Today is World Stroke Day 2019
Physiotherapy after a stroke
A stroke is a serious medical condition, with over 110,000 occurring every year in the UK, accounting for approximately one person every 5 minutes. A stroke happens when blood supply to the brain is restricted or cut off; the brain needs oxygen and nutrients supplied from blood to survive and if this is restricted the brain cells start to die, which can lead to brain injury, disability and possibly death.
There are 2 main causes of strokes:
1. Ischaemic; the blood supply is stopped because of a blood clot, this accounts for 85% of all cases.
2. Haemorrhagic; where a weakened blood vessel supplying the brain bursts.
Treatment of a stroke depends upon the cause but it is vital that anyone suspecting of having a stroke receives immediate medical attention as the sooner they can receive treatment the less damage occurs.
How can a stroke affect movement?
If an area of the brain involved in movement is damaged this may cause issues with moving and using different parts of the body.
Hemiplegia, this is a weakness or even complete paralysis of one side of the body.
Change in sensation, one side of the body may feel different, the limbs can feel heavy due to muscle weakness or they may feel numb. Some people can experience more unusual sensations such as a hot or cold sensation or pins and needles, which can be painful.
Muscles may become tight and cause stiffness and difficulty moving certain joints.
Problems with posture and balance making it difficult to stay upright, this can be even when trying to sit upright or when walking making falls more likely.
How can a Physiotherapist help?
Physiotherapy after a stroke is a very important part of the rehabilitation process, especially if movement is affected. Specialist Neurological Physiotherapist are trained to assess the affects the damage from a stroke has caused on movement, balance and sensation.
After a stroke, the brain cannot repair the damaged area, but it has the ability to reorganise the undamaged cells, making up for the area of damage, this is called neuroplasticity. It is a bit like a road closure occurring on a car journey, the route is redirected around the closure, resulting in arrival at the planned destination.
What does a Physiotherapist do?
A Physiotherapist will provide expert guidance to relearn movement and gain function, depending on the needs a Physiotherapist may:
Advise on positioning when sitting or lying
Provide therapy sessions to strengthen the areas of weakness and teach how to move the limbs correctly and independently.
Work with family and other members of the rehabilitation team to coordinate and support recovery.
Work with a patient to relearn normal movement patterns.
Decide when best to get up into sitting or walking and be involved in deciding and equipment that is needed.
Advise on activities or exercises to do between sessions if appropriate to aid recovery.
What does Physiotherapy involve?
Anyone who has a stroke should be assessed as soon as possible by a Physiotherapist in hospital, this is to identify the problems so that care can be organised to give the best chance of recovery.
Moving: once medically appropriate the Physiotherapists will aim to get someone moving as soon as possible this may initially involve moving in the bed, sitting up or getting up onto their feet and walking. This is likely to be a gradual process so that each stage is done in the correct way and may be progressed slowly over a long period of time.
Exercise: The Physiotherapist may practice specific movements or tasks based on problems the individual patient has, for example, if weakness in the leg is a big issue, appropriate exercises to strengthen these muscles may be taught. Exercises to prevent muscle and joint stiffness as well as improving stamina can also be beneficial.
Equipment: With the Occupational Therapist the Physiotherapist will decide on any equipment that may help with everyday activities. It may be necessary to use certain mobility aids either in the short term or long term to allow independence and safety when walking.
Goals: A Physiotherapist should work with the patient to set a number of individual goals to work towards taking into account their priorities, hopes and plans which enables treatment to be focussed toward the patient's individual goals.
The guidelines recommend that following a stroke at least 45 minutes per day or each type of therapy that a person requires should be provided.
How long will Physiotherapy last?
This can vary greatly between individuals depending on the severity of the stroke and their previous medical history. It is recommended that if there are ongoing difficulties resulting from a stroke then to continue rehabilitation as long as you need, this means as long as there are clear goals and Physiotherapy is helping make progress towards them.
Some individuals will continue with regular Physiotherapy once the initial symptoms plateau, through advice, exercise and activity by being generally fitter and stronger it allows someone to more easily use their body and prevent further complications such as another stroke or falls.
Who should I speak to about Physiotherapy after a stroke?
Anyone who has had a stroke should be assessed by a Physiotherapist, some people feel that they need more Physiotherapy than they are receiving or want to restart it at a later date in which case a Physiotherapist with experience and expertise in assessing and treating strokes will be able to give you the advice and support you need.
At Physiofit we have specialist trained Neurological Physiotherapists with experience and the knowledge for treating people after a stroke, we will be able to assess and recommend the best course of management for your condition no matter what stage you are at.
For more information see our website: www.physiofit.co.uk
Alternatively call on 01625 590444 or email firstname.lastname@example.org where one of our Physiotherapist would be happy to discuss your condition and what would be the most appropriate course of action.