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

During the early stages of stroke rehabilitation, patients usually make rapid gains in function. After a few months, however, progress may slow or 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 of 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 post-stroke. 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

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. It also plays a role in the functional recovery that takes place with consistent rehabilitation post-stroke. Unfortunately, this heightened state of plasticity 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 and time.

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

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 Interactive Home Therapy Equipment

Interactive home therapy devices such as FitMi are great ways to find the motivation to push through a stroke recovery plateau. FitMi combines elements of gaming with therapist-approved stroke recovery exercises.

This helps turn therapy into an immersive experience and prevents boredom. As a result, survivors accomplish hundreds of repetitions per half-hour session, which helps maximize neuroplasticity and push through plateaus after stroke.

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.