Can a Patient Who Is Paralyzed for 2 Years Recover?

One of our consultants asked: my mother had a clot in her brain 2 years ago. She received physical therapy but did not recover. Does she have a chance to recover anymore?

It is very important for patients who had a stroke to start physical therapy at the earliest period. In patients who have had a stroke, the rate of recovery is quite high especially in the first 6 months. However, this does not mean that recovery does not occur after 1 year or 2 years. There are some misconceptions about stroke in the society and even within the health system.

A patient has a stroke, is admitted to the emergency service and then to intensive care. The patient is finished with neurosurgery, neurology and leaves the intensive care unit. Then the patient's relatives may be told to take their patient home to rest for 1-2 months before starting physical therapy. This is a big mistake and unfortunately, it is still being done. Physical therapy should be started at the earliest stage when the patient's condition stabilizes.

Some patients may be called care patients at an early stage before undergoing rehabilitation. These patients may be sent to home care or patient care clinics. Many patients have been taken from patient care clinics in the early period and conducted to returning to daily life. The patient should first be directed to a clinic where they can receive intensive rehabilitation and their potential for recovery should be stimulated.

Another mistake is thinking that a patient who had a stroke 2-5 years ago has no chance of recovery. The relatives of the patient should seek advice from a combined center which works in the field of neuro-rehabilitation first.

Such a center includes specialists from many different disciplines such as physiotherapist, occupational therapist, physical therapy technician, speech and swallowing therapist and respiratory therapist. In these teams, each professional group can evaluate the patient in terms of their own specialty and make predictions about the patient's potential for recovery.

In a comprehensive neurorehabilitation center, the physical therapy and rehabilitation physician will draw a road map for the patient and their relatives. They find out what can be done for the patient, what functions can be improved and proceed accordingly.

The idea that it has been 2 years and recovery is impossible is very wrong. Maybe the patient did not reach optimum rehabilitation within 2 years. Maybe the patient had a disease such as diabetes and because it was not fully regulated, the neural tissue did not have the opportunity to recover. Maybe there is a heart rhythm disorder, and the patient has small repetitive strokes. These need to be detected well. The focus should be on how to improve the patient's activities of daily living, their functions and increase their quality of life.

Goals should be set for each patient according to the patient's condition. For example, enabling a patient who has been in bed for 2 years to sit with or without support will increase the patient's quality of life and independence.

Does The Brain Recover Itself?

It used to be thought that neural tissue could never recover. But studies have shown that there are a lot of reserve stem cells in the brain. Stem cells are the cells that are ready to be processed. If we can train the stem cells in the brain well, they can re-learn the task.

Neural tissue is open to recovery at any age and in any period. The potential to regenerate the brain of a 5-10-year-old child is of course much higher. But the brain has the capacity to regenerate itself at any age. Older people can learn a lot of new things, they can learn languages, they can learn to play an instrument, or they can study at university. As people learn new things, life is prolonged, and the brain renews itself.

What needs to be emphasized is the frequent, repetitive and continuously applied rehabilitation practices. Half an hour or an hour of exercise therapy in the clinic will not be enough for the patient to recover. The patient needs to transfer the activities which are gained in the clinic to daily life and home. With intensive and correct rehabilitation practices, recovery in neural tissue is always possible.