Types of Treatments
It has been shown over and over in the research, that physiotherapy has a great impact on the recovery of a stroke. In hospital, you were likely assessed by a physiotherapist immediately after your diagnosis and medical treatment. From there, most people are admitted to a rehabilitation program such as the Intensive Rehabilitation Unit (IRU) at the hospital, or Slow Paced Rehab in a continuing care facility like St-Joseph's Continuing Care or Extendicare York. Once discharged home, you might have access to LHIN Community Care or ICAN.
All of this rehabilitation is to help you learn how to move safely around your home. However, physiotherapy has a bigger potential than this. Some physiotherapists have training to help your muscles learn to move again. Using the correct techniques in physiotherapy, your legs can learn to support you, and your hand can learn to grasp.
For best outcomes, it is better to be assessed early on, to prevent any decline in mobility that might occur. However, even if you are now unable to walk or using a wheelchair, it is never too late to improve.
There are different types of physiotherapy. When it comes to neurology you need someone who knows how the nervous system works. In most cases, your muscles are still strong and healthy. The issue lies within the brain.
It is not enough to simply strengthen your muscles. This would be the same as having the best cell phone, with no reception. If the network is not working, it doesn't matter what kind of phone you have, you still won't be able to make a call. If the pathways within your nervous system are broken, it doesn't matter that your muscles are strong, you still won't be able to create movement.
In neurology, physiotherapy targets the pathways in the brain, and re-creates the ones that have been injured by Stroke. We have special techniques that teach your brain which muscles need to work, and when, to help you get back to a normal movement.
The type of exercise that you do is important. When trying to re-create pathways in the brain, you need to keep your exercises challenging and functional. In physiotherapy, we rarely prescribe standard strengthening exercises. All of our Home Exercise Programs include functional activities, like standing up from a toilet, putting your pants on or climbing the stairs. These are things that you do every day.
Your brain is most likely to remember how to use your muscles, if you practice during activities that are meaningful to you. We want to make the changes permanent, so we use activities that you enjoy in the clinic, and in your Home Exercise Program.
In order to make the brain understand which one is the correct pathway, it is important to practice them correctly, and often. Just like remembering a new phone number. You might choose to review it, to make sure you remember it correctly, then you will repeat it to yourself often to make sure that you don't forget it.
The same strategy applies to your movements. You need to make sure that you are recruiting the correct muscles every time you perform an activity, like standing up from a chair. For this reason, we design our treatment plans with visits 2 to 3 times per week. This allows us to correct any abnormal patterns, to continue making progress in the right direction.
The length of treatment has two components. First, the type of session, and second, the total length of the treatment plan.
There are two types of treatment sessions to choose from: regular treatment and complex treatment. In most cases, clients who have experienced a stroke have a variety of goals to work on, which can be better addressed during a complex session. This allows us to address several problems in one session.
For your first treatment plan, we often suggest a duration of 4 weeks. This allows us to see how you progress and how you are doing with your Home Exercise Program. After these 4 weeks, you may choose to continue on your own, or to continue for another treatment plan, which can be for up to 12 weeks.
The duration of your treatment will be discussed with your physiotherapist on the day of your initial assessment. Depending on what the findings are, and what your goals are, you will talk about what type of session is most appropriate and how many weeks you should start with.
Exercise is Important!
What to expect from your neurologist (and what not to):
When you are first diagnosed with a stroke, you might know that the road ahead is a long one. You were likely admitted to the hospital and received treatment to prevent further damage to your brain. Most people participate in a variety of rehabilitation programs before being discharged from all types of care.
Here's some information that your physician won't discuss with you: You can still improve! We know that a stroke causes damage to the nervous system. We also know that the brain has the ability to heal itself. All you need to do is provide a little bit of guidance.
When the brain has lost specific functions, the body will learn to compensate. This means that it will use different movement patterns to accomplish a specific task. This is not always the most efficient way to move and people can experience pain and weakness. Over time, the muscles that are not being used, can start to waste away, because the body thinks that they are no longer useful. As we all know, "if you don't use it, you lose it".
Exercise is very important to make sure that you continue to use the correct muscles, to prevent them from wasting away. You can do this on your own, or with the help of a physiotherapist who practices neurology. The important thing is that you learn to use your muscles again.