Healthsouth - Harmarville

Stroke is a leading cause of adult disability in the United States. There are approximately 700,000 new and recurrent strokes each year and approximately 4.4 million stroke survivors who continue to live in the aftermath of stroke. (American Heart Association, Heart Disease and Stroke Statistics-2004 Update) The impact of stroke can be significant, resulting in impairments in physical function, communication, reasoning, emotion, and behavior.

Despite the devastating effects of stroke, many stroke survivors do not receive adequate post-stroke rehabilitation. In fact, many people, including health care providers, still have misconceptions with regard to rehabilitative care after stroke. One misconception is that the brain, itself, is unable to recover or "heal" after a stroke. To the contrary, numerous research studies (Nudo and Friel, Rev Neurol, 1999) have shown that the brain undergoes significant re-organization after a stroke and that the motor experiences provided to patients after stroke actually affect how this brain "re-wiring" occurs.

A second misconception is that stroke rehabilitation produces the same outcome regardless of the setting in which it is provided. A study published in the Journal of the American Medical Association (Kramer et al, JAMA, 1997) found that stroke patients treated in rehabilitation hospitals were three times more likely to return to the community than those treated in traditional nursing homes.

In addition, stroke patients treated in rehabilitation facilities had better functional outcomes scores at six months than similar patients treated in skilled nursing facilities. The authors comment: "We can only infer that the greater comprehensiveness and intensity of rehabilitation services was responsible for the enhanced functional outcomes for stroke patients admitted to rehabilitation hospitals."

When it comes to rehabilitation after a stroke……know the research…..be an advocate…..make an informed choice.

Shelly George, MPT
Director, Parkinsons and Stroke Programs
HEALTHSOUTH Rehab Hospitals of Pittsburgh

Submitted by Ann Ciotoli
Healthsouth Harmarville