Strokes are one of the leading causes of disability in the United States but good stroke rehabilitation can help mitigate the effects of the stroke. It is important to begin stroke rehabilitation as soon as possible after the patient has been stabilized, often as soon as 24 to 48 hours after the onset of the stroke. Stroke rehabilitation helps survivors relearn skills lost when the brain is damaged and the goal of stroke rehabilitation is to help the survivor to be as independent as possible.

Successful stroke rehabilitation depends on the following factors:

• How early the rehabilitation begins
• The extent of the brain injury
• The survivor’s attitude
• The rehabilitation team’s skill
• The co-operation of family and friends
  
  

Stroke rehabilitation begins in acute care after the patient’s medical condition has been stabilized. The first step is to promote independent movement and range of motion exercise. If the patient is unable to move a limb, the therapist will do it. The rehabilitation goes in small steps from sitting up, then transferring from bed to chair, to standing and bearing one’s own weight, the walking with or without help. Survivors then move to more complex tasks like bathing, dressing, and using the toilet.

The disabilities from stroke are paralysis or problems controlling movement; sensory disturbances, including pain; problems using or understanding language; problems with thinking and memory; and emotional disturbances. The aim is to improve the ability to move, think, talk, and take care of oneself.
From acute care the patient may move on to several different places, depending on her needs, upon the ability of the system of services to provide rehabilitation in the most homelike environment, and upon the natural supports the patient has.

The patient may go to one of the following:

• A rehabilitation hospital
• A long term care facility 
• Her own home using home health services
• An outpatient facility
  
  

In addition to physical and cognitive disability stroke survivors often suffer from clinical depression and also from inappropriate laughing or crying so the emotional needs of the patient must be addressed.

A team, led by the patient’s doctor, is needed for stroke rehabilitation and may include some, or all, of the following:

• Rehabilitation nursing
• Physical therapy 
• Occupational therapy
• Speech-language therapy
• Audiology
• Recreational therapy
• Rehabilitation counseling
• Social work
• Psychiatry/psychology
• Patient/family education
• Support groups
  
  

Researchers at Rutgers University have developed an interesting bit of stroke rehabilitation. Using an Xbox modified to run on Linux they have made virtual reality hand exercises to help rehabilitate patients. The glove used is the Essential Reality P5 gaming glove. While this system isn’t as sensitive as the much, much more expensive systems used at some rehabilitation centers, it is inexpensive enough to use at home and at rehabilitation centers that can’t afford the more expensive solutions. Thus the Xbox can be used for stroke rehabilitation.