Timeline of Stroke Recovery

As I’m sure you are well aware, the return of strength and function occurs the most quickly in the first couple of months after a stroke.  As i discussed in “How does Stroke Recovery Occur?” there is a reason that stroke recovery slows down at a certain point, as the brain’s natural healing mechanisms complete their work, and the brain’s neuroplastic potential takes over any remaining improvement.

If you are looking for somebody to shoot straight with you about your potential for recovery, you’ve come to the right place.  First let’s talk about the Copenhagen Stroke Study.  Several articles have been published on the data collected from 1,197 stroke patients treated in a hospital in Denmark.  They basically found that functional recovery in the first few months is somewhat predictable, and that the largest gains occur in the first month.  Agreed.  No argument with that.  BUT, they went on to state that “no functional recovery should be expected after 5 months.” (1)

DON’T STOP READING YET! Here are a few problems with this Copenhagen study:  I couldn’t find any mention of the type of rehab program these stroke survivors were participating in, other than treatment using the Bobath Neurological Rehab techniques daily, until they were deemed to have reached maximum benefit.  No mention of how much time spent daily, use of FES?, use of treadmill training with robotic or therapist assist?, use of mental practice?, use of aerobic exercise?   how was their nutrition?  AND no mention of when their inpatient rehab services ended during this study.  It did say that the final follow up evaluation was performed at 6 month post-stroke, and seemed to imply that this was after they had been released from rehab services.  Soooooo…. did they stop rehab at 2 months?  3 months?

In my opinion, this study made some misguided assumptions about what is possible in stroke recovery.  Perhaps they did a good job of describing the typical process after a stroke:  intense rehab for the first 8-10 weeks (when the process of brain healing is at it’s fastest anyway), then discontinuation of rehab services when progress seems to slow down, the person goes home and loses motivation and guidance in their rehab efforts, and not much further progress is seen after that point.  That’s typical.

But that does not in any way define what is POSSIBLE in stroke recovery!  There are so many variables in this equation, the main one being your motivation.  So don’t be discouraged!  Other studies have continued to show improvements long after 6 months, and there are many reports of people improving their function through rehab efforts years after their stroke.