What happens during stroke rehabilitation?

We often receive requests for information or articles, or just an explanation of what a person can expect during the rehabilitation process. Unfortunately, we're librarians and not rehabilitation professionals, so we can't provide first-hand knowledge of what you or your loved one may experience during recovery and rehabilitation. We can, however, help you find reputable and knowledgeable sources of information online. The articles, web pages, and book recommendations below are written by health professionals. Please share what you find helpful.

About stroke

MedlinePlus has an excellent, well-written explanation of what happens before, during, and immediately after a stroke. During a stroke, blood supply to the brain is blocked or stopped, causing brain cells to die. This interactive tutorial (also available in Spanish) also explains what causes a stroke, what a patient may experience, and how it may be treated.

About stroke rehabilitation

MedlinePlus also offers several excellent pages on stroke rehabilitation. Start with the basics, or an easy-to-read guide; try the interactive tutorial in English or Spanish, or dive into a longer article that explains who provides rehab, where, and when.

The American Stroke Association also covers the basics of post-stroke rehabilitation (what will I do in rehab, when does it begin, and what is the program). Their Life After Stroke guide also offers advice, explanations, and resources on regaining independence, healthy living, and help for caregivers.

The National Stroke Association offers HOPE: A Stroke Recovery Guide. Each chapter covers aspects of the rehabilitation and recovery process. You can download the whole guide (PDF) or read individual chapters online. 

The NIH Stroke Scale offers a series of sophisticated questions that help medical professionals evaluate patients for inclusion in stroke protocols. It is a valuable tool for medical professionals to determine a baseline for stroke treatment assessment.

How do I find a good stroke rehabilitation program?

We use several resources to help our patrons identify rehabilitation programs in their area. We can't recommend one facility over another, but we can provide tools to help you evaluate each program and find the right one for you and your family.

• Download the Consumers Guide to Choosing a High Quality Medical Rehabilitation Program (PDF). This free guide was developed by National Rehabilitation Hospital and Boston University. It has checklists, questions to ask an admissions counselor, a glossary of terms, insurance information, and more. Start by reading through the guide to understand what "quality" means and what questions to ask.
• Search QualityCheck, the database from the Joint Commission, for facilities in your area (this tutorial may help [PDF]). The Joint Commission offers certification specifically for stroke treatment. This usually covers acute care, so you may want to look for facilities that have the stroke certification AND offer rehabilitation. Here's a sample search looking for facilities in or around Los Angeles, CA that are certified as Comprehensive Stroke Centers. If you click View All Services for Cedars-Sinai you'll see they also offer rehabilitation.
  • If you cannot find a facility in your immediate area, try a Zip code search and expand the range.
  • You can also search Quality Check for rehabilitation providers without specifying stroke certification. You'll find Physical Medicine and Rehabilitation listed under General Medicine in the Type of Service menu. Check the View All Services link to see whether they offer inpatient or outpatient rehabilitation.
• You can also search the Commission on Accreditation of Rehabilitation Facilities (CARF International) by using their Find an Accredited Provider advanced search page.
• The American Physical Therapy Association offers a Find a PT database to help searchers find a therapist or facility in their area. You may need to check with your insurance whether additional services are covered.
• Where are the best rehabilitation hospitals? US News and World Report ranks the best hospitals every year, including rehabilitation hospitals. If you live within range of one of these hospitals, or are willing to go anywhere, you can start with this list.

I've finished all the rehab my insurance will pay for. What next?

Unfortunately, we do hear this question often and have not found any easy answers. You can always appeal the insurer's decision, especially with a physicians recommendation.

Your physical, occupational, or speech therapist will likely give you "homework" or exercises to do on your own. These are very important to your recovery and should be followed. The guides listed above also discuss the work you will need to do on your own and activities you can do to improve your recovery. Other books and guides are out there. We recommend visiting your local public library and working with a librarian to find good resources in their collection.

Lastly, visit the AT3 center to find your state's assistive technology program. These centers provide information on everything from grab bars and reachers to communication aids to modified vehicles.

If you have additional questions or would like to recommend a resource for this list, please leave a comment below!