stroke. In some ways, it starts in the intensive care unit, where you start planning for a recovery right away and doing things to prevent other complications down the line. So it starts right away. We like to get the patients as active as possible as quickly as they can tolerate it medically.

DAVID R. MARKS, MD: What are the steps of rehabilitation?

DAVID ALEXANDER, MD: There are a number. A lot of it has to do with mobilization of the patient, and I try to think of it in several categories. One is working to help the patient recover neuronal function. That is, brain cells have been damaged and brain cells have died, and the process of helping the brain to recover as much of that function as possible is one of the basic principles of rehabilitation.

The other principle is compensating for the deficits that you have. For example, if you can't do something -- for example, if you can't walk -- then you need to learn to use a wheelchair or other ways to compensate for the deficit.

DAVID R. MARKS, MD: And I assume that there are many different ways that you can teach people to compensate for whatever problems they have.

RICHARD ZOROWITZ, MD: Yes. We can use one-handed techniques, for example, to button buttons or eat, for example. With walking, you can also use braces and canes or walkers to be able to allow you to walk better.

DAVID R. MARKS, MD: What should a person who has a stroke expect after their stroke and when they start rehab? How fast should they think that they're going to progress, and when should the greatest progression, the greatest improvement occur?

RICHARD ZOROWITZ, MD: Progression usually will occur, the majority of it begins to occur in the first month.