You or your loved one just had a stroke. Once the initial shock subsides, you want to know, “How long will it take for me to recover?” Will I make a full recovery? Will I be able to walk?” These are questions that everyone wants their physician to answer.
Your doctor or therapist is not being evasive when they say, “It depends.” Early on the exact time line and amount of recovery can be difficult to predict. After a few weeks we generally have a much better idea of how you will do. However, it is still possible to make some general observations about stroke recovery.
In animal research studies, the first 30 days seem to offer the best opportunity for recovery. However, humans have a longer window of opportunity, with the most rapid recovery taking place in the first 90-120 days. That does not mean that you will not continue to improve after the 3-4 months, but it will probably be at a slower rate. This is why it is so important to get aggressive rehabilitation early. Start thinking “rehab” immediately after the acute danger of the stroke has passed.
Just about everyone who has had a stroke will experience more than 50% improvement. Motor movement (hand or leg paralysis) tends to recover faster. The majority of patients will walk again, although they may require an assistive device like a cane or walker. The brain cells that control individual movements are grouped closer together and this allows for faster recovery. It is more encouraging when hand movement starts to return in the first two weeks and the patient has a better chance of regaining functional use of their hand. Functions like speech or attention require larger “distributed” areas of the brain and take longer to recover.
Research studies suggest that the amount (dose) of therapy makes a difference. When your doctor orders a medicine for you there is a specific dose of the medicine. If you have a strep throat you may take Amoxicillin 500mg twice a day for 10 days. Improvement after a stroke requires a minimum dose of “deliberate practice” to achieve the best outcome. The patient needs to perform multiple repetitions of a functional task in a highly motivated environment. Rehab!! The repeated performance of these tasks promotes repair of the brain.
An inpatient rehabilitation hospital provides at least three hours of therapy per day while other settings such as a skilled nursing facility do not. Just like your blood pressure medicine, be sure you are getting the right dose of rehabilitation. It matters.
Finally, if you have reached a plateau in your recovery, there may still be an opportunity for additional improvement. We believe that many patients still have a “reservoir “of abilities and can still make some additional recovery with high intensity therapy that is focused on the remaining problems. It always pays to get a re-evaluation by a rehabilitation expert.