Stroke management in physiotherapy

Am a physiotherapy Technologist with an experience over 5 years now am here to help you and explain how stroke can be managed under physiotherapy.

Stroke is defined as an accident to the brain with rapidly developing clinical signs of focal or global disturbance to cerebral function, with symptoms lasting 24 hours or longer, or leading to death, with cause of vascular origin.
It's a result of complications of a vascular disease caused by reduced or lack of blood supply to a portion of brain due to thrombotic or embolic occlusion of a vessel (cerebral ischemia) or due to vascular rupture (intracerebral hemorrhage, and subarachnoid hemorrhage) leading to cerebral infarction.
Types of strokes are:

. Ischemic stroke. Is caused by interruption of blood flow to certain areas of the brain as a result of blockage or obstruction of an artery leading to the brain. Ischemic stroke is the most common type of stroke in people and it has a 85% of all acute strokes
. Hemorrhagic stroke is caused by the bursting of a blood vessel

Risk factors of stroke:
. Hypertension
. Hyperlipidemia
. Diabetes
. Age
. Genetic
. Lifestyle
. Obesity
. Oral contraceptives

Signs and symptoms:
. Depending on the side of the brain affected the signs and symptoms are usually presented on the opposite side of the body they may include:
. Hemiplegia or Hemiparesis with facial Palsy
. Numbness and Weakness
. Reduction in sensory or vibratary sensational
. Initially they is flaccidity which is replaced by spaciticity
. Dropping of eyelid
. Decreased reflexes such as swallowing and pupil reactivity to light
. Poor balance
. Memory deficits and confusion

Physiotherapy Management:

Physiotherapy treatment should start as early as possible whether the patient is in intensive care unit, in the ward or at home.
The aim of treatment by physiotherapist include;
.preventive measure targeted at maintaining physical integrity and minimizing complications that will prevent or prolong functional return
.to minimize the effect of the stroke by promoting functional recovery and to regain as much independence as possible.

The method the physiotherapist will use will depend on the ability of the patient to communicate and understand, and on his reaction to the treatment.
Correct positions must be taught to the patient and patient is encouraged to maintain them.
Active/active assisted exercises
Emphasis is on symmetrical positioning and movements.
The physiotherapist will facilitate movements particularly those pertaining to function such as rolling, bridging, sitting up and these are progressed when patient shows signs of recovery.
Transfers are also important to enable the patient to move about.

Later stages of treatment;
.This is carried out when the patient is able to get out of bed. A more active programme is introduced whose progression and intensity is dependent on the response of the individual. This may include the following:
Correct positioning through sitting and standing
.Passive movements which are continued as long as possible and patient is taught how to do them him/herself
.Strengthening of weak muscles and encouraging normal movement patterns when movement returns. Patient should also be encouraged to move around and if he/she cannot walk, use of wheelchair is taught.
.Practising functional task-specific training while standing
.Balancing
Gradually activities will be carried out in standing, progressing to walking and stairs.