Hello Jane,
Thank you for reaching out to StrokeLine through ‘Ask A Health Professional’. We are sorry to hear about your mother’s stroke and how it has affected her. We appreciate that both you and your brother care for and want what is best for your mother.
Where are you based? We would highly recommend you all converse with your mother’s doctor on what is the best action to take post-stroke.
It is important to get advice and information from professionals who know your mother’s medical history and to make sure she is currently medically stable before engaging in any form of rehabilitation.
If she is cleared by her GP or medical professional to partake in rehab , she may be referred to allied health professionals that have experience with stroke and rehabilitation. This may include an Occupational Therapist, Physiotherapist or Speech pathologist. They are experts in their field and will be able to assess your mum, her impacts of stroke and make individualised recommendations and guidance for you and for your mum in terms of what she may or may not be able to do as part of her rehabilitation plan and goals.
The My Stroke Journey is a good booklet to help outline what to expect after a stroke, and which health professionals can be involved and how. You can find the booklet at My Stroke Journey booklet
Fatigue may be something to keep in mind with your Mum when looking to partake in any form of rehab. Fatigue is very common post stroke and it’s important to keep this in mind and talk about it openly with your Mum to see if it is affecting her.
When considering “what is the best treatment in days after a stroke” , According to the Australian and New Zealand Living Clinical Guidelines for Stroke Management, the following information are strong recommendations:
- All stroke patients should commence mobilisation (out-of-bed activity) within 48 hours of stroke onset unless otherwise contraindicated (e.g. receiving end-of-life care). (Bernhardt et al. 2015 [9]; Lynch et al. 2014 [10])
- For stroke survivors with reduced strength in their arms or legs, progressive resistance training should be provided to improve strength. (Dorsch et al. 2018 [83])
- For stroke survivors who have difficulty sitting, practising reaching beyond arm’s length while sitting with supervision/assistance should be undertaken. (Veerbeek et al. 2014 [125])
- For stroke survivors who have difficulty in standing up from a chair, practice of standing up should be undertaken. (Pollock et al. 2014 [134]; French et al. 2016 [232])
- Stroke survivors with difficulty walking should be given the opportunity to undertake tailored repetitive practice of walking (or components of walking) as much as possible. (French et al. 2016 [232])
- For stroke survivors with some active wrist and finger extension, intensive constraint-induced movement therapy (minimum 2 hours of active therapy per day for 2 weeks, plus restraint for at least 6 hours a day) should be provided to improve arm and hand use. (Corbetta et al. 2015 [236])
- Community-dwelling stroke survivors who have difficulties performing daily activities should be assessed by a trained clinician. (Legg et al. 2017 [269])
- Community-dwelling stroke survivors with confirmed difficulties in personal or extended activities of daily living should have specific therapy from a trained clinician (e.g. task-specific practice and training in the use of appropriate aids) to address these issues. (Legg et al. 2017 [269])
- Communication partner training should be provided to health professionals or volunteers who interact with people with aphasia after stroke. (Simmons-Mackie et al 2016 [432]; Finch et al 2017 [442]; Power et al 2020 [439])
I hope some of this information helps.
We would be more than happy to talk with you further if you need any more help on 1800 787 653, or email us on strokeline@strokefoundation.org.au. We are available Monday to Friday 9am to 5pm AEST and would be more than happy to talk with you.
Regards
Karina and Alicia (StrokeLine)
