A decade ago, stroke was the third leading cause of U.S. deaths but has now dropped down to fifth. The higher survival rates are due to advances in medical treatments and care. The right care, done the correct way, can save lives and the survivors’ quality of life.
Unfortunately, despite the decreased death rate caused by stroke, the numbers are still relatively high in the U.S., with a stroke occurring every 40 seconds and someone dying every four minutes, according to ScienceDaily. An estimated 7.2 million Americans over 20 years old have had a stroke, with approximately 800,000 people suffering a new or recurrent stroke annually.
Despite these bleak numbers, the improvements in stroke systems of care and the advances in treatment have improved outcomes, according to the 2019 policy statement from the American Stroke Association.
Stroke Care is Dependent on Initial Treatment
Time is critical when treating stroke, a leading cause of disability in the country. Stroke occurs when a blood vessel breaks (hemorrhagic) or a clot forms (ischemic) and interrupts blood flow to an area of the brain, and the symptoms are sudden in onset. The longer the blood-flow interruption, the greater the damage, which is why every minute counts.
New technologies are aimed at extending the window of opportunity, the timeframe, and the number of people treated. The push is to work faster, efficiently, and appropriately because the quicker you treat stroke, the less disability it causes.
Initial treatment now may include intravenous alteplase, a clot-busting drug, and endovascular thrombectomy, also known as stent retrievers whereby the physician goes into the head and pulls out the clot. Ideally stroke patients would be transported to a Comprehensive Stroke Center where these resources are available.
What’s New in Stroke Care?
Intense Speech Therapy
Intense therapy is essential for stroke rehabilitation, particularly for language recovery and swallowing difficulties. Intensive rehabilitation is necessary to achieve optimal speech outcomes, for significant language improvements, and for overcoming dysphagia.
Task-Specificity for Motor Therapy
Intensive therapy, however, is not as effective for occupational therapy and physiotherapy interventions. Instead, task-specific therapy (designed to deal with lost tasks or abilities) has proven more effective for motor functions than traditional approaches focused primarily on impairment.
Sensory Stimulation to Facilitate Recovery
Sensory stimulation can facilitate stroke recovery in motor functions. Several sensory input modalities (vestibular, attentional, optokinetic, somatosensory-magnetic, and neck proprioceptive) have undergone investigation and have resulted in dramatic improvements in survivors with neglect syndrome.
Virtual reality (VR) as a stroke rehabilitation training tool is one of the newest potential therapies presently under study. VR refers to computer technology that simulates real-life situations and learning, and it allows for increased intensity of training and rehabilitation while providing augmented sensory feedback.
Motor imaging can result in a stroke survivor’s increased functional MRI activity, a latent precursor of recovery. Its present use is in stroke rehabilitation trials, particularly for retraining the motor function of hemiparetic limbs.
The use of robotics in stroke rehabilitation has increased over the years, with studies noting that robot-aided sensorimotor training in the upper extremity demonstrates greater motor recovery. Robotic therapy can reduce motor impairment in chronic stroke survivors with moderate to severe impairments. Efforts to bring these robotics to the commercial market are ongoing.
Extended Therapy Efficacy
A structured and progressive physical therapy program in stroke survivors who have completed their acute stroke rehabilitation allows continued improvements in lost mobility, endurance, and balance. Therefore, doctors now prescribe a relatively aggressive home-based exercise program for stroke survivors discharged home.
Mobile Stroke Unit
The Mobile Stroke Unit is an ambulance equipped with a mobile CT scanner, laboratory, neurologist, critical care nurse, CT technologist, and paramedic. It brings resources directly to the patient to immediately diagnose a stroke, and if confirmed, rapidly begin treatment. This is the same treatment a patient would receive in the hospital, only begun much sooner.
The Stroke Support Association (SSA)
The SSA offers information and resources about stroke and its care and rehabilitation. It also has active support groups for survivors and caregivers, held every Tuesday in Long Beach, CA. During the COVID-19 pandemic, SSA opted to hold Zoom virtual meetings to reach more people and offer support remotely.
To join one of the support group sessions or get more information, get in touch via the email address firstname.lastname@example.org, or send us your name and contact details for an invitation.