Over the past month or so, I’ve been on a course teaching me how to help rehabilitate people who have suffered from a stroke. I’ve still to do the course assessment to qualify, so to help me remember the things I’ve learned, here are a few things about stroke and its rehab. I will be updating this page on the fly, as I learn and remember more…
What is stroke?
Where part of the brain is starved of blood and oxygen, and so dies. There are 2 main types of stroke. These are:
- Ischaemic – Where a blood clot forms in a blood vessel in the brain and cuts off the blood supply to everywhere beyond this point. These are the most common form of stroke (over 80%).
- Haemorrhagic – Where a blood vessel in the brain bursts/leaks, starving parts of the brain beyond this point of blood/oxygen.
Who is at risk of suffering stroke?
75% of stroke sufferers are 65 or older. But anyone can get one, including children.
What are the risk factors involved in getting a stroke?
The most common type of stroke (ischaemic) is caused by blood clots in the brain. These usually happen where the blood vessels are clogged up or narrowed. Major causes of this narrowing include:
- Smoking. It’s a stupid habit that is entirely voluntary. If you are one of the minority in this country who still do it…stop. Everything starts to improve the day you quit. Good luck!
- High blood pressure.
- High cholesterol.
- Family history (there is a genetic element).
- Excessive alcohol drinking.
- Irregular heart beat.
The main cause of haemorrhagic stroke is high blood pressure bursting the blood vessels in the brain. This high blood pressure is caused by:
- Excess alcohol.
Looking at the above list, you can see that the majority of these risk factors are down to our personal behaviours and habits. In other words…they are under our control…
What happens after a stroke?
During a stroke, parts of the brain die through lack of oxygen. This causes the parts of the body controlled by the effected part of the brain to become paralised. Probably the most well known fact of a stroke, is that if it happens in the left hand side of the brain, the right hand side of the body is effected. And vise versa.
Depending on just what part of the brain has been effected, the person can lose all movement/control in the muscles down one side of their body. This paralysis can come in 2 main forms:
- Flaccidity – causing the muscles/limbs to be loose and floppy.
- Spacicity – causing the muscles/limbs to contract and really tighten up/stiffen.
Again, depending on what part of the brain has been damaged, the ability to talk or understand what others are saying can also be impared. This is called aphasia.
Some stark statistics for you:
- In the developed world, 10% of stroke survivors recover almost comletely.
- 25% recover with minor impairments.
- 40% experience moderate to severe impairments requiring special care.
- 10% require care in a nursing home or other long term care facility.
- 15% die shortly after suffering a stroke.
I am learning how to help rehabilitate people after they have been discharged from hospital and have finished their physiotherepy. It seems at this point, many people stagnate. Maybe because they either don’t think they ever will improve, or because they don’t know what to do to improve.
One of the main things I have learned, is that improving is a long, slow, gradual process. It is measured not in weeks or months, but in years and decades. But improvements can be made!
The brain is just like any other part of our body…it can adapt through experience.
If one part of our brain is damaged and can no longer function, another part of our brain can “bypass” it and learn to take on its role.
The important factors required in this re-wiring of our brains are:
- Repetitions. The more times, the better. You can not do too many repetitions. They say 400+ repetition every day is a good starting point. So your mantra must be “practice, practice, practice”.
- Intensity. Once you can do the move, make it harder. Making it harder makes a “louder” signal in the brain. And the louder this signal, the better and quicker the re-wiring is.
Just like “normal” training for otherwise healthy people, the basic fundimental moves should be mastered first. This creates a solid foundation on which to build other, more advanced and refined moves. Some of these foundation moves include:
- Sit to stand, unaided.
- Walking unaided.
- Getting to the floor with aid.
- Getting up off the floor with aid.
- Getting to the floor without aid.
- Getting up off the floor without aid.