Rehabilitation After a Stroke

People who have had a stroke may need to relearn basic skills, including walking and talking. A stroke may result in a variety of lasting problems, such as paralysis on one side of the body, or a loss of speech or motor skills. NYU Langone’s Rusk Rehabilitation offers a stroke program with physical and cognitive services led by a highly skilled team of specialists.

A Rusk Rehabilitation physician who specializes in rehabilitation medicine, called a physiatrist, is an important member of the stroke team. He or she determines what kinds of specialized services a person needs, such as physical therapy, speech therapy, psychological counseling, and therapies for swallowing disorders. 

A physiatrist works with the person who has had a stroke and his or her family members to identify the person’s medical needs and determine treatment goals. Next, the physiatrist and rehabilitation team develop a treatment plan designed to help the person achieve the best possible outcome.

The stroke rehabilitation services at Rusk Rehabilitation include both inpatient and outpatient programs. Inpatient rehabilitation often begins in the acute stroke unit at NYU Langone’s Tisch Hospital. It may continue for an additional two to three weeks at Rusk Rehabilitation’s inpatient unit for stroke rehabilitation at the Hospital for Joint Diseases

As a person recovers, he or she may receive outpatient rehabilitation from Rusk specialists at NYU Langone’s Ambulatory Care Center.

Acute Stroke Rehabilitation

Rusk Rehabilitation offers specialized services for people who have had a stroke. Patients and their family members work with a team that may include nurses, social workers, physical and occupational therapists, speech-language pathologists, swallowing disorder specialists, psychologists, and nutritionists.

People who have had a stroke and their families are encouraged to participate in Rusk’s stroke-specific orientation series, a program designed to educate people about stroke and the rehabilitation process. 

Acute stroke rehabilitation is performed on an inpatient basis for a minimum of 15 hours a week and typically lasts 1 to 3 weeks.

Inpatient and Outpatient Rehabilitation Services

NYU Langone’s Rusk Rehabilitation offers inpatient and outpatient rehabilitation services for people who have had a stroke.

Physical Therapy

The goal of physical therapy is to improve mobility, increase independence, relieve pain, and minimize limitations due to permanent disabilities. To accomplish this, our physical therapists develop programs tailored to each person’s needs, which may include working on strength, flexibility, balance, and coordination. 

Physical therapy sessions, exercises, and activities focus on removing obstacles to movement and on educating a person about how to move around safely.

During an inpatient stay, you may have physical therapy sessions for a few hours every day. A therapist works on restoring your ability to perform daily activities, such as sitting up in bed, standing, sitting in a chair, walking, and climbing stairs. 

Our therapists use multiple treatment techniques to help people regain functional mobility. These include body weight-supported treadmill training for early walking efforts. This technique uses an overhead suspension system to support a person’s body weight as he or she walks on a treadmill. Training may also include specialized equipment to help people regain balance.

Occupational Therapy

Occupational therapy also plays an important role in the rehabilitation process. The goal is to help people regain their independence after a stroke. An occupational therapist works with each person for a minimum of an hour a day to address difficulties that affect a person’s daily life, such as dressing, bathing, managing a household, or working.

A therapist assesses a person’s abilities after a stroke. This includes physical skills, such as strength, coordination, and balance, and cognitive skills, which include memory, problem solving, and the ability to focus on an activity. 

The therapist also observes a person’s visual skills, including scanning and depth perception. Psychological skills are assessed, such as the ability to cope and manage frustration. Occupational therapists also check a person’s sensory skills, such as the ability to identify different textures or temperatures.

Together, people who have had a stroke and their occupational therapists identify and prioritize the skills that need to be improved on to increase functional independence. If necessary, occupational therapists can recommend and provide tools to make activities of daily living easier, such as canes, walkers, or wheelchairs,  and home modifications, such as ramps and support bars. 

Speech-Language Therapy

People may experience many types of communication challenges after a stroke. Speech-language therapists can address communication difficulties, including aphasia, dysarthria, and cognitive-communicative impairment. 

In aphasia, a person’s ability to use or understand language is impaired. People with this disorder have difficulty speaking and understanding spoken language, reading, and writing. Treatment involves addressing one or more of those areas. 

Dysarthria occurs when a person has trouble performing the movements required for speech. Typically, the major difficulty is a lack of strength in or control of the muscles of the lips, tongue, or larynx (voice box). Treatment involves strengthening these muscles. 

Cognitive-communicative impairment arises from problems in the underlying thought processes involved in communication. For example, having trouble concentrating, remembering, or reasoning can affect a person’s ability to communicate. Treatment involves identifying the impact this impairment has on everyday activities, and finding ways to work with this impairment or restore cognitive function. 

Upon discharge from Rusk Rehabilitation, people who have speech-language problems often continue therapy through an outpatient program.

Psychological Services

People who have had a stroke may work with NYU Langone psychologists to address the stress associated with stroke and being in the hospital. Rehabilitation psychologists provide emotional support and help people who have had a stroke get the maximum benefit from their treatment. 

Our specialists identify and address the emotional reactions that often occur as a result of different disabilities. They help people develop coping skills and strategies that address the psychological and social impact of stroke, improving their overall wellbeing. 

Psychologists first see people who have had a stroke when they are referred to rehabilitation. These specialists ensure that the rehabilitation program is tailored to the person’s and family’s needs. They also help the rehabilitation team maximize treatment efforts. A brief neuropsychological exam is used to help determine which functions have been most affected by the stroke. 

Treatment typically involves individual therapy and, when appropriate, group therapy. Cognitive remediation and supportive therapy—which teach strategies for improving everyday memory—are provided to help people compensate for and manage cognitive changes. 

Community Reintegration

Each person faces unique challenges after a stroke and may need to develop new ways to perform everyday activities. Rusk physical therapists work collaboratively with other members of the rehabilitation team, including occupational therapists, speech therapists, nurses, social workers, and psychologists. This team of experts can prepare a person who has had a stroke for a safe discharge home or, when appropriate, to the next level of rehabilitative care. 

Our therapists help people prepare for reintegration into the community. They help people relearn the skills required to cross streets and take public transportation, as well as those necessary to function at home, work, school, and in recreational settings.