University of Calgary

Improving recovery

August 21, 2007


Improving recovery from minor strokes

The after-effects of a medically-termed ‘minor stroke’ often result in hidden disabilities that significantly impair a stroke patient’s full recovery, a new study at the University of Calgary demonstrates.

“Strokes are typically classified as minor, moderate or severe, based on the extent of resulting physical deficits,” says Teri Green, a PhD candidate in the U of C’s Faculty of Nursing and post-doctoral fellow in the Calgary Stroke Program. “A minor stroke therefore results in minimal to no residual physical deficits, but for our study participants, their difficulties were often related to these hidden disabilities that impeded functional recovery and full reintegration into family and community roles.”

Green suggests increased awareness and access to education programs targeting prevention and lifestyle modification strategies are essential for patients to better comprehend the obstacles, including fatigue, loss of concentration and memory recall, which will challenge that recovery process.

Green suggests that, in addition to public education, enhanced health care services could better support minor stroke patients and their families by following up post-discharge and allowing for re-access to the health care system for rehabilitation support.

Numbers from the Heart and Stroke Foundation of Canada indicate that 40 to 50,000 Canadians per year have a stroke: about 60 percent of those have what is considered a mild stroke with no or minimal residual physical deficits. Less than one-half of these patients return to their previous employment.

For her study, Green followed a group of patients who had suffered minor strokes and their wives for the first three months after discharge. She interviewed 48 couples at the time of discharge and contacted each couple monthly for three months. Green found that nearly half of the patients and spouses had difficulties in recuperation and family function, with problems surfacing in their employment, social and recreational activities and family interactions.

Richard Lamoureux, 41, suffered a minor stroke in March 2006 and, although discharged from the hospital four days later, found that his recovery took much longer.

“In terms of what came after the stroke, it was definitely not something I would call minor,” Lamoureux said.  He felt unusually tired and wanted to sleep all the time and experienced memory problems and physical weakness on the left side of his body. 

“I also lost the ability to drive for a time due to visual problems directly caused from the stroke.  This made it very difficult to have any real independence,” he said.  “When I eventually got back to work full-time nearly six months later,  I started to notice that I seemed to be a lot more serious about things and wasn’t as ‘happy-go-lucky’ anymore.  That bothered me,” Lamoureux said. “I would try to be more happy and I knew that it wasn’t me anymore – a very different thing.  No one really told me what to expect for recovery.”  

When he suffered a second stroke earlier this year, the symptoms and recovery were entirely different and infinitely more trying. While he is back to work, Lamoureux admits that it is more difficult now and he is uncertain about his future health.

Lamoureux’s wife and primary support person, Allison, also experienced difficulty during the early recovery period.

"When we left the hospital I had no idea what to expect and at first the desire to just help him 'rest to recover' was strong,” she said. “With having four children at home, it became tiresome to also be a caregiver to my husband – being his chauffeur, always reminding him to take his medicine because he would forget.  You take simple things for granted until they are not there.”

Allison Lamoureux describes how her husband’s recovery process has impacted her family and how she feels a stronger support system is needed.

“Everybody but Richard noticed how he became irritated so easily, and especially after the second stroke, there have been many days where I have felt like this is not the same man I married,” she said.  “My older children have even gone through a grieving period for the loss of how their father was.  There was no way to prepare for this and no real help or support to help us go through it. It is truly day by day, with a hope for things to improve over time."

Green acknowledges that Lamoureux’s experience is not atypical of other participants in the study and is something she became familiar with as a clinical nurse.

"This is such a superb example of how nursing research develops: it comes from what nurses are directly experiencing in the health care environment," says Dr. Kathryn King, Faculty of Nursing professor and Green's PhD supervisor. “Teri's study began with a hunch based on her many years of clinical practice with stroke patients and the results have justified what she has thought for some time.” 

King adds that the next step for Green will be to undertake a much larger study to fully examine the extent of these findings.

Green was supported by the Heart and Stroke Foundation of Canada and the Canadian Stroke Network and by the Alberta Heritage Foundation for Medical Research. Research funding was provided by the Canadian Association of Neuroscience Nurses and the Calgary Health Region.

For more information, contact:
Karen Cook
Communication Manager
U of C Faculty of Nursing
Phone: (403) 220-4361

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