Advances in health policy 2007

Life interrupted and life regained? Coping with stroke at a young age

Stroke is a leading cause of disability across the developed world, affecting an increasing number of younger people. In this article, we seek to understand the experience of stroke as a disabling life situation among young people and the strategies that they use to recover and cope. Directed content analysis was conducted from interviews with 17 community-dwelling stroke survivors aged 55 years and younger across the United Kingdom. The sample was drawn from a larger maximum variation sample of stroke survivors. Using the sociological concepts of biographical disruption and biographical repair as a guide, excerpts from the interviews pertaining to aspects of the patients’ life that were interrupted, in addition to how they coped with the changes, were selected and analysed. All individuals described an “altered sense of self,” a theme that included loss of identity, family disruption, and/or loss of valued activities. Individuals sought to adapt their sense of self by seeking external support, by restoring normality, and/or through positive reflection. Despite the adapted self that emerged, most individuals continued to experience impairments. While young stroke survivors adapt to their illness over time, they continue to experience impairments and disruptions in their personal and work lives. A holistic model of rehabilitation that helps individuals regain the capacity for everyday activities related to work, family life, and leisure can begin to address the emotional ramifications of diseases such as stroke, restore wellness, and work towards minimizing the burden felt by family caregivers and children.

Maximizing recovery from stroke: new advances in rehabilitation

Stroke is the leading cause of disability in the United States. The magnitude of its economic impact is growing due to improved survival and the aging of the population. Acute interventions for stroke have had little effect on cost. Functional neuroimaging and transcutaneous magnetic stimulation have enhanced our understanding of how the brain reorganizes during recovery and in response to rehabilitation. Cell transplantation combined with growth factors holds promise for the future. Restorative approaches involving repetitive practice are emerging as effective techniques in improving post-stroke function. Clinical adoption remains slow due to time and funding constraints. Health policy changes are needed that focus funding and research efforts on stroke recovery.