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What is a CVA/Stroke?
CVA, or cerebral vascular accident, also known as a stroke, occurs when blood supply to the brain is interrupted. Essentially, a stroke is a "brain attack" similar to what occurs during a heart attack, where the blood supply to the heart is blocked. There are 2 main types of strokes: 1) ischemic and 2) hemorrhagic. In an ischemic stroke, a blood clot forms and blocks an artery in the brain. This blood clot can either develop directly in an artery that supplies the brain or it may have first developed in another part of the body, usually in the heart or the carotid arteries from plaque fragments. The clot breaks off, and travels in the bloodstream to the brain, where it blocks a blood vessel and causes a stroke. In a hemorrhagic stroke, the blood vessel bursts in the brain and is typically caused by high blood pressure and/or aneurysms, which weaken the blood vessel walls.

What are some controllable risk factors for a stroke?
Patients and physicians should watch for the following conditions: high blood pressure (140/90), tobacco use (smoking doubles the risk for stroke), diabetes, carotid or other artery disease, atrial fibrillation or other heart disease (causes blood to pool in the heart leading to increased risk of clots), certain blood disorders such as sickle cell anemia, high cholesterol (increased risk of blockage), physical inactivity/obesity, excessive alcohol intake/illegal drug use.

What are some common stroke symptoms?

• Sudden numbness or weakness of face, arm, or leg, especially on one side of the body
• Sudden confusion, difficulty speaking, or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance, or coordination
• Sudden severe headache with no known cause
• Other less common symptoms include sudden nausea and vomiting different from a viral illness because of how fast it begins (minutes or hours vs. several days), brief loss of consciousness or decreased consciousness (fainting, confusion, convulsions, or coma)

What kind of therapy will stroke patients receive in a hospital?After a stroke occurs and you are admitted to the hospital, your doctor may order physical therapy, occupational therapy, and/or speech therapy to help increase your strength, ROM, balance, functional mobility/ADL, speech, comprehension, and ability to eat/swallow. Generally, activities in therapy will encourage you to increase awareness on your affected /weak side (often times, stroke patients neglect their weaker side), increase weight bearing on the affected side, and increasing mobility to avoid complications of prolonged bed rest during a hospital stay. Depending on your progress during your hospital stay, the therapists may recommend for discharge to inpatient rehabilitation, where you can undergo extensive therapy (up to 3 hours per day) to work on increasing independence and returning to your prior level of function. Other discharge options include home health care or home with outpatient therapy 2-3 times a week.

What are important factors in selecting an outpatient facility?Choosing the right outpatient facility is very important. It is recommended that you call various facilities to find out if they take your insurance and ask if they offer the various therapies that you need. It is also important to ask if you will get the same therapist each time you go for consistency and what types of equipment they have. For example, if you have difficulty walking or standing, does the facility have parallel bars? It may be a good idea to visit the facility to see if it is a right fit for you. At Brooks Outpatient, patients generally will see the same therapist for continuity of care and each treatment time typically lasts about 60 minutes.

What sort of treatment is given in outpatient therapy?
While in outpatient therapy at Brooks, your therapist will work on progressing you further with your strength, balance, coordination, and other higher level activities. Examples include weaning you to the least compromising assistive device, trunk/core strengthening, single leg stance balance activities on uneven surfaces, and establishing a wellness program to reduce risk of a second stroke. The goal is to get you back to your prior level of function before your stroke so that "you can be you again."

How long is outpatient therapy needed?
The length of stay in Brooks Outpatient therapy may vary depending on the severity of your stroke, your progress, and insurance limitations. Your Brooks therapist will work with you and your family on discharge planning from day one and discuss it on an ongoing basis as you go through therapy. Every 30 days, a progress report will be sent to your physician to update them on your progress in therapy.

To learn more about Brooks Rehabilitation Outpatient Therapy and to speak with Sally Yang, MS PT, call 321-594-5514, or please visit our Web site at www.brookshealth.org.


Sally Yang, Center Manager at Brooks Rehabilitation's Winter Park outpatient clinic, comes to us with 10 years of experience in PT. She was awarded her Masters of Science in Physical Therapy from the University of Miami in December of 1998 and Bachelor of Science in Biology from Cornell University in May of 1995. She has presented abstracts at the American Physical Therapy Association Convention and has been published.

Her specialties include pediatrics, orthopaedics and neurological diagnoses including cerebral vascular accidents/stroke, traumatic brain injury, spinal cord injuries, and guillion-barre.

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