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Improvements After Strokes Years Later?
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itmatsb posted:
Can you expect continued improvements after strokes years later, e.g. 3 yrs, 5 years, 7 years, 10 years or more later?

Are they probably just very small improvements?

Any examples of these later improvements?
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Richard C Senelick, MD responded:
You have asked an important questions. The traditional answer has been that person gets back most of what they will get back in the first year after a stroke. There is no question that improvement is much faster in the first 6 months and can slow considerably.

There has been a good deal of research on the concept of "Learned Non-Use." This is the idea that the person still has a residual capacities to improve that can be tapped through intensive rehabiliation. This therapy has been called, "Constraint Induced Movement Therapy." The patient is forced to use the impaired limb for up to 6 hours each day. I don't have the space to provide you with the data, but have supplied some links to information on CIMT.

http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/PhysicalChallenges/Constraint-Induced-Movement-Therapy_UCM_309798_Article.jsp

http://134.74.134.21/tro/Grotta04.pdf

You can Google CIMT and find many more references.

The key is find a physician and therapist to evaulate you and see if you are a candidate for more therapy. Much of this therapy can be performed at home. The dose of therapy is important so a home program becomes very important. There are new devices like the Bioness Ness 200 that also can give a person's hand more repetitions in preforming a functional task.

Try to find rehabilitation physician and therapist who are familiar with these techniques and working with patients who have reached a plateau and want to know what else they can do.
Good Luck
After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.
 
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itmatsb replied to Richard C Senelick, MD's response:
Thank you for your response. This is impossible for me, since 6 hours of activity more than 2 days in a row greatly exacerbates my daily migraines. And I'm not talking about exercise which is beyond me with the migraines. But I'm sure others will find this helpful to know. It does show that progress is still possible and I will work harder on the PT exercises that I was given knowing this. Thanks again.
 
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ar4jenk replied to itmatsb's response:
itmatsb,

Sorry to hear of your stroke. I am also a stroke survivor, 13 years now. Still to this day there are small improvements in me. There are things that I couldn't do last year that I can this year. But they have only come with the constant work at the improvement of your self. Still to this day there are nerves that are coming back. I now have some feeling where I didn't 2 years ago. So you just have to keep pushing yourself to go further than you did the week before. It is a slow process, but you can make big improvements in your life, and be proud of all the work you have done to get yourself there. It does help if you have someone giving you a little push. But you can do it.
 
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itmatsb replied to ar4jenk's response:
Thanks for your very helpful response. It's great to know that you are still finding improvements so many years forward.

My biggest struggle is to not do too much or I get severe
migraines. It is so hard when I am so ready to go and get caught up on everything. The migraines were caused by my stroke, but I get several different injections constantly, plus PT exercises for the migraines, plus medications. So I am improving very gradually over the last 4 years with my extremely disabling migraines. So I guess I'm in a little different boat from most stroke survivers.

Thanks again.


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Richard C. Senelick M.D. is a physician specializing in both neurology and the subspecialty of neurorehabilitation. He did his undergraduate and medic...More

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