Our Stroke Rehabilitation Approach
How Physical Medicine & Rehabilitation Can Help in Stroke Recovery
Our multi-specialty stroke rehabilitation program aims to address a variety of impairments caused by stroke, working in a close partnership with you and your family. Below is an overview of rehabilitation professionals that may be involved in your care.
-
Our rehabilitation physicians develop rehabilitation plans that meet recovery needs of each patient. A physician will help you build a recovery roadmap, set milestones, coordinate care, evaluate progress, and will meet with you as long as necessary to offer support in your life post stroke.
-
Our physical therapists can help address such symptoms as weakness, loss of balance, difficulty walking or moving a part of your body due to paralysis. They may recommend a variety of therapies based on your needs, which may include aquatic therapy, gait analysis and training, strength and flexibility exercises, endurance training, and may others.
-
Our occupational therapists focus on helping you be more independent when it comes to self-care tasks like getting dressed or brushing your teeth, as well as other activities of daily living essential to being functional at home or at work. Occupation therapists can also help with certain cognitive impairments like trouble concentrating.
-
Our speech-language therapists offer solutions to a variety of swallowing, voice, language and speech issue that may arise after a stroke.
-
Our rehabilitation psychologists and neurospychologists work with you and your family to help adjust to emotional, cognitive and behavioral changes brought on by surviving a stroke.
Innovative Rehabilitation Technology and Techniques
Depending on the parts of the brain affected, you may have trouble with some activities you were able to do before. Our stroke rehabilitation program offers the latest rehabilitation technology and therapy techniques to address a variety of impairments caused by stroke and help assist in your recovery. Some of the technology and techniques we may use include:
-
Our therapists use interactive games, similar to video games, to get patients moving in a more engaging way. A number of games and systems may be used, depending on your recovery needs. In general, they use sensors and body motion capture technology to give real-time feedback on a patient’s quality of movements during therapy. This information will then be utilized for motor retraining and practice.
-
Often after stroke, people are not able to walk in the same way. We employ a variety of technologies to help you regain strength and balance:
- Weight assistance treadmill: A body weight-assisted device that allows patients to practice walking with reduced body weight and without the hazard of falling.
- Split-belt treadmill: A treadmill with belts that go at different speeds — people who have had a stroke are quick not to use the affected side, which helps balance out strength and comfort on the affected side.
- Gamified treadmill: A treadmill that projects images onto the track to promote high repetition movements which is important for recovery.
-
Functional electrical stimulation is a technique that implements electrical currents to cause muscles to contract and can be applied to various parts of the body to help improve muscle strength, reduce muscle tone, improve functional tasks such as reaching, grasping, rolling, standing and walking.
-
An interactive metronome is a dynamic computer-based tool that is used to connect thinking processes and physical movement. The interactive metronome can be used during speech, physical or occupational therapies.
-
After stroke, some people may experience changes in their vision. Therapists perform a vision screening to identify visual challenges that may impede one’s ability to complete their daily routine. We work with neuro-optometrists and ophthalmologists to guide treatment programming. Our therapists provide a variety of treatments to promote safety and functional independence.
-
Anyone who has had a change in status that may impact their ability to safely operate a vehicle and engage with the surrounding environment during driving can benefit from a driving evaluation. Our driving evaluation provides objective data and professional clinical input regarding a person’s ability to safely engage in driving. An evaluation is conducted by an occupational therapist to assess cognitive, motor and visual perceptual skills as they relate to driving and MVA standards. Resources, equipment and strategies can also be discussed to ensure both independence and safety are maximized.
-
NIBS can increase the excitability of targeted parts of the brain. Pairing it with individualized, tasks specific, intense rehabilitation can lead to greater improvements in function than rehabilitation alone. Your care team will evaluate your case to see if this would be beneficial. NIBS is partially covered by insurance, but requires some out-of-pocket payment from the patient; for details, please speak with your insurance provider.
Inpatient Rehabilitation
At Johns Hopkins, we involve rehabilitation professionals such as physiatrists and physical therapists, occupational therapists, speech therapists and psychologists into patient care teams for stroke patients within the first 24 to 36 hours of hospital admission. This early intervention helps prevent complications of bed rest and immobility while also enabling holistic treatment planning for functional improvements.
Our Approach to Inpatient Stroke Rehabilitation
Rehabilitation begins while you are still under the care of a neurologist in the Brain Rescue Unit as part of our Acute Stroke Services.
Early in your hospitalization, on a daily basis you will receive up to two 30-minute sessions of:
- Physical therapy
- Occupational therapy
- Speech therapy
Treatment plans are crafted around areas where you need support. For example, if you do well getting in and out of bed but are unsteady while walking, the team will focus on exercises to improve balance.
These early and often interventions during hospitalization can help patients graduate more quickly to outpatient care rather than transferring to an acute rehabilitation unit.
Our Inpatient Locations
We offer inpatient stroke rehabilitation services comprised of a team of experts in two inpatient rehabilitation treatment facilities in the Baltimore region.
How We Help Plan Your Stroke Recovery Beyond Inpatient Rehabilitation
Our stroke rehabilitation experts have developed effective protocols for follow-up care when you leave the hospital after a stroke. Each treatment plan is individualized depending on your needs. For each discipline (speech, occupational and physical therapies), you will enter at the appropriate path below based on your impairment.
| Treatment Plan | ||||
|---|---|---|---|---|
| Step 1 | Evaluation At this initial evaluation, our stroke rehabilitation specialists will determine which path is right for you. You may start at Path A and go through each path in order, or you may start at Path B or C depending on your needs. |
|||
| Step 2 | Path A5 Session Frequency: 5 times per week for 2 weeks, then 4 times per week for 2 weeks |
Path A3 Session Frequency: 3 times per week for 6 weeks. |
Path B Session Frequency: 2 times per week for 4-8 weeks |
Path C Session Frequency: Once a week for up to 12 weeks |
| Step 3 | Re-evaluation At any point, you can transition between paths or move to monitoring once you are re-evaluated and it is deemed appropriate. |
|||
| Step 4 | Monitoring After the completion of your rehabilitation program, you will have periodic follow-ups to keep track of your progress and identify any additional needs for treatment. |
|||
Schedule An Appointment
Schedule by phone
Therapy appointments:
Maryland clinics except Bayview: 443-997-5476
Johns Hopkins Bayview: 410-550-0414
Sibley Memorial Hospital: 202-364-7665
Schedule online through MyChart
