Stroke Aftermath: Understanding Potential Dangers, Issues, and Remedies in the Subacute Stage
In the critical subacute stroke phase (1-6 months post-stroke), individuals may face a variety of complications due to neurological deficits affecting motor, sensory, and cognitive functions [1][2][3][5].
Preventive Measures
Preventive measures during this period focus on several key areas:
Intensive Rehabilitation Therapy
Intensive rehabilitation therapy plays a crucial role in promoting motor recovery and reducing limb dysfunction. This includes physical therapy, manual therapy, and advanced technologies like electrical stimulation. Cognitive training and fatigue management are also essential, as they help combat cognitive impairment and post-stroke fatigue [4][5].
Fall Prevention
Given that spasticity, altered mental status, and motor weakness increase the risk of falls, fall prevention is critical. Monitoring and managing these risk factors, environmental modifications, and caregiver support can help reduce falls [3].
Preventing Non-Neurological Complications
Preventing non-neurological complications such as aspiration pneumonia, pressure ulcers, and venous thromboembolism is also important. This can be achieved through swallowing assessments and safe feeding practices, regular repositioning and skin care, and early mobilization and prophylactic measures [2].
Ongoing Patient Education
Educating stroke survivors about stroke recovery mechanisms, symptom management, and rehabilitation importance improves adherence to therapy and outcomes [5].
Common Complications
Common complications during the subacute phase include physical impairments such as limb dysfunction and spasticity, falls, cognitive impairment, post-stroke fatigue, aspiration pneumonia, pressure ulcers, venous thromboembolism, and loss of bladder control [1][2][3][5].
The Role of Rehabilitation
During the subacute phase, a rehabilitation team continually monitors a person's progress and assesses motor function, evaluating how well they perform everyday tasks [5]. Physical therapy is a significant part of post-stroke rehabilitation, with the goal of restoring and maintaining functions necessary for everyday life through targeted exercises and movements [4].
Other Considerations
Persistent inflammation can aggravate preexisting conditions, such as cardiovascular disorders, increasing the risk of secondary vascular events like recurrent stroke, heart attack, and progression of atherosclerosis [6]. Depression is common in the first 3 months after a stroke and can affect as many as half of stroke survivors for up to 2 years [7]. Up to 25% of people experience delirium after a stroke, a type of cognitive impairment involving a lack of situational awareness [8]. During the subacute phase, immune activation and inflammation can pose health risks, leading to increased vulnerability to infections such as pneumonia and urinary tract infections (UTIs) [9]. Difficulty swallowing can increase the chances of aspirating food or liquid into the lungs, posing a risk for pneumonia during the subacute stroke phase [10].
The subacute phase is a pivotal time for brain reorganization and regaining plasticity, making it a critical window for rehabilitation to minimize disability, maximize functional recovery, and prevent complications through multidisciplinary care tailored to the individual's deficits and risks.
Sources: [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666840/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4505759/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094378/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252155/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820951/ [6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888408/ [7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845786/ [8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303265/ [9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666840/ [10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478406/
- To minimize disability and promote functional recovery, a rehabilitation team continually monitors motor function during the critical subacute stroke phase.
- Physical therapy is a significant component in post-stroke rehabilitation, focusing on restoring and maintaining functions necessary for everyday life.
- Preventive measures in the subacute stroke phase focus on intensive rehabilitation therapy to combat cognitive impairment, motor deficits, and post-stroke fatigue.
- Cognitive training and fatigue management are essential elements in the intensive rehabilitation therapy process during the subacute stroke phase.
- Environmental modifications, caregiver support, and monitoring risk factors help prevent falls in individuals during the subacute stroke phase.
- Aspirating pneumonia can be a common complication during the subacute stroke phase, posing a risk for individuals with difficulty swallowing.
- Pressure ulcers and venous thromboembolism are preventable non-neurological complications that can be addressed through early mobilization, prophylactic measures, safe feeding practices, and regular repositioning.
- Swallowing assessments and regular skin care are crucial in preventing complications like pressure ulcers during the subacute stroke phase.
- Up to 25% of stroke survivors can experience delirium, a type of cognitive impairment involving a lack of situational awareness.
- Depression is a common medical condition after a stroke, affecting up to half of stroke survivors for up to 2 years.
- Persistent inflammation in the subacute stroke phase can aggravate preexisting conditions like cardiovascular disorders and increase the risk of subsequent vascular events.
- Health and wellness programs in the workplace can help manage chronic diseases and prevent complications in individuals during the subacute stroke phase.
- Aging can impact motor function, cognitive abilities, and overall health during the subacute stroke phase.
- Skin care is essential for maintaining healthy skin to prevent skin conditions during the subacute stroke phase.
- Therapies and treatments such as CBD have shown potential in managing various neurological disorders, including those arising from a stroke.
- Sleep, a vital aspect of overall health and wellness, can be affected during the subacute stroke phase and contribute to post-stroke fatigue.
- Mental health play a significant role in emotional well-being during the subacute stroke phase, and mental health counseling may be beneficial.
- Mens health includes various aspects such as prostate health, sexual health, and cardiovascular health, all of which can be impacted during the subacute stroke phase.
- Nutrition plays a crucial role in maintaining overall health and vitality during the subacute stroke phase, with a focus on weight management and optimal organ function.
- Falling under the category of respiratory conditions, pneumonia can pose a risk during the subacute stroke phase due to difficulty swallowing.
- Digestive health is essential in maintaining proper nutrition during the subacute stroke phase, with an emphasis on digestive functions and suitable diet choices.
- Sports like football, soccer, basketball, baseball, hockey, tennis, golf, and mixed martial arts require appropriate care and physical preparation to prevent injuries during the subacute stroke phase.
- Eye health is crucial in preventing vision loss and eye-related complications during the subacute stroke phase.
- Hearing impairment is a possible complication that may require regular check-ups and appropriate care during the subacute stroke phase.
- Womens health, encompassing gynecological and maternity care, can be impacted during the subacute stroke phase, emphasizing the importance of regular medical check-ups and prenatal care.
- Parenting responsibilities may require additional support during the subacute stroke phase, particularly in managing physical and emotional needs of both parent and child.
