Stroke Rehabilitation in Kyiv and Bila Tserkva

A stroke is a sudden disruption of blood flow in the brain: an area of tissue stops getting oxygen and begins to die. That is why help is needed immediately. If you suspect a stroke, call 103 and do not wait to see whether it passes. Speed affects both survival and how much function can be regained later.

Stroke rehabilitation at CSM Clinic helps restore what the stroke took away: movement, speech, swallowing, memory and the ability to take care of yourself. A hospital treats the acute phase, and we take over once the condition is stable. In Kyiv, patients go through rehabilitation on an outpatient basis, following a personal program. In Bila Tserkva we accept patients for both outpatient and inpatient rehabilitation, with a continuous stay at the clinic.

Each patient works with a team: a neurologist, a physical and rehabilitation medicine doctor, a physical therapist, an occupational therapist, a speech therapist and a psychologist. We build the plan around the individual and set goals you can see in daily life: standing up from a chair without help, getting dressed, talking on the phone.

What causes a stroke, and what are the symptoms?

A stroke happens when an artery that feeds the brain narrows, becomes blocked or ruptures. Common contributing factors are:

• atherosclerosis and high cholesterol;
• high blood pressure, especially when it goes untreated;
• atrial fibrillation and a previous heart attack;
• poor blood clotting;
• diabetes and obesity;
• a ruptured aneurysm;
• a sedentary lifestyle and harmful habits.

What are the warning signs of a stroke?

A stroke almost always begins suddenly. Watch for these signs:

• sudden weakness or numbness in a limb, or a drooping face;
• trouble speaking or understanding what is said;
• loss of consciousness;
• disorientation, loss of coordination and balance;
• severe headache.

If you notice even one of these signs, call 103 right away. Do not drive to a clinic and do not wait for it to pass. Note what time the symptoms started, because the doctors will need it. Once the acute phase is over, a neurologist and a physical and rehabilitation medicine doctor take over: they draw up the recovery plan and treat the effects of the stroke.

What are the types of stroke?

There are two main types of stroke: ischemic, when a clot or cholesterol plaque blocks a vessel, and hemorrhagic, when a vessel ruptures and bleeds into the brain.

• Ischemic stroke is the most common and accounts for more than 80% of cases.
• Hemorrhagic stroke is bleeding in the brain from a damaged vessel.

Doctors also note which side of the brain was affected. The left hemisphere controls the right half of the body and, in most people, speech. So after a left-hemisphere stroke the right arm and leg weaken and speech is often affected. After a right-hemisphere stroke the left side weakens, and a person may not notice objects on their left. A doctor determines the type and location of the damage from brain imaging.

What are the possible effects of a stroke?

The effects depend on which part of the brain was damaged and how severely. In the acute phase a person may lose speech completely or partly, see worse, or be unable to keep their balance. If these problems disappear within minutes or hours, it may have been a transient ischemic attack (TIA), a brief disruption of blood flow in the brain. It is a warning sign: even if the person feels better, call 103 and get examined.

Hospital treatment is only the beginning. Everyone who has had a stroke needs help restoring lost functions and managing the effects. This is especially true for patients with severe damage, who often have the following problems:

• weakness or paralysis of an arm, a leg or one side of the body (paresis, hemiparesis);
• problems with speech, understanding and swallowing;
• problems with memory, attention and thinking;
• poor balance and coordination, an unsteady gait;
• loss or reduced sensation;
• emotional changes: anxiety, depression, irritability, tearfulness.

How much time is there to get help for a stroke?

Every hour counts. Clot-dissolving treatment (thrombolysis) is possible only within the first 4.5 hours after symptoms start, and only for ischemic stroke. That is why you call an ambulance (103) immediately, without waiting to see whether the symptoms pass. This treatment is given in a hospital, not at our clinic.

The outcome also depends on age, general health and chronic conditions. But even when the window for thrombolysis has passed, there is still a chance to regain function: rehabilitation works months after a stroke too.

Does CSM Clinic treat acute stroke?

No. CSM Clinic provides rehabilitation, not treatment of the acute and subacute phases. Patients come to us after their main treatment in a hospital.

Where can I get stroke rehabilitation: Kyiv or Bila Tserkva?

In Kyiv, stroke rehabilitation is outpatient. In Bila Tserkva it is outpatient or inpatient with 24/7 care. Which one fits depends on the patient's condition.

Stroke rehabilitation in Kyiv

At the Kyiv clinic, patients come to scheduled sessions on their own or with a companion, including in a wheelchair. There is no inpatient unit in Kyiv.

Stroke rehabilitation in Bila Tserkva

At the Bila Tserkva branch you can go through either outpatient or inpatient stroke rehabilitation. Inpatient means the patient lives at the clinic under round-the-clock supervision. Family members can stay in a comfortable hotel on the clinic grounds for the whole rehabilitation period.

CSM Clinic in Bila Tserkva has more extensive equipment and facilities. This matters in severe cases, where starting on time and training intensively are what count.

Can a patient who can barely move be admitted for rehabilitation?

The doctor decides this at the consultation. They will assess the patient's condition and tell you whether we can take the patient for rehabilitation and in what format.

How does a stroke rehabilitation course work at CSM Clinic?

One course lasts 14 days, with at least 3 hours of sessions per day. A course can include, among other things, work on speech and memory. Every case is different: before a consultation and examination it is impossible to say which stages of rehabilitation will be needed, so we build each program individually.

When can stroke rehabilitation start?

Rehabilitation can start once the acute phase is over. Timing depends on the type of stroke:

• ischemic stroke: usually no earlier than one month, after treatment of the acute condition;
• hemorrhagic stroke: two to three months later;
• aneurysm or hematoma: after a consultation with a neurosurgeon.

What does stroke rehabilitation help restore?

A course can be aimed at the following goals:

• eliminating or correcting movement disorders (paresis, hemiparesis);
• restoring balance and coordination;
• restoring sensation;
• restoring speech;
• restoring memory;
• correcting insufficient cerebral circulation;
• social adaptation.

What exactly is needed depends on the patient's condition and medical indications. In patients who start on time and train regularly we typically see strength return in the arm and leg, a steadier gait, clearer speech, and a person who eats, dresses and manages household tasks on their own again. How complete the recovery is depends on the brain damage, the patient's age and how much time has passed since the stroke.

What happens when you contact CSM Clinic?

It all starts with a consultation and examination. After that we follow this sequence:

• an examination by a neurologist and a physical and rehabilitation medicine doctor (and, as indicated, other specialists: a psychiatrist, psychotherapist, neurosurgeon, cardiologist or general practitioner);
• a personal rehabilitation plan, including the choice of recovery methods;
• an outlook based on the results of the rehabilitation assessment;
• the rehabilitation itself;
• monitoring of the clinical condition;
• psychological support, if needed.

What methods are used in stroke rehabilitation?

• Medication therapy.
• Physical rehabilitation: physiotherapy, massage, occupational therapy and therapeutic exercise to restore muscle strength, movement, coordination and balance.
• Occupational therapy: helps patients eat, keep up personal hygiene and dress on their own again.
• Speech therapy to restore speech and swallowing.
• Psychological support to help patients accept the changes and cope with fear, anxiety and depression. Music and art therapy may be used.
• Cognitive therapy to restore memory, attention and thinking.
• Assistive devices that speed up recovery and make daily life easier: exercise machines, walkers, orthoses.
• An individual nutrition plan.

Where indicated, hyperbaric oxygenation (HBO) and transcranial micropolarization are also available.

Why choose CSM Clinic for stroke rehabilitation?

We combine physical and psychological rehabilitation with medical care, and in Bila Tserkva we can offer inpatient stays. Here is what else sets our clinic apart:

1. Leading evidence-based methods of physical and psychological rehabilitation together with medical care.
2. A team of specialists from different fields working toward one goal: helping the patient return to independent life.
3. A strong equipment and facilities base and inpatient rehabilitation in Bila Tserkva, including a stay for an accompanying person.
4. A plan built around the individual patient, with clear goals.
5. A new, comfortable interior.

How much does stroke rehabilitation cost, and how do I book?

The cost of the program is set individually after we review the patient's medical records, because it depends on the prescribed procedures. To book a consultation or ask a question, fill in the online form or call our contact center. The sooner rehabilitation starts after the acute phase, the better the chance of regaining lost functions.

Sources

• Ministry of Health of Ukraine
• Ukrainian Wikipedia
• Public Health Center of the Ministry of Health of Ukraine