The Recovery Process
The rate of recovery after stroke varies among individuals and may be affected by the amount or extent of damage to the brain, the cause of stroke, and the general health of the individual.
There are many individual differences among stroke survivors and, therefore, recovery is only partly predictable. Some people recover rapidly within the first two to three days after the onset of a stroke, and for others, recovery is a long term process which continues over a period of months. Subtle changes may continue to occur over years. There is a difference in the recovery timetable for physical disabilities as compared with the recovery of communication impairments, behavior and thinking problems resulting from a stroke:
Generally speaking, movement in the affected leg is the first of the stroke symptoms to show improvement. Increased strength and control of movement generally begins at the hip and knee. Often lack of return of movement in the ankle requires the support of a brace. Standing and walking may be possible for some people. Others may require the use of a wheelchair at least for a period of time after the stroke. Movement in the arm usually takes a longer time to show changes. Improvement of strength and control of movement takes place slowly beginning at the shoulder and the elbow. Gross movement in the affected hand may be possible; fine movement of the fingers may or may not return. Frequently, it is necessary to wear a support for the shoulder and a support for the wrist and hand while changes are taking place. For this reason, it is important to learn to use the nonaffected arm when doing self-care activities, such as eating and dressing and personal hygiene. This is possible with or without assistive devices.
Communication Impairments, Behavior and Thinking Problems
When speech and language are impaired after a stroke, improvement occurs gradually over a prolonged period. For some patients, recovery will consist of increased ease in using speech; with others it may be improved ability to use compensatory strategies to communicate thoughts or feelings. For those with impaired speech as a result of decreased strength or coordination of the speech musculature, recovery will enhance the clarity of speech.
For some individuals following a stroke, difficulties may be experienced in the thinking process, memory and focusing attention. For the most part, these will improve over time. These difficulties are helped by rehabilitation treatment.
The rate and degree of recovery from the consequences of stroke are not affected by age, gender, or social factors. Associated conditions such as medical complications and severe depression may, in some cases, interfere with recovery.