Steven Said:

would physical therapy be appropriate for a stroke victim? why/why not?

We Answered:

Yes, physical therapy is appropriate immediately after a stroke. At first, it may only involve very basic things such as learning how to sit up, get in a chair, maybe a little walking or balance. Not only does this help estabilish neuroplasticity (the ability of other areas of the brain to compensate for damaged ones), but also helps prevent pneumonia, contractures and bed sores. It is part of our standing orders that a patient who has a diagnosis of a stroke automatically receives a physical therapy evaluation. Of course, precautions such as monitoring vitals signs are important. Further more, aggressive therapy such as constraint induced therapy is avoided in the first few days because this can increase glutamate production, causing further damage. Therapy gets more aggresive in the first week or two AFTER the stroke.

Christy Said:

what would be the recommended timeline for speech and physical therapy for a ischemic stroke patient?

We Answered:

Every patient is different in the severity of the stroke, and you will see the most dramatic recovery in the first 3 months. She will continue to progress for many months (I was able to elicit progress with a patient 10 yrs after a left hemisphere ischemic stroke left him with only single-word utterances). Typically, with a stroke affecting Broca's area, a patient will have expressive aphasia and some degree of receptive aphasia (loss of language use). Hopefully, your friend (?) has good insurance so she can get the needed amount of therapy. HMO's usually limit the amount of therapy, and the therapists must get authorization every week, vs. every month with Medicare. I usually saw Medicare patients in nursing homes and outpatients at hospitals for up to three months, some as long as six months, as long as they were making "significant" progress in using gestures and drawing pictures as an adaptive way for communication. A "communication board" can be very helpful in allowing her to point to pictures to get her basic needs met. These should be the first objectives in order to reduce patient, family, and staff frustration. Developing home therapy programs and coaching family members in how to elicit the patient's best communication was essential.
I suggest occupational therapy for treatment of her right arm and for activities of daily living (ADL's), such as grooming, bathing, dressing and transfers.
Physical therapy can help her with walking (you didn't say if her right leg is weak), trunk control, balance, and muscle strengthening.

Leo Said:

TX- What type of aid is available for a young stroke victim without insurance?

We Answered:

He should have his doctor certify him as disabled so he can qualify for Medicaid. There is no other way. He would not be able to buy individual insurance. What was the reason for denial of Medicaid? Unless his doctor can get him into a nursing home that accepts Medicaid, nothing you can do. The nursing home or hospital would apply for social services and Medicaid for him.

Justin Said:

Where can I get free physical therapy in the Sacramento, CA area?

We Answered:

Try contacting the Physical Therapy schools in your area (California State University, Sacramento - for example). A student physical therapist may be interested in helping.

Otherwise, look into social security, medicare, medicare in your state.

Cheryl Said:

My friend had a stroke 3 months ago. Are there any games/puzzles I can take her to help w/ physical therapy?

We Answered:

Bring a magazine of her interest?

Almost anyone likes reading magazine don't know what particular subject magazine to pick up? Try Reader's Digest.

Puzzles- Crossword books, Sudoku books these can be found at practically any store.

Is she a big reader? Maybe more then just a magazine pick up a good book you don't think she's read nothing to you know depressing something more inspirational or humourous.

Ricky Said:

How can I get a Referral for physical therapy?

We Answered:

A referral for physical therapy will not mean it is free. One or both of you would have to be willing to pay out of pocket for the physical therapy. You should be able to get a "referral" from the doctor that treated him initially. Although, if you are paying out of pocket, that will not be necessary.

Juanita Said:

how can we do physical therapy ourselves?

We Answered:

It's a very complex situation and no one can really just tell you how to do it yourselves.

I recommend you approach a local hospital based facility...most likely a faith based one (a catholic hospital, etc)...in most cases, they have a charitable program and/or reduced fees for those in the situation like your grandfather. Then you could get professional guidance from a PT who could make specific recommendations based on your grandfathers presentation.