2024-01-12 13:19:00
In 2019, 123,000 people were hospitalized for a stroke in France. 85% of these strokes are caused by a blocked vessel or artery, 15% by an artery that ruptures. While approximately 30% of stroke victims die within the following year, the majority of survivors have following-effects. Thus, according to the figures put forward by the High Authority for Health (HAS), “ Stroke victims have following-effects of varying severity in 40% of cases, and serious following-effects in 25% following one year.
The time frame and abilities recovered are difficult to predict and vary from person to person. However, the National Academy of Medicine estimates in a May 2022 bulletin that “At least three to six months are necessary to recover the deficits. An even longer time is required to recover functions and activities.”
While there is always an element of spontaneous recovery in stroke, solid rehabilitation/rehabilitation is essential to recovering from a stroke. “It has been shown that rehabilitation/rehabilitation significantly reduces mortality, dependence and the risk of institutionalization”, notes the HAS. This must begin as early as possible.
An assessment within 24 hours of the stroke
Upon hospitalization, an initial assessment is carried out by doctors and specialized rehabilitators. At this time, in the first hours following the patient’s admission (the acute phase of the stroke), a specialist (geriatrician, neurologist or specialist in physical medicine and rehabilitation) assesses the deficits, the severity of the stroke. stroke and the patient’s prognosis for recovery. A second evaluation is carried out to refine the diagnosis.
As soon as the patient’s health permits, rehabilitation begins. “To be effective, rehabilitation/rehabilitation must be initiated early and practiced intensively with sessions of at least 45 minutes per type of rehabilitation, five to seven days a week”, recommends the HAS. To be as effective as possible, rehabilitation is multidisciplinary and coordinated. At the end of this so-called subacute phase of rehabilitation, which ends three to six months following the stroke, the patient then enters the chronic phase of the stroke.
500,000 people with following-effects
It was not until 2022 that the HAS published its first recommendations on rehabilitation during this phase. In France, 500,000 people live with following-effects of a stroke. “ If the patient’s survival and possible repercussions depend on the speed of initial treatment, serious follow-up during the months and years following the stroke is also essential to limit the long-term consequences. », adds the HAS.
Without explanation, some patients recover better than others, but recovery also depends on certain factors. According to the Academy of Medicine, “ the prognostic factors are mainly the size and especially the site of the lesion (…), appropriate rehabilitation and rehabilitation, with specialized professionals, sufficiently intense and prolonged “. Age is also a prognostic factor due to the person’s comorbidities and neurological history.
Throughout the rehabilitation/rehabilitation course, the patient performs physical activities assisted or not by technology. In order to recover cognitive abilities, cognitive and emotional therapies can be implemented (occupational therapy, speech therapy). The first objective is to recover deficits and, where necessary, to find compensation strategies always with a view to maintaining the patient’s autonomy.
After a rapid first phase of recovery in the first months, it is much slower during the second phase. It is important that the patient does not become discouraged. Although progress is rarer following a year, it can nevertheless occur up to eighteen months following the stroke.
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