Stroke Rehabilitation

Stroke rehabilitation is something that can never be accomplished by a single professional. Some of the most important professionals in the rehabilitation of stroke patients are neurologists, general practitioners, physiotherapists(PTs), occupational therapists (OTs), social workers and nurses. In places where rehabilitation services are not widely offered, like Malawi, PTs take a leading role and they are expected to fill the gaps of the other rehabilitation specialists. Physiotherapy management is not aimed at healing the stroke, it is aimed at aiding the patient to regain their functional abilities that were lost.

Common Problems After Stroke

Communication Problems

  • Aphasia or dysphasia

    This is a problem with language. Aphasia may be in the form of:

    • Broca's aphasia

      This is also called expressive aphasia. You may be able to speak comprehensible words but in short sentences.

    • Wernicke's aphasia

      This is sometimes called fluent aphasia. In this type of aphasia, you may be able to speak but what you say doesn't make sense. Usually people with Wernicke's aphasia get frustrated when people don't understand them since they don't know that what they are saying is wrong.

    • Global aphasia

      This is a serious communication problem. You may not be able to speak, read or write at all.

  • Signs of aphasia
    • Not able to undersatnd what others are saying
    • Inability to form words but sounds only
    • Speaking slowly with very long pauses
    • Only being able to say single words or very short sentences, like “want drink”
    • Missing out words or getting them in the wrong order
    • Getting stuck on a single word and repeating it over and over
    • Not able to find the right word even though you can describe what you are thinking about
    • Saying one word when you mean another, so you may say “milk” instead of “water”, or “yes” instead of “no"
    • Talking nonsense, but not realising that you’re not making any sense
    • Being able to read headlines in a newspaper, but not the rest of the text
    • Being able to write but not read what you have written.

    Sometimes you may fail to read because you are not able to recognize the letters and this is called alexia / visual aphasia or word blindness.

    When you are failing to write it is called agraphia.

    • Dysarthria

      This is when one fails to control muscles of the face, mouth and throat to allow normal speaking. It doesn't affect your understaning or the ability to form words but to speak them. Dysarthria affect people differently: others can speak with little difficulties that they are understood very well while others can't speak comprehensible words at all.

    Signs of Dysarthria

    • Slurred or slow speech
    • Inability to speak clearly
    • Hesitating a lot or speaking in short bursts instead of full sentences
    • Speaking with a quiet or strained voice, or one that doesn’t change its tone

  • Speech apraxia

    This is an inability to move muscles of the face, mouth or throat in the order that it required to speak. There may be normal movement in the muscles but the order of movement is a problem and it makes the words spoken difficult to understand. Apraxia is a problem in planning muscles movement sequence not the movement itself.

    Signs of Apraxia

    It is hard to tell which one is apraxia or other forms of speech problems. Some of the signs of apraxia include:

    • Not being able to say words clearly, especially when someone asks you to
    • Your speech changes and words sound diffrent every time you say them
    • You try to correct yourself, because you know things sound wrong
    • You hesitate between words or need several attempts before you can say a word
    • You are able to say things clearly when you recite them in a list (like days of the week or numbers), but not when you’re asked to say them on their own
    • Not being able to speak at all sometimes

Cardiopulmonary Physiotherapy
Chimwemwe Masina, PT

Author: Chimwemwe Masina

Chimwemwe Masina is currently working as a Resident Physiotherapist at DDT College of Medicine in Gaborone, Botswana. Before joining DDT College of Medicine, he worked in the Ministry of Health at Kamuzu Central Hospital in Malawi, MagWaz Physiotherapy and Wellness Services in Lilongwe, Malawi. as well as Volunteering at Physiopedia.
His interest is in Neuromusculoskeletal Physiotherapy and currently he is an assisting lecturer in Manual Therapy and Lumbar Spine Management.

Disclaimer! Information provided on this page is for educational purposes only and is not meant for specific medical intervention. If you have a medical problem, please contact us or consult a certified medical professional