Stroke affects many older adults. Its consequences may be devastating for stroke survivors and their families.

Stroke or a TIA may be manifested in many different ways, and a trained neurologist or physiatrist (a specialist in neurological and musculoskeletal rehabilitation) may be needed in some cases to identify if a stroke actually took place or not. More commonly however, strokes may cause facial, arm or leg weakness on one side of the body, sensory deficits, or difficulty with eye movement, swallowing or even breathing.  

Acutely stroke is usually managed by the emergency room doctors with assistance of neurologists and occasionally with need for vascular surgery, brain surgery or interventional radiology assistance. On one extreme some are admitted to the ICU (intensive care unit) when strokes are more serious, while on the other extreme, others may be discharged after a short work up and told that they had a “mini-stroke” or a TIA (transient ischemic attack) which by definition means that all stroke symptoms have resolved. Medical work up is usually needed to help understand which medications to give to help reduce risk of strokes in the future.

After completing the acute phase of stroke care, most patients are still burdened with the consequences of stroke: changed gait, balance, weakness, tightness (aka spasticity), numbness, difficulty with speech, swallowing and speech deficits, bowel/bladder incontinence, pain, emotional lability, seizure risk, post-stroke osteoporosis, contractures,  and/or eye movement causing difficulty in self-care and mobility.

While acute medical management with neurology and general physicians primarily focuses on containing acute effects of the stroke or preventing future strokes, helping improve these post-stroke deficits is often the job of rehabilitation professionals. Most of these patients receive rehabilitation services including physical, occupational and speech therapy. Stroke rehabilitation management is often complex, and a physician specialist in neuro-rehabilitation, a physiatrist, works with rehabilitation specialists to help improve chances of recovery. It is not a surprise therefore that American Heart/Stroke Association guidelines recommend stroke rehabilitation management under care of physiatrists (Stroke. 2016 Jun;47(6):e98-e169).

At Steady Strides: Fall Prevention and Stroke Rehabilitation Medical Institute Dr Atanelov works closely with our physical and occupational rehabilitation specialist team to help maximize your chances of recovery after stroke