In a stroke, the blood supply to part of your brain is cut off.There are two types of stroke: ischemic – when a clot blocks the artery in your brain; and hemorrhagic – when the artery pops and the blood damages the cells in the brain. Symptoms come almost immediately, which can be very frightening for the patient and those around them. Without a supply of blood, your brain cells don’t get enough food and oxygen. The symptoms you get depend on which part of your brain is affected and also if the lack of blood supply is temporary (Transient Ischaemic Attack) or permanent (Cerebro VascularAccident).
In the time when blood supply is cut off, you may experience following symptoms: head ache, nausea, dizziness, confusion, inability to speak, general weakness with paralysis of one part of your body and you may feel very sleepy.
Also people around you may notice that your face sweats, your face expression is asymmetrical.
It is very important that A&E is called immediately and you receive help straight away.
After the accident there are two phases seen with patients which differ in symptoms and according to them the approach.
Acute phase – lasts a few weeks depending on the type of stroke. In this phase, one side of the victims body is weak or completely flaccid. The person has no sensation in this side apart from pain. the weakness and other symptoms may spread to less affected side as the brain tissue is still swollen. It is important that the blood pressure is being monitored, and the patient is repositioned properly to both sides and back. Proper repositioning will increase sensation and has got great influence on developing neglect syndrome in later phase.
The therapist will focus on body mapping using external stimulus as well as proprioceptive stimulus.
Chronic phase – starts whet the tonus on direct affected side is rising and is noticeable. It is very important to start physiotherapy as soon as this happens. Regeneration process happens thanks to the so called plasticity of nervous system. This is the power of the nervous tissue to create more and more new connections between cells.
The spontaneous regeneration process without physiotherapy will create too many connections with different, not related to the function cells and as an effect it will create spasticity in direct affected side and pathological movement patterns.
Spontaneous regeneration affects your movement as well as balance activity. It happens not only on direct affected side but less affected side as well because the swell of the brain tissue in the acute phase damages both hemispheres.
The quicker the therapy starts the more function you will gain and the less pain you will suffer in the future that may come from mal-alignment of the joints.
It is very important that all the family and carers are involved in the therapy as it speeds up recovery process.
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Benefits of Physiotherapy
Physiotherapy is a very important part of your recovery. The physiotherapist will help you gain the sensation back, teach you how to properly turn in the bed, how to transfer from the bed to the chair, how to dress up properly.
Also you will have to learn how to stand up from the chair, keep the balance in sitting and standing, walk on straight and up and down the stairs.
You will undergo falls training, where you will learn in safely environment how to fall and not get injured as well as how to get yourself up from the floor. The physiotherapist will also help you to decrease the spasticity level and reduce structural changes that may cause great amount of pain.
Techniques will be used like weight transfer, simple through complicated tasks, muscle strengthening, movement control, massage, gait training to help your normal movement and strength return.
After a stroke our brain cells that have been damaged do not grow back but luckily we experience neuroplasticity which allows the brain to reorganise and stimulate new neural links and ways of doing things to compensate for this loss. Physiotherapists are expert in helping accelerate this process.
It is important to be as active as you can after your stroke and work as quickly as possible with your physiotherapist and your family to regain your movement, your strength and your independence.
Much improvement after stroke happens in first 3-6 months but important gains can continue after this with new learning, strength and practice.
Also it is important to do follow-up training once you have reached your goals as patients tend to lose learnt abilities as time passes by.
You should be doing daily physiotherapy in the hospital and 2-3 times a week after discharge (depending on your condition). Your physiotherapist will advise in your first session.