What are the effects of a stroke?
A person may present with weakness of one side of the body, disturbed sensation or body awareness. Balance and movements maybe impaired making everyday tasks more difficult to perform such as standing up and walking. They may also have problems with speech and understanding. Arm function maybe impaired.
As time progresses the person may develop neurological stiffness known as spasticity and this unfortunately can hinder recovery in the limb and interfere with limb movements and function.
The onset of stroke is usually very sudden and can have devastating affects for the individual and their family. Fortunately many people make significant progress with rehabilitation. Of key importance is the capacity of the nervous systems to reorganise itself or recover. This is known as neuroplasticity and can be optimised through appropriate rehabilitation and movement re-education from a NeuroPhysiotherapist..
When should rehabilitation begin?
Rehabilitation will usually begin immediately after a stroke, when the person is medically stable. It is widely accepted that much of the improvement occurs in the months immediately post stroke. Unfortunately patients are often told recovery is limited to 1 year after a stroke. In my opinion and from years working in the field of stroke rehabilitation improvement may continue long after (possibly years) after the initial stroke although usually to a much lesser extent. It is likely in some cases a person may reach their optimal potential and progress may plateau. When this occurs maintaining functional gains and prevention of secondary problems such as tissue tightness, discomfort and pain are the key focus These secondary problems are not uncommon and may arise as a consequence of residual weakness, postural change and altered movement patterns.
What type of stroke do we treat?
- Mild strokes: Patients who have suffered a stroke but have not been admitted to hospital. This is often classified as a minor stroke ie the person maybe mobile but can identify minor weakness or functional difficulties which they want physiotherapy to focus.
- Stroke with ongoing problems: Following discharge from the hospital/ community services when symptoms persist and interfere with functional independence. The person may want to explore their full potential.
- Long standing strokes (to date we have treated someone with a stroke 25 years ago who improved with treatment). It is not uncommon that a person with a longstanding stroke will present for Physiotherapy complaining of a deterioration in their condition. They may report being stiffer, slower on their feet, have greater difficulty moving eg getting out of the chair, walking to the shops or may experience discomfort or pain. Even at this stage post stroke physiotherapy can assist with these impairments