Yes! There is still a possibility of a quality life after a stroke!
The very word “stroke” indicates that no one is ever prepared for this sudden, often catastrophic event. Life changes quickly, but with rehabilitation, the quest for better quality of life begins and continues. Rehabilitation starts in the hospital as soon as possible after the stroke, to enable an individual to achieve the highest possible level of independence.

Successful rehabilitation depends on:

• Extent of damage to the brain
• Timing of rehabilitation - the earlier it begins the more likely the survivors are to regain lost abilities and skills.
• Skill on the part of the rehabilitation team
• Cooperation and motivation of the affected individual, family and friends.

At Normah, our multi-disciplinary team, which includes physiotherapists and occupational therapists, works with the patient and family to evaluate the effects of the stroke and develop a goal-orientated program to recover functional abilities, or develop skills to compensate for a long and maybe a permanent disability.

For most stroke patients, physiotherapy is the cornerstone of the rehabilitation process. A physiotherapist evaluates muscle power, control, balance and coordination, and mobility and uses exercises training, with the intent of restoring movement and functions. The aim of the physiotherapy is to have the stroke patient relearn simple motor activities such as lying down, sitting, standing, walking, and the process of switching from one type of movement to another.

Occupational therapists assess cognition, arm and hand movement, coordination, mobility and balance to determine how each is affecting a person’s ability to complete his/her daily routine. It involves exercise and training to help the stroke patient relearn everyday activities such as grooming, self-feeding, bathing and dressing, reading and writing, getting on/off the toilet etc.

Caring family and friends can be one of the most important factors in rehabilitation.

Our Stroke Rehabilitation program promotes family involvement in the rehabilitation. In the early phases of the care, the rehabilitation team develops a treatment plan with the patient and his/her family. The therapists will teach the family how to assist with specific therapeutic activities. In this ongoing process, family members develop skills to help while the patient is still in the hospital and at home after discharge.

In view of providing intensive therapeutic sessions to those who are unable to achieve functional goals as effectively on an outpatient basis, an Inpatient Rehabilitation Program was introduced at NMSC. This program offers a discounted rate for rooms and therapy sessions. This program helps to “bridge the gap” between hospital and home and prepares individuals/ families to return home after a hospital stay. Patients stay in the ward, usually 2 to 3 weeks, and engage in a coordinated, intensive program of at least 3 hours of active therapy a day. Full- time access to medical services is available if required. Normah also provides comprehensive rehabilitation services in an outpatient setting in which patients come from home for their therapy sessions.

Sometimes we perceive and make remarks like “he or she is lucky to be walking again.” We have learned that the word luck suggests accident, or some random fluke. Luck just doesn’t happen enough in hospitals or in Physiotherapy Department. It is about providing the best care available from the medical professionals, determination, love and perseverance of all involved, to renew hope, realize new potential and restore independence.

What actually happens in our Physiotherapy Department? My answer- “some great stories”. If you think of it, each day of all our lives is filled with stories: what did you do in school today; tell me what happened at work and so on.

It is a story of a pleasant seventy year old Chinese lady who suffered a rather severe stroke. During the initial therapy session , tearfully, she expressed her desire to be able to walk into the temple one day to worship. Her several months on the wheelchair had discouraged her enough that there was no hope left to be ambulant. Following a period of intensive therapy, determined effort and much encouragement, her dream was realised. She is now independently walking with a walking stick - free to choose where, when and with whom she would like to be, or even to be on her own, a freedom we often take for granted. Total ignorance of the benefits of rehabilitation could have deprived her the chance of restored ability.

Picture 1: Sitting Balance Activities
Picture 2: Reorientation patient to upright position with a tilt table
Picture 3: Balance activity in standing
Picture 4: Practicing fine motor skills

A Chinese man, in his 60s, had his brain surgery done elsewhere and was discharged without physiotherapy. After several months of sedentary, almost bed bound life, he was encouraged by a relative to come for rehabilitation. He is now able to walk around independently. This not only gave him a chance to enjoy a reasonable quality life again, his recovery also makes much difference to the lives of those loved ones involved.

A Bidayuh man in his 70s , previously seemingly fit, found himself waking up one morning, unable to get out of bed. Stricken with a severe stroke, the man was nursed comfortably in bed 24 hours without knowing that there is still hope for him to enjoy an improved quality of life. Rehabilitation commenced, soon enough before complications set in. Although he is still not as mobile as others, the family has learned to manage him so well that he can be transferred effortlessly in and out of bed , enabling him to enjoy a life out of the bedroom.

This is a small portion of our harvest of NMSC Physiotherapy Department stories.

Stories of overcoming spirit, dedication, love and faith;

Stories of anger, injustice and acceptance...

This is not just about luck. It is about hard work of achieving goals of very basic skills, which we often take for granted.

I’ve just told you the stories of my day in Physiotherapy... it is not just about exercises and walking aids.

What are your stories? ..........

Stroke Rehabilitation Program

Picture 1,2 & 3: Strengthening exercise & balance training with and without a splint support.
Picture 4:  Assisted arm exercise

Ms. Su Lee Nah
Chief Physiotherapist