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

Current Focus on Prevention and Treatment of 'Brain Attack' Saves Lives but

Appears to Mask the Needs of the Forgotten Stroke Survivor

Aug 14, 2006, 01:00 ET from National Stroke Association

    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
     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
     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:

          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:

      (5) National Stroke Association Web site:

      (6) Williams GR, Jiang JG, Matchar DB, Samsa GP. Incidence and Occurrence
          of Total (First-Ever and Recurrent) Stroke. Stroke.

SOURCE National Stroke Association