Monday, February 11th, 2019
The stroke rehabilitation process throughout the first several months of stroke recovery can be intense, with dramatic inclines and declines in progress that can encourage and depress survivors. Weakness and paralysis are common effects of stroke and adjusting to the demands of recovery may require significant lifestyle changes.
Establishing and gaining momentum towards a stroke survivor’s goals is key to thwarting an often-frustrating phenomenon– the plateau phase. What does “plateau” mean? A plateau period is a state of little or no change following a period of activity or progress. During a plateau, it may feel as though the initial positive progress was the end of successful rehabilitation and that no further improvement is possible. But for many, a plateau period or plateau phase is quite common and even to be expected. Understanding this will help both survivors and caregivers avoid the derailment of recovery by losing hope, motivation, and persistence.
Over the last twenty years, research has reaffirmed the commonness of the plateau phase in newer stroke patients. Recently published reports show that patients can regain motor recovery and function up to 23 years after a stroke. Medical professionals are now finding that this complex recovery period often continues months and even years after a patient has left rehab, but only if patients and caretakers build a recovery plan and use evidence-based technology after leaving traditional rehabilitation. A well-designed home exercise program, often an upgrade from the previous inpatient therapeutic regimen, is the key to maintaining momentum or restarting progress after a plateau.
During the subacute healing phase, the three to six months immediately after a stroke, the most consistent and encouraging signs of progress occur. This is often jump-started by patients being coached along in rehab. If the plateau stage occurs around the end of the natural healing phase, patients are commonly discharged to home care.
For patients in plateau, this is a difficult transition for several reasons: familiar exercises must be altered and adjusted, the home routine requires greater adaptability, and patients must overcome the impact of no longer seeing an uptick in progress on their motivation. Indeed, many patients and caregivers are deterred from pushing through and thus suffer a slowed or stunted recovery. Successfully working through lack of motivation and frustration is easier when patients and caregivers know and understand the plateau phase.
Research in the medical community confirms that working with a health care professional on a series of ongoing exercises does promote improvement in a stroke patient’s long-term recovery. When signs of recovery seem to stall altogether, here are a few common practices for jumpstarting at-home care.
The brain’s cortical plasticity is a key component in recovery, and all of Saebo’s product offerings capitalize on this natural capacity. Let’s say a survivor has suffered hand weakness or paresis as a result of their stroke event, and they have recently plateaued during recovery. Motor function and utilization of the hands can be regained with the use of the SaeboGlove or SaeboFlex during at-home exercises and therapy at home, with minimal assistance. The SaeboMAS may be more appropriate if the stroke has impaired the function of the shoulder or elbow. Saebo’s pioneering treatment principles are based on the latest advances in neurorehabilitation research documenting the brain’s ability to “re-program” itself through mass practice, task-oriented arm training. Many Saebo devices offer a risk-free 30-Day trial to make sure it’s the correct fit for your rehabilitation needs.
Constraint-induced movement therapy (CIMT) encourages the facilitation of neurological pathways damaged by a stroke. Constraint-induced movement therapy is most commonly used to treat hand impairment. In CIMT, a patient’s unaffected hand is covered by a mitt, committing the patient to rely on the affected hand. By keeping the functional hand from taking full responsibility for daily tasks, the patient is forced to grow and develop pathways for the affected hand to the brain. CIMT is an intensive process that requires guidance and supervision for several hours at a time, so it may not be the best choice for you and your loved one.
Maintaining an exercise regimen that both meets the needs of ongoing recovery and the demands of patient ability is difficult, but essential to progressing past the plateau stage after traditional rehab. Neuroplasticity enables the brain to constantly adapt, but persistence and regularity are the keys to capitalizing on this ability. Continuing physical exercispe assists with many aspects of the healing process, from increasing motor function and strength to supporting flexibility, coordination, and balance.
During the difficult transition to home care, supportive family and medical professionals are the vital factors in helping patients maintain motivation and feel guided toward success. As a patient is just beginning the rehabilitation process, it is almost solely in the hands of the caregiver or therapist to set the tone of the session, and this mutual understanding will drive the exercises forward, making it easier to set and meet small goals along the way. Roadblocks and frustrations are common, but with a structured and steady plan, these stages will pass and times of progress will return.
When difficult emotions arise, remember that this is completely normal. Stroke recovery is a long process, and frustration, anger, and depression are common obstacles. Know that these feelings can pass with time when both patients and caregivers allow themselves self-care and patience. It is also helpful for families to keep this in mind, as maintaining a genuinely flexible and positive atmosphere during rehabilitation will help all parties see these changes and efforts as a long-term process.
When heading into long-term stroke treatment, remember that awareness of evidence-based treatment interventions and consistent use of at-home tools during task-based exercise can prevent or combat the plateau period. Here at Saebo, we are committed to stroke support and recovery for all survivors and their families. Saebo offers a wide range of products that combine cutting-edge technology with evidence-based rehabilitation techniques. Our offerings and network of Saebo-trained therapists can help you or a loved one to obtain all the necessary tools to maximize stroke recovery.
All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.