Stroke can cause severe, sometimes disabling and long lasting dysfunctions for the victim especially in aged seniors. The consequences are huge drains on the economy of the victim, the family members, the carers and the society at large. It also impacts on the physical, social and psychological make up of the same group of people most times dictating the pace of recovery, return to social life, family members and workplace.
- Functional movement, disabilities and gait dysfunction.
- Speech defects- problems using or understanding language and problems with swallowing (Aphasia, Dysphasia, Dysphagia)
- Spasticity, muscle stiffness and spasms.
- Joint Pain, ligament laxity and Joint rigidity
- Knee hyperextension disabilities
- One- sided hemiplegia or weakness with problems of balance and coordination
- Problems with your sense of touch or your ability to feel hot and cold with resultant pain, numbness, or tingling in your limbs.
- Emotional, thinking and memory disturbances
- Difficulties with activities of daily living
- Presence of co-morbidities- (Diabetes, Benign Prostatic Hyperplasia, High blood pressure, dysfunctional bowel and bladder control)
Solutions to Stroke Disabilities.
- Easy access to stroke unit or clinic in a well established hospital or private unit or clinic will ensure that stroke patients are quickly referred to physiotherapist for assessment and eventual mapping of treatment plans.
- Emphasis on early start of highly specialized physical rehabilitation programs formulated with immediate term needs, medium and long term goals of the patient with emphasis on early ambulation, independent living and eventual graduation to lifestyles and work the patient is engaged in or used to will help in turning the tides against stroke and put the patient on an early start towards full recovery.
- Speech defects and swallowing problems could be very frustrating for patients especially the aged seniors when they suddenly find out they can’t express themselves audible or coherently. Also problems with swallowing could be a source of worry when patients can’t meet up with drug and meal expectations. Speech therapy is a major form of therapy which can help in reversal of the defect.
- Spasticity has become a major disability for stroke patients acting as a source of severe pain, stiffness and muscle shortening. Brain injury from stroke sometimes causes muscles to involuntarily contract (shorten or flex) when you try to move your limb. This creates stiffness and tightness. When a muscle can’t complete its full range of motion, the tendons and soft tissue surrounding it can become tight. This makes stretching the muscle much more difficult. If left untreated, the muscle can freeze permanently into an abnormal and often painful position. Early joint and limb passive mobilization carried out daily with stretching, positioning helps to maintain full range of motion and prevent muscle shortening. Braces, oral medications and Botox injection are some of the ways you can use to prevent or reduce limb spasticity.
- Joints pain is a common denomination during and after stroke attack most times present all through the period of rehabilitation for some patients. Joint pain spans a spectrum of patterns ranging from crippling migraines, to pain from shoulder subluxation, to central post-stroke pain (CPSP). Most of the common joints affected are the shoulder, elbow, wrist, phalanges, hip, knee and ankle. For most patients post-stroke pain could be crippling enough to prevent them from participating in physical rehabilitation and jeopardizing their quick or total recovery. Early joint passive mobilizations, joint positioning, muscle facilitation and early activations both by auto assisted and active resistive exercises with an adjunct of trans electrical nerve stimulator (TENS) and massage therapy using a non-steroidal anti-inflammatory gel will go a long way to alleviate most of these joints pain.6. When stroke attacks an individual it tends to take a part of the body rendering it incapable of performing functional movement and activities of daily living. The use of a part of the facial muscles, upper limbs, trunk and lower limbs are grossly affected. This is called hemiplegia with resultant loss of coordination and balance and gait dysfunction too. Early introduction of physical rehabilitation programs that will impact and emphasize the activation of muscles that are weak, functional use of these muscles, exploration of opportunities of independent lying to sitting, sitting to standing and standing to movement. Early muscles activation especially the ones responsible for erect postures, ambulation, normal gait patterns and activities of daily living.7. During stroke attack, sense of touch or ability to feel hot and cold is sometimes impaired making it difficult for the patient to feel the part of the body affected right from the facial muscles to the toes. Most times these are accompanied with resultant pain, numbness, or tingling sensations and sometimes tremor which could cause bed pressure sores, neglect of the side affected and inability to assume erect positions and perform functional movement. Motor sensory and skin sensation modulation techniques and sensory activations will help to quickly bridge this gap.8. Emotional thinking and memory disturbances-You may have damage to parts of your brain that control awareness, learning, and memory. You may have trouble focusing or remembering. It may be difficult to make plans, learn new activities, or do other complex tasks. Fear, anxiety, anger, sadness, frustration, and grief are common after a stroke. About one-third of people older than 65 who have had a stroke have symptoms of depression. Most stroke patients with emotional depression and memory issues will require treatment.
9. Knee hyper-extension disability is a serious and common condition in stroke patients when the quadriceps and hamstrings are not properly activated during rehabilitation or when the ankle plantar flexors are not good enough to help in movement. Muscle facilitation or activation of the quadriceps, hamstrings, gastrocnemius muscles with adequate gait training and proprioceptive neuromuscular facilitation will help in normal gait patterns and movement.
10. Diabetes, high blood pressure, benign prostatic hyperplesia, and a host of other co-morbidities could impact your eventual recovery and independent functional movement. Proper dieting, compliant drug regimen, and exercises will help in maintaining them and controlling their impacts on recovery.