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stroke/ CVA/ Hemiplegia


Stroke / CVA/ Hemiplegia
              BPT, MPT, (Neurology)


A stroke occurs when a blood vessel in the brain ruptures and bleeds, or when there’s a blockage in the blood supply to the brain. The rupture or blockage prevents blood and oxygen from reaching the brain’s tissues.
Without oxygen, brain cells and tissue become damaged and begin to die within minutes. 


Stroke symptoms
The loss of blood flow to the brain damages tissues within the brain. Symptoms of a stroke show up in the body parts controlled by the damaged areas of the brain.
The sooner a person having a stroke gets care, the better their outcome is likely to be. For this reason, it’s helpful to know the signs of a stroke so you can act quickly. Stroke symptoms can include:
  • paralysis
  • numbness or weakness in the arm, face, and leg, especially on one side of the body
  • trouble speaking or understanding speech
  • confusion
  • slurring speech
  • vision problems, such as trouble seeing in one or both eyes with vision blackened or blurred, or double vision
  • trouble walking
  • loss of balance or coordination
  • dizziness
  • severe, sudden headache with an unknown cause
A stroke requires immediate medical attention. If you think you or someone else is having a stroke, have someone call emergency right away. Prompt treatment is key to preventing the following outcomes:
  • brain damage
  • long-term disability
  • death

Types of stroke

Strokes fall intthree main categories: transient ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke. These categories are further broken down into other types of strokes, including: 
  • embolic stroke
  • thrombotic stroke
  • intracerebral stroke
  • subarachnoid stroke

Five Warning Signs of Stroke

·        Sudden numbness or weakness in the face, arm or leg (especially on one side of the body).
·        Sudden confusion or trouble speaking or understanding speech.
·        Sudden vision problems in one or both eyes.
·        Sudden difficulty walking or dizziness, loss of balance or problems with coordination.
·        Severe headache with no known cause.
Causes and risk factor
  •         High blood pressure
  •         Tobacco
  •      Diabetes 
  •      weight and exercise
  •         Medications
  •     Heart disease
  •         Age


Management of stroke patients begins as the acute care during acute hospitalization and continues as rehabilitative care as soon as patient’s medical & neurological status has stabilized. Moreover, community reintegration of patients continues during the community care stage.

1. Acute Care
2. Rehabilitation care
3. Community care
             
Stroke Physical Therapy Interventions

  1. Bobath
  2. Brunnstrom
  3. Rood
  4. Proprioceptive neuromuscular facilitation (PNF)

B. Learning theory approach
  1. Conductive education 
  2. Motor relearning theory 
  3. Functional electrical stimulation (FES)

C. Physiotherapy Exercise (other Approaches)

  1. Improving motor control
  2. Limb physiotherapy
  3. Chest physiotherapy 
  4. Positioning
  5. Balance retraining
  6. Fall prevention
  7. Gait re-education
  8. Functional Mobility Training
  9. Upper limb training
  10. Mobility appliances and equipment



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