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

Question

For a woman in her 50s, who suffered a ischemic stroke
on the left side which affected her brocas area as well as part of her right upper limb.

Answer 1

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.

Answer 2

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