Stroke rehabilitation

Rehabilitation after a stroke: returning to everyday life

A stroke is caused by an acute lack of blood supply to part of the brain. The affected tissue receives insufficient oxygen and can then die. Immediate treatment of a stroke focuses on eliminating the reduced blood supply and restoring normal blood flow to the entire brain.

Rehabilitation is aimed at re-establishing basic physical functions and learning how to deal with functional limitations. In the event of a stroke, patients are offered and recommended neurological rehabilitation measures.

Strokes are one of the more common diseases in industrialized countries like Germany. According to the Federal Statistical Office, around 270,000 people in Germany suffer a stroke every year and around 700,000 people live with the consequences of a stroke.

A stroke may have serious implications for those affected. Up to 15% of people die within the first four weeks after the event and only one third of survivors can live their lives without restrictions. Another third can manage everyday life independently but live with physical or mental impairments. The other third is permanently dependent on long-term care.

This highlights the importance of post-stroke rehabilitation.

What are the goals of stroke rehabilitation?

The goal of neurological rehabilitation measures is to improve the limitations caused by the stroke so that patients can manage their everyday work and social life with as much independence as possible. It also aims to help those affected deal with their condition and the associated impairments.

A stroke may not only cause physical limitations like paralysis, but it can also cause cognitive deficits such as spatial neglect. Neglect refers to the disregard or loss of awareness of one side of the body. Following a case of hemiplegia, patients often perceive their affected half of the body as foreign. This perception can be trained and improved as part of a rehabilitation program.

The purpose of rehabilitation following a stroke is to help individuals manage their everyday lives as independently as possible by facilitating their physical, psychological, social and occupational reintegration.

What does rehabilitation involve?

Rehabilitation encompasses a multimodal approach based on different treatment methods for individuals recovering from a stroke. Specially trained therapists support patients at multiple levels.

One of the most important approaches in stroke rehabilitation is physiotherapy. Many patients suffer with temporary or permanent muscle damage after a stroke. To prevent the muscles from breaking down excessively, patients must undergo physical therapy. This creates conditions for improving mobility and coordination while alleviating possible muscle spasms.

Furthermore, patients also receive speech therapy regularly to assist in improving or relearning speech. Many of those affected by a stroke also have difficulties swallowing, which can also be treated.

During occupational therapy, motor skills of patients are trained to help with managing daily tasks as independently as possible. These include activities like dressing, bathing, and eating.

Alongside to the physiotherapy, speech and occupational therapy, other treatment methods are available. These include, for example, psychological counselling, heat and cold applications or measures to help patients reintegrate into everyday working life. Each patient is given an individual therapy plan based on their symptoms, and any existing secondary conditions are considered.

How long does rehabilitation take after a stroke?

There is almost no way to estimate the duration of rehabilitation after a stroke. It depends on the extent of the functional impairment caused by the stroke and on individual factors.

Generally, a rehabilitation program is initially approved by the respective payer for a period of three weeks. By the end of this period, the attending doctors, nurses and therapists decide together with the patient whether additional rehabilitation is required. If so, a suitable application is made, and the rehabilitation is continued after approval.

Patients make different degrees of progress during rehabilitation. Therefore, those affected have an individual requirement for therapy measures and the duration of rehabilitation can vary greatly.

What phases of stroke rehabilitation are there?

Rehabilitation after a stroke is divided into different phases. Phase A includes the acute treatment of a stroke in the hospital and phase F includes long-term care measures. Traditional rehabilitation therefore takes place in phases B to D.

The phase directly following acute treatment is also known as early rehabilitation. In this phase, patients may still be dependent on intensive medical care measures such as continuous monitoring of vital signs.

Once the vital signs like blood pressure and respiration are well-controlled, phase C of rehabilitation begins. Here, the patient may already be able to work independently to some extent but will still require continued nursing support.

Phase D is referred to as medical rehabilitation. As a rule, this is carried out as part of an inpatient stay at a specialized rehabilitation clinic. The patients are usually already relatively independent in this phase.

Rehabilitation in phase E generally takes place as an outpatient program and mainly focuses on reintegration into everyday working life. The amount of time spent working can be increased gradually.

Patients who are dependent on continuous support in their everyday lives are integrated into a phase F rehabilitation program. Alongside long-term care, the patients often receive simultaneous therapies like physiotherapy or occupational therapy.

These phases do not necessarily have to be completed in this order. Each patient's rehabilitation plan must be individually tailored so that the appropriate treatment measures can be provided for their situation. For instance, it is possible that patients switch directly from the acute phase to phase D of rehabilitation.

Who covers the costs of rehabilitation after a stroke?

The two main funding sources for a rehabilitation program are the health insurance and pension insurance. In general, rehabilitation measures carried out in a hospital are covered by the relevant health insurance provider.

For working individuals, the cost coverage usually falls under pension insurance providers.

Sometimes, an out-of-pocket contribution may be needed for the rehabilitation program. Therefore, it is advisable to clarify the individual cost coverage with the relevant health insurance after the acute treatment to submit a corresponding application.

Which clinics specialize in stroke rehabilitation?

Rehabilitation after a stroke should be carried out in specialized neurological rehabilitation clinics which offer patients an individual and interdisciplinary treatment plan.

We are committed to finding patients the most suitable specialist clinics to provide the highest level of medical care. All the clinics listed here specialize in post-stroke rehabilitation and offer outstanding support to help patients regain the ability to lead an active life.

Get in touch with our experts simply and let us convince you of their expertise in a personal consultation.