You never expected to get sick or injured – it was the furthest thing from your mind. Just the day before you were jogging around the block and playing catch with your son, but now you find yourself in the hospital after experiencing a stroke. Your right side is weak and your speech is a bit slurred. How will you ever get home and get your life back on track?

We never think we will need rehabilitation. We worry about a heart attack or cancer, but most of us don’t see ourselves in a wheelchair or living with a severe disability. Yet, there are more than 50 million people with disabilities in the United States. Rehabilitation is the key to getting back to functioning at a level where you can live at home, enjoy your family and hopefully work.

Just like school

Going for therapy and rehabilitation is kind of like going back to school later in life. You may have to relearn information that you had previously acquired. In therapy, there are tasks that may require activities like learning to walk again or learning to transfer yourself from your bed to a chair.

You may need to learn to read again, speak clearly or improve your memory. Rarely is it easy, and I always tell patients and families that it will be the hardest thing they ever do. Like school or learning a new skill, there are certain principles that make a difference.

Dose matters

When we take a medication for a medical problem, we carefully adjust the dose. Too little or too much antibiotic and the infection worsens or never goes away. The same is true of rehabilitation. The intensity and amount of therapy you receive matters. Much like it takes hours of practice to learn and improve playing a musical instrument, it takes hours of therapy to retrain the brain, nervous system and muscles. Typically, an inpatient rehabilitation hospital will provide at least three hours of therapy throughout the course of a day.

Function matters

If you want to learn to play a piano, you need to practice on a piano and not just read about it. The same is true for rehabilitation. If you had a stroke and have lost the use of your right arm, you will need to do tasks and therapy that require the use of your right arm. Performing these tasks will help rewire your brain. The more “functional” tasks you perform the more you will improve and more positive changes will take place in your nervous system.

Motivation matters

The person who is motivated and tries harder has a better chance of getting better. It is not always the brightest student who is the most successful: hard work can make a huge difference. People undergoing rehabilitation are motivated by their caregivers and therapists, but also by their surroundings.

So, don’t forget – dose, function and motivation matter.

Richard C. Senelick, M.D., Neurorehabilitation physician and editor of Encompass Health Press. To learn more about Encompass Health Rehabilitation Hospital of Concord, seek a referral or tour the hospital, visit or call (603) 226.9804.