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What should a stroke survivor know about the recovery plateau?

Zachary Smith, MS, CCC-SLP |

So, you feel stuck…

Whether you’re a brain injury or stroke survivor, caregiver for someone with neurological damage, or a healthcare worker, you’ve probably heard the term “recovery plateau” when talking about the recovery process. Right after a neurological event, things can be very challenging, and the first few months afterward are when you’ll typically see the most rapid progress. During this time, people often dive into intense, acute rehab to make the most of this window and try to improve their speech, mobility, and dexterity, as much as possible.

But here’s the twist: around six months after the initial injury, stroke survivors might start hearing the term “plateau” tossed around. You might be wondering, “What exactly does that mean?”  If so, don’t stress—this post is here to demystify the concept of the neurological recovery plateau and give you the information you need to take your next steps forward with confidence! 

What is the neurological recovery plateau? 

When we talk about stroke recovery, “plateau” is often used to describe a phase when progress starts to flatten out or slow down. Right after a neurological event, recovery can be quite rapid. But at some point, stroke survivors can feel like things aren’t getting better as quickly. During this time, you might find yourself working on the same skills in therapy sessions over and over again. Your therapist might even mention the possibility of ending therapy, leading you to wonder: “Where do I go from here?” 

Will stroke survivors be stuck in a plateau forever? 

Stroke survivors, we hear you: Recovery plateaus are no fun. If it feels like you’re not progressing, you might start to think that where you are now is where you will always be. But is that really true?  

The short answer is: No! 

What does the research say about stroke survivors and recovery plateaus? 

At BrainWire, we’re constantly in awe of the brain’s resilience and complexity—and recovery plateaus are no exception! Even if it’s been a while since your neurological event, there’s solid evidence that shows you can keep making progress! A study by Basso & Macis (2011) found that people with chronic aphasia can still make neurological process through an intensive program, even after being previously discharged from speech therapy. Likewise, research from Santhanam et al (2018) found that people were able to benefit from the effects of neuroplasticity even if their stroke had occurred more than a decade prior!  To cap it off, Moss & Nicholas (2006) found that the amount of time that’s passed since a stroke does not determine how much therapy can help you. 

So, when you’re feeling disheartened, remember: Your brain can find ways to rewire itself to get better, even if it’s been a while since your neurological injury!

What steps can I take if I’ve met a recovery plateau? 

If you’re in a recovery plateau and you’ve been wondering, “Should I keep going with or restart therapy?”, the answer is a resounding yes! The studies mentioned above are just a taste of the research within the field that shows that therapy can make an impact even years after your neurological event. In other words, that idea of “this is where I’ll always be stuck” doesn’t really apply

Recovery isn’t a one-size-fits-all journey, and each stroke survivor takes a different route to reach their goals. While traditional speech therapy can be effective, sometimes clinicians working within healthcare institutions have their hands tied due to insurance restrictions. While the science is clear that there is no linear path to recovery, insurance companies often require evidence of rapid and steady progress to continue covering services. 

But your recovery journey doesn’t have to be stymied if you find yourself in that situation! Constant Therapy can step in to help you continue striving toward your speech, language, and cognitive goals. With Constant Therapy, stroke survivors have an entire library of evidence-based exercises at their fingertips, and you can move through them at your own pace! This means that you can keep getting therapy right from your home, and you move from “I are where I am” to “I am working towards where I want to be!”

Give Constant Therapy a try for free. Click here to start your 14-day trial today.

References 

Basso, A. & Macis, M. (2011). Therapy efficacy in chronic aphasia. Behavioral Neurology, 24, 317-325.

Moss, A. & Nicholas, M. (2006). Language rehabilitation in chronic aphasia and time postonset: A review of single-subject data. Stroke, 37, 3043-3051.

Santhanam, P., Duncan, E.S., & Small, S.L. (2018). Therapy-induced plasticity in chronic aphasia is associated with behavioral improvement and time since stroke. Brain Connect, 8(3), 179-188.

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4 Comments

  1. Susan Z Ott

    Not a stroke, a minengioma

    Reply
    • Constant Therapy

      Hello Susan! Recovery plateaus are relevant for many types of neurological events, including strokes, as discussed here, and brain tumors like meningioma and its related treatment.

      Reply
  2. Tinsley Preston

    I totally agree. My husband is in his seventh year since his bleeding stroke and surgery. He had six months of professional speech therapy and then I took over. We used Constant Therapy and a few other programs on the internet for several years. I was an elementary school teacher and taught my children and grandchildren to read and write. Therefore, I also taught my husband to read and write again. We still work every day on the aphasia, retrieving words. Some days he does VERY well and other days are difficult.
    Even if he isn’t improving a lot, at least it gives him courage and he is not going backwards. He is showing front lobal dementia now, and that is difficult, but we will take it one day at a time and keep working and praying.

    Reply
    • Constant Therapy

      Hello Tinsley, thank you so much for sharing your story! It sounds like your husband is working very hard and continues to persevere with your love and support as a caregiver. We are sorry to hear that you are facing some new challenges, and hope for the best as you both continue this journey. We will be cheering you on!

      Reply

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