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Health & Wellness

Physical Therapy Offers Best Option for Stroke Rehabilitation

May. 25, 2022

A new lake house, a new grandbaby, an engagement—Stephanie Handerman was enjoying life. That, unfortunately, came to a screeching halt when she experienced a grade-five ruptured brain aneurysm that led to a stroke.

Stephanie Handerman: Stroke Rehabilitation with Physical Therapy

Stroke is the fifth-leading cause of death in the United States, a leading cause of long-term adult disability and it affects more than 795,000 people a year, according to the American Stroke Association.  Some patients may need months or years of therapy, though it’s encouraging to know many can relearn how to speak, walk, read and eat independently.

While at home, getting ready to go out with friends, Stephanie experienced an intense headache unlike any other she’s ever had, and immediately knew something was wrong. With the help of her fiancé  Bryan, she called 911.

The key to surviving a stroke, like Stephanie did, is getting immediate medical attention. Afterwards, a survivor’s recovery requires specialized rehabilitation, provided by multiple healthcare professionals.

Stephanie spent 30 days in intensive care at UC Medical Center, and another 30 days at Daniel Drake Center for Post-Acute Care, is a member of UC Health, and the region’s premier provider of long-term care, including specialized rehabilitation for stroke recovery.

Stephanie’s stay at Daniel Drake Center was followed by weeks of in-home and outpatient therapies, and she was bedridden for 24 days as a result of her brain injury. The beginning of her physical therapy journey started when one of her therapists, Kate Jones, helped her walk without a walker for the first time—which helped her start gaining strength and mobility, and improve overall functions.

The Key to Stroke Rehabilitation: Early and Often

Starting the right stroke rehabilitation program as soon as possible may help survivors recover more fully, says the American Stroke Association This can begin in the hospital as soon as a patient is stable, and will continue at a rehabilitation center or at home. Rehabilitation usually includes speech, physical and occupational therapy, as described by the Centers for Disease Control and Prevention.

  • Physical therapy uses exercises to help patients relearn movement, balance and coordination skills they might have lost because of the stroke.
  • Speech therapy helps people who have problems producing or understanding speech and helps improve swallowing function and cognition.
  • Occupational therapy focuses on improving daily functional activities, such as eating, drinking, dressing, bathing, reading and writing.

During rehabilitation sessions, highly skilled therapists will administer training exercises to improve stroke-related impairment, depending on a patient’s symptoms.

Common symptoms after stroke that can improve with physical therapy include:

  • Partial or complete weakness on one side of the body.
  • Vision loss.
  • Aphasia (loss of spoken language and ability to comprehend).
  • Slurred speech.
  • Difficulty swallowing.
  • Cognitive impairment (memory, attention, processing speed, reaction time).
  • Depression and anxiety.

“The long-term goal of all therapy is for the patient to regain the abilities that are lost. When started early, therapy can improve function and independence of stroke survivors,” Oluwole O. Awosika, MD, MSCR, FAAN, neurologist at the UC Gardner Neuroscience Institute and assistant professor in the Department of Neurology and Rehabilitation Medicine at the UC College of Medicine said.

For Stephanie, age 53, getting to the emergency room as soon as she did and the immediate therapy that followed has given her a new lease on life.

“I was not expected to live. If not for my neurosurgeon, Dr. Prestigiacomo, and the wonderful care from the medical team, I wouldn’t be here today. I got to celebrate my granddaughter’s first birthday while I was in rehab,” Stephanie said.

Like many stroke survivors, Stephanie relied on occupational therapists to relearn activities of daily living (ADL). Occupational therapists utilize devices that can help stroke survivors with tasks such as dressing, toileting, eating, walking and communicating.

Therapy sessions are comparable to the intensity of world-class athletes' training—multiple times a day, seven days a week. Relearning how to do some daily tasks requires thousands of repetitions to make improvements.

Camille Woods: Stroke Rehabilitation with Physical Therapy

Patience and Determination Helped Camille Through Stroke Rehab

Camille Woods knows a lot about training—she was a figure competitor, weightlifter and fitness coach prior to suffering two ischemic strokes at age 40—but nothing could have prepared her for the recovery process following her strokes.

“I didn’t realize when, for a brief time, my left arm was numb and painful that it was a stroke,” Camille said. “The next day it happened again, but with the added symptom of not being able to form words. I thought I had a bad case of jet lag, but I called a friend who told me to get to a hospital.”

After spending 10 days at UC Medical Center, she moved to Daniel Drake Center where she began physical, occupational and speech therapy with the rehabilitation experts.

“I couldn’t do anything at first. I went to therapy several times a week for over a year at Daniel Drake Center,” Camille said. “My therapists also gave me at-home workouts. My mind would tell my body to move, but it just wouldn’t. It took a lot of time repeating exercises to regain my strength, especially on the left side of my body. Through therapy I regained my fine motor skills by doing tasks like picking up straight pins and putting them on a pin cushion repeatedly”  

Camille’s always been a determined person, and only eight months post-stroke, she returned to her job.

“Through therapy I regained my fine motor skills by doing tasks like picking up straight pins and putting them on a pin cushion repeatedly,” Camille added. “They taught me the skills necessary to drive again like increasing my reaction time. I relearned basic life skills that previously were easy, like cooking, but the toughest part of rehab was how exhausting it was to do the simplest thing. I had a strong team of therapists at Daniel Drake Center, and they knew how to push me even—when I wanted to stop.”

Physical Rehabilitation Reduces the Risk of Complications After Stroke

Studies show that rehab should start early, preferably while the patient is still in the hospital, and it’s most effective when it’s a team effort, with experts from different rehab and neuroscience specialties working together to help the patient—it can be a long process.

“The more work a patient puts into practicing a skill, the more likely they are to hit specific milestones,” Dr. Awosika explained. “We want to help them avoid inactivity, which can lead to worsening conditions. Therapists play a key role in motivating their clients to push beyond what the client might think is possible for themselves.”

When progress is slow or limited, many survivors and their caregivers get discouraged and stop therapy services, but continued effort is the only way to improve. Without therapy, the likelihood of complications increases. It can lead to muscle tightness, contractures, musculoskeletal injuries, falls and even another stroke or heart attack.

Stephanie and her fiancé Bryan know firsthand that stroke recovery can take a long time and there is no set schedule.  

“Dr. Prestigiacomo told us, that there will be a repetition of gains and plateaus throughout Stephanie’s recovery,” Bryan said. “I didn’t know what he meant at first, but that is really how it was. Stephanie was slow to walk, but she didn’t stop at the plateaus. Now, two-and-a-half years later, her mobility is perfectly fine.”

The road to stroke recovery starts with a single step. While speech, physical and occupational therapies  are crucial, Stephanie and Camille said they recognize the value of having others to rely on during recovery. Stephanie’s family coordinated her appointments and drove her to every therapy session, while Camille’s mother came from out of town to care for her, and her sorority sisters, church family and gym friends helped in every way.

Stephanie's Story: Stroke Recovery with Physical Therapy
Camille's Story: Stroke Recovery with Physical Therapy

A Second Chance

Stephanie still struggles with short-term memory.

“Every day I review what happened the previous day,” she said. “I know my condition was as bad as it could be, but I’m still here. Today, I look forward to the birth of another grandbaby and the simple joy of a boat ride on the lake with Bryan.”

A second chance at life is not lost on Camille.

“I’m working on earning a master’s degree in business,” she said. “Eventually, I’ll return to physical fitness training. Most importantly, I want to be an advocate in the Black community, where I feel more stroke awareness, support and resources are needed.” After all she has endured, Camille said she is excited about life and lives by her mother’s advice—do your best and God will do the rest.

No two strokes are alike—but every stroke requires immediate attention. The chance for the best recovery requires around-the-clock collaboration of specialists. The UC Gardner Neuroscience Institute’s stroke experts are highly trained and experienced in the latest research and treatments for complex stroke care.

Call 513-475-8730 for more information or to schedule an appointment with a UC Gardner Neuroscience neurologist.