Rehabilitation refers to a comprehensive program designed to help the patient regain function as much as possible and compensate for permanent losses. Approximately 10% of stroke survivors are without any significant disability and able to function independently. Another 10% are so severely affected that they must remain institutionalized for severe disability. The remaining 80% can return home with appropriate therapy, training, support, and care services.
Rehabilitation is coordinated by a team that may include the services of a neurologist, a physiatrist, a physical therapist, an occupational therapist, a speech-language pathologist, a nutritionist, a mental health professional, and a social worker. Rehabilitation services may be provided in an acute care hospital, rehabilitation hospital, long-term care facility, outpatient clinic, or at home.
The rehabilitation program is based on the patient's individual deficits and strengths. Strokes on the left side of the brain primarily affect the right half of the body, and vice versa. In addition, in left-brain-dominant people, who constitute a significant majority of the population, left-brain strokes usually lead to speech and language deficits, while right-brain strokes may affect spatial perception. Patieh right-brain strokes may also deny their illness, neglect the affected side of their body, and behave impulsively.
Rehabilitation may be complicated by cognitive losses, including diminished ability to understand and follow directions. Poor results are more likely in patients with significant or prolonged cognitive changes, sensory losses, language deficits, or incontinence.
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