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Stroke Recovery Plateau: Why Progress Slows Down & How to Keep Going

doctor escorting stroke patient out of hospital after stroke recovery plateau

During the early stages of stroke rehabilitation, patients usually make rapid gains in function. After a few months, however, progress may stall. Therapists call this the plateau phase.

The stroke recovery plateau is a common phase that most survivors experience. But contrary to popular belief, it does not mean that your recovery has ended. In fact, it is possible to push through a plateau after stroke and regain more functions.

Today’s article will explain causes a stroke recovery plateau, and how you can overcome one when it occurs.

What Is a Stroke Recovery Plateau?

A stroke recovery plateau is a period of little or no gains in function after a period of rapid progress. These plateaus are frustrating and can make you feel as though you will make no further progress.

Most commonly, the stroke recovery plateau occurs around the 3-month mark. This is roughly the same time that spontaneous recovery slows down, too (more on this soon).

Many doctors in the past believed that recovery ended once a patient hit their first plateau. As a result, stroke rehab programs would discourage therapy after six months.   

But more recent research shows that plateaus are not permanent. Stroke recovery can, in fact, continue after a plateau. For example, a recently published report described one man who finally recovered movement in his hand 23 years after his stroke.

Therefore, if you experience a plateau after your stroke, do not give up. You can still make progress in your recovery, as long as you take the correct steps.

Causes of Plateaus After Stroke

3d drawing of Brain to illustrate what causes a stroke recovery plateau

Before you can learn how to break out of a plateau, it helps to understand what causes them to begin with.

The answer has to do with neuroplasticity, the brain’s natural repair mechanism. Immediately after a stroke, the brain enters a heightened state of plasticity. This means that it becomes easier for the brain to reorganize itself and recover lost function.

Heightened plasticity is responsible for most of the spontaneous recovery that occurs after a stroke. Unfortunately, this cannot last forever, and eventually the brain will revert to its less pliable state.

When the brain loses its extra plasticity, progress will slow down. This loss of plasticity is what causes plateaus.

However, even though plasticity is at a lower level, it is still present. This means you can still make progress, but it will take more work.

How to Get Past Stroke Recovery Plateaus

Repetitive, task-specific exercise engages the brain’s neuroplasticity, even during a plateau. Therefore, the best way to push through a plateau is to continue with your therapy.

This can be hard to do though, especially when it feels like you are not making progress. The following are a few ways to boost your motivation and push through plateaus after stroke:

1. Add Variety

group of seniors laughing in a community art class

Changing up your routine can help break up the monotony and increase your motivation. Some examples of how to add variety to your therapy regimen include:

  • Try different exercises. For example, if you have been focusing on your arms, switch to leg exercises.
  • Find a hobby. Pick a new skill you want to learn, such as piano or painting, and practice that instead. Using your mental and physical skills in fun ways can help you improve without even realizing it. For example, playing the piano can improve your fine motor functions and cognitive skills.
  • Set a new goal. Use the acronym SMART to set new goals for stroke recovery. The goal should be Specific, Measurable, Achievable, Relevant, and Time-bound. For example, maybe you will want to increase the amount of time you can stand unsupported from 30 seconds to one minute.

These simple changes can add the variety your brain craves during learning and give you a boost of motivation.

2. Seek Accountability

Another good way to push through a stroke plateau is to find an accountability partner. This could be your physical therapist or a family member or friend.

For example, if you struggle with memory, your accountability partner could check in to remind you to do your exercises every day.

Having someone to remind you or encourage you to exercise can help you overcome the inertia of a stroke recovery plateau. It’s especially helpful if your stroke has caused decreased motivation.

3. Try Home Therapy Equipment

Home therapy devices such as FitMi are great ways to motivate you to push through a stroke recovery plateau.

FitMi combines elements of gaming with stroke rehab techniques. These minigames stimulate the brain and make therapy more engaging. In fact, the average patient accomplishes 23x more reps than with traditional therapy. That’s because FitMi is designed to motivate players to beat their high scores and complete more and more exercises.

The more exercises you complete, the more you will activate neuroplasticity, which will help you overcome your plateau much sooner.

Overcoming the Stroke Recovery Plateau

Plateaus are a common aspect of the stroke recovery journey. In the past, scientists believed they signaled the end of a patient’s recovery. Today, however, we know that survivors can continue to regain function even decades after their stroke.

Overcoming a plateau after stroke is difficult, but not impossible. Keeping up with your stroke recovery exercises is still the best way to ensure that you regain more functions.

Most importantly, never give up hope. Best of luck on the road to recovery.

Featured Image: ©iStock/Ridofranz

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See how Susan is recovering from post-stroke paralysis

“I had a stroke five years ago causing paralysis on my left side which remains today.

I recently began using FitMi.

At first it was difficult for me to be successful with a few of the exercises but the more I use it, the better my scores become.

I have recently had some movement in my left arm that I did not have before.

I don’t know if I can directly relate this to the use of the FitMi but I am not having occupational therapy so I conclude that it must be benefiting me.

The therapy modality motivates me to use it daily and challenges me to compete against my earlier scores.

I heartily recommend it!-Susan, stroke survivor

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