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Stroke

A stroke is a disruption of blood flow to the brain caused by either a blockage or a bleed in the brain. The disruption of blood flow means that areas of the brain are starved of oxygen and nutrients which causes damage to the brain.

The specialist physiotherapists at Liverpool Physio are trained to assess and treat the wide variety of physical symptoms caused by a stroke. Our physiotherapists will work out a treatment plan incorporating your own personal short and long term goals in order to improve your function and quality of life.


What is a stroke?



A stroke is a medical emergency that mainly affects people over the age of 65 although it can affect someone at any age. Blood is prevented from reaching areas of the brain because of a blood clot or a burst blood vessel when the brain is starved of its oxygen supply which causes the brain cells to die. The severity of the stroke and its symptoms depend upon which areas of the brain have been starved of oxygen.

The brain is separated into two sides or hemispheres. The right hemisphere of the brain controls function of the left side of the body and the left hemisphere controls function of the right side of the body. There are also specific areas within the brain which control specific functions. If the left hemisphere is damaged by a stroke this may cause problems with speech, language, reading and writing. Areas on the right side control skills such as spatial awareness and perception.





A physiotherpaist supporting her client following a stroke.Above: A physiotherpaist supporting her client following a stroke.



What causes a stroke?



A stroke is caused by a disruption of blood flow to areas of the brain. A disruption in blood flow causes brain cells to be starved of oxygen and other nutrients causing them to become damaged or die. Damage to the brain can lead to a wide variety of symptoms depending on where the stroke occurs.

There are many reasons why people may experience a stroke. Some risk factors of a stroke can be changed and others cannot. Controllable factors include good diet, not smoking, low alcohol intake and good levels of exercise. Factors you cannot control are your age, ethnicity and family history.


Types of stroke



There are two main forms of stroke:

Ischaemic stroke

:? An ischaemic stroke happens when a blood vessel in the brain becomes blocked. The blockage itself could be a blood clot, an air bubble or a fatty deposit. An ischaemic stroke is the most common type of stroke.

Haemorrhagic stroke

: A haemorrhagic stroke arises when either a blood vessel in the brain bursts or a blood vessel between the brain and the skull bursts.

TIA

: It is also possible to experience a mini-stroke (transient ischaemic attack), a temporary blockage of the blood supply the brain. Many people experience these attacks along with temporary symptoms as a warning sign that they are at risk of major stroke. The signs of a transient ischaemic attack are the equivalent to those of a major stoke but last anywhere from a number minutes to 24 hours.





Our physiotherpaist promoting independance following a stroke.Above: Our physiotherpaist promoting independance following a stroke.



How is a stroke diagnosed?



Strokes are normally diagnosed through a combination of brain scans and by reviewing the individual?s symptoms.


Signs and symptoms



The signs of a stroke have been highlighted by the Act F.A.S.T campaign:
  • Face - has one side of their face fallen?
  • Arms ? can they raise their arms and keep them there?
  • Speech ? is it slurred?
The campaign highlights that if you see any of the above signs of a stroke you should call 999 immediately.


Scans for stroke



A Computer Tomography or CT scan is commonly used to produce a 3D image of the brain to confirm the type of stroke and the area of the brain affected.

A Magnetic Resonance Imaging or MRI Scan is used to provide even greater detail of brain tissue and may be required for individuals presenting with more complex symptoms.


What problems caused by stroke can physiotherapy help with?



Physiotherapists that specialise in stroke rehabilitation are neurological physiotherapists. Neurological physiotherapists are experts at treating problems as a result to damage of the brain.

Physiotherapy can help many symptoms caused by stroke. These include:
  • Pain
  • Weakness or paralysis (normally experience on one side of the body)
  • Neglect of one side of the body
  • Balance and coordination difficulties
  • Altered sensation
  • Changes in muscle tone
  • Decreased mobility
  • Facial weakness
  • Foot drop
  • Increased risk of falls



Our physiotherpaist helping a patient who has a foot drop following a stroke.Above: Our physiotherpaist helping a patient who has a foot drop following a stroke.



Functionally, it may be the case that you cannot move around your bed independently, cannot achieve sitting balance or are unable to walk at all and may have been discharged from hospital believing that this will always be the case. With the correct level of physiotherapy input, further recovery is possible.


How does physiotherapy help stroke?



Following a stroke many people are left with significant physical disability. Our specialist neurological physiotherapists have many therapies available to them that can help reduce or even overcome the impact of these disabilities.?

Physiotherapy can help people who have experienced a stroke in a variety of ways. Physiotherapy can help to:
  • Improve the function of the affected arm and leg
  • Increase strength to improve mobility and independence
  • Improve balance and walking
  • Increase ability to roll, sit and stand
  • Reduce muscle spasms and stiffness
  • Minimise the risk of falls
  • Elevate energy levels
  • Retrain normal movement patterns
Above all, physiotherapy is able to increase your independence and greatly improve your quality of life.

All of this is made possible through our expert knowledge of the different principles of neurological rehabilitation which allows us to carefully select from a number of treatment options in order to tailor therapy to your own specific requirements.

Treatment following a stroke is based largely around the concept of neuroplasticity which is the ability of the brain to adapt and relearn processes following damage. Rehabilitation involves practicing activities and movement patterns which were affected by the stroke repeatedly with the aim of exercising the brain in order to encourage the activation of adaptive neural pathways. This ability to adapt can lead to improvements a number of years following a stroke but it is thought that the majority of changes occur in the first three months so it is crucial to seek therapy as quickly as possible.


What would physiotherapy treatment for stroke involve?



Physiotherapy treatment following a stroke is based on the outcome of an initial assessment with your physiotherapist.

Your physiotherapist will carry out a detailed assessment to assess how the stroke has affected you and your ability to carry out functional tasks. Muscle power and control, sensation, reflexes and movement patterns are examined alongside a range of functional daily tasks.? The assessment will also include discussion of your own goals and ambitions so that we are able to tailor the treatments to best achieve the goals discussed.

A treatment programme may include:
  • Assessment
  • 1:1 therapy
  • Clinic visits
  • Home visits
  • Home exercise programmes
  • Medical Reports
You may also require specialist adaptive equipment such as splints, orthotics or equipment for the home environment to improve your ability to complete normal tasks. Our expert physiotherapists have the knowledge to provide the relevant equipment for you or refer you to another specialist if necessary.

Our neurological physiotherapists have the experience to create an individualised therapy programme to suit your needs whether these are complex or more straightforward.


How do I arrange a physiotherapy assessment following a stroke?



If you or someone you know has had a stroke, you can arrange a physiotherapy assessment today by calling 0151 558 0077 or e-mail office@liverpoolphysio.co.uk


Summary



A stroke is a disruption of blood flow to the brain causing a wide variety and severity of symptoms depending on the part of the brain affected. A stroke is unique to the individual.

Physiotherapy is extremely important as part of the rehabilitation process in order to improve mobility, function and most importantly quality of life.

If you would like to arrange an appointment with our specialised neurological physiotherapists please email our team at office@liverpoolphysio.co.uk or call us on 0151 558 0077.

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Email: office@liverpoolphysio.co.uk
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