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New Survey From National Stroke Association Emphasizes Need for More, Better Care After Stroke

Posted on: Monday, 14 August 2006, 06:00 CDT

ENGLEWOOD, Colo., Aug. 14 /PRNewswire/ -- Approximately 5.4 million people(1) have survived a stroke, but few of them get the rehabilitation they need to improve their quality of life, according to a new national survey of more than five hundred stroke survivors and caregivers. In fact, more than 40 percent of stroke survivors surveyed reported limited success in meeting their rehabilitation goals, which include the ability to walk better and regain their speech. Nearly the same percentage of respondents said they lack information on rehabilitation and recovery after stroke.

"Because more than two-thirds of people who sustain a stroke will survive, it's important that they know about all their rehabilitation options for getting the best possible treatment for their particular situation," says Dr. Gerard E. Francisco, physical medicine and rehabilitation doctor and spokesperson for the National Stroke Association. "Recent research has shown that rehabilitation can help a stroke survivor regain motor function after a stroke, however, recovery is a journey and interventions need to be considered along the way for the patient to gain and sustain as much independence as possible and attain the best possible quality of life."

The specific abilities that will be lost or affected by stroke depend on the extent of the brain damage and, most importantly, where in the brain the stroke occurred. Stroke survivors in the survey report that among the potential after-effects of stroke they may experience -- which may include depression, memory loss, communication problems, difficulty performing daily tasks, muscle tightness or pain -- they are most concerned with regaining their movement and mobility (53 percent).

"We know that stroke survivors are on a lifelong journey but the majority of survivors are not getting the latest information about their rehabilitation needs and options. They have become the forgotten stroke survivor," says James Baranski, chief executive officer and executive director of the National Stroke Association. "National Stroke Association and its partners are working to bring the latest information to survivors and empower them to ask their doctors the appropriate questions to improve the quality of their lives."

One of the many tools offered by the National Stroke Association is the Stroke Recovery Scorecard. This tool helps stroke survivors and caregivers rate quality of life issues from movement to sexuality. It also can be used as an aid in discussing stroke issues with their doctors.

Post-Stroke After Effects

Difficulty with movement and mobility after a stroke is caused by a condition known as spasticity -- tight or stiff muscles that can make movement, especially of the arms and legs, difficult or uncontrollable. Managing spasticity can sometimes have dramatic and meaningful results on a stroke survivor's ability to complete basic activities of daily life, such as movement and walking, as well as bathing and dressing. However, while 58 percent of survivors in the survey experience spasticity only 51 percent of those have received treatment for this condition.

For those who experience spasticity, which usually appears within the first year after a person sustains a stroke, rehabilitation may involve one or more of the following: physical or occupational therapy, oral medications, or injectable options. However, according to the survey, there is another rehabilitation tool -- which is under-utilized, yet safe and effective - called Intrathecal Baclofen Therapy or ITB Therapy(SM). ITB Therapy uses an implantable drug pump that can ease the tight, stiff muscles that affect stroke survivors. It is a rehabilitation option that has been proven to offer significant improvement in functional motor control, independence, and quality of life.(2)

The survey indicates that only a small percentage (three percent) of stroke survivors are offered this treatment option, despite the fact that ITB Therapy results in statistically significant improvement in walking speed, functional mobility ranges, and spasticity.(3) Survey respondents were more commonly given motion exercises (58 percent), gentle stretching (51 percent), oral medications (47 percent) or injectable medication (33 percent) for their rehabilitative treatment.

Rehabilitation Options

The majority of those who experience stroke will need some form of rehabilitation in their recovery process. However, because there is a wide range of options available, many may not be receiving the treatment that best fits their needs. According to survey results, approximately half are not seeing a specialist to treat the after-effects of stroke and nearly half are not receiving home therapy to address their needs.

"Post-stroke rehabilitation needs vary from person to person," said Dr. Francisco, associate director of the Brain Injury and Stroke Program at The Institute for Rehabilitation and Research (TIRR) in Houston, Texas. "But the important thing is that the individual begins rehabilitation immediately and is aware of all the options available to him or her so he or she maintains or regains as much movement and mobility or prevent complications such as contractures that can develop when spasticity is not adequately treated."

Rehabilitation options for those who sustain a stroke have advanced in recent years. However, this survey suggests that in many cases, a patient's spasticity is not addressed properly with an interventional option, like ITB Therapy. According to Dr. Francisco, "This lack of adequate and timely treatment may account for the fact that many survey participants reported that they are not reaching their rehabilitation goals."

About Stroke

A stroke, or "brain attack," occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain. Brain cells can die from decreased blood flow and the resulting lack of oxygen.(4)

When brain cells die during a stroke, abilities controlled by that area of the brain are impaired. These abilities include speech, movement and memory. How a stroke survivor is affected depends on where the stroke occurs in the brain and how much of the brain is damaged. Some people recover completely from stroke, but more than two-thirds of survivors eventually have some type of disability.(5)

Although we know more about stroke signs and symptoms than ever, more than 750,000 Americans have a new or recurrent stroke every year -- and the incidence is on the rise.(6) Despite the number of people stroke affects, there is still a stigma for survivors. In fact, according to the survey, 43 percent of the general public said they wouldn't help, or weren't sure if they would help, someone who had a stroke.

"Unfortunately, there is still a stigma associated with having a stroke, especially when it comes to the after-effects that may occur as a result," said Dr. Salman Azhar, spokesperson for the National Stroke Association and director of the stroke center and chief of rehabilitation services, Lutheran Medical Center, Brooklyn, NY. "Individuals who experience stroke clearly want to return to their pre-stroke self as much as possible, and now we have the tools at our disposal to accomplish a significant level of recovery."

About the Survey

This national survey included 504 Americans who have either suffered a stroke or are the primary caregiver for a stroke survivor, and 523 individuals in the general population, ages 18 or older. To qualify for participation in the survey, the stroke survivors indicated that they have experienced difficulty or limitations with movement, speech or balance as a result of their stroke. Interviewing for the study was conducted from March 27 - April 2, 2006. The margin of error for this group is plus or minus 4.3 percentage points. The survey was conducted by Russell Research on behalf of the National Stroke Association with funding provided by Medtronic, Inc.

About National Stroke Association

National Stroke Association is the leading national non-profit organization devoting all of its efforts and resources to stroke. National Stroke Association provides the most up-to-date information on prevention, treatment, rehabilitation and support for stroke survivors and their families. For more information on National Stroke Association and our programs please contact 1-800-STROKES or visit http://www.stroke.org/.

ITB Therapy is a registered service mark of Medtronic, Inc. (1) Howard, VJ. Data Needs for Cardiovascular Events, Management, and Outcomes. As presented at the National Heart, Lung, and Blood Institute workshop, May 26-27, 2005. Available at: http://www.nhlbi.nih.gov/meetings/workshops/cvd-events/howard.htm. Accessed 6/22/06. (2) Schiess M. Neurology 2006 S48.006 [abs] (3) Francisco G. Arch Phys Med. 2003 (4) National Institutes of Health, National Institute of Neurological Disorders and Stroke: Brain Basics: http://www.ninds.nih.gov/disorders/stroke/preventing_stroke.htm (5) National Stroke Association Web site: http://info.stroke.org/site/PageServer?pagename=STROKE (6) Williams GR, Jiang JG, Matchar DB, Samsa GP. Incidence and Occurrence of Total (First-Ever and Recurrent) Stroke. Stroke. 1999;30:2523-2528.

National Stroke Association

CONTACT: Brian Kolonick of National Stoke Association, +1-303-754-0918;or Trina Chiara of Ogilvy Public Relations Worldwide, +1-215-751-7074

Web site: http://www.stroke.org/

Source: PRNewswire

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