How physiotherapy can help stroke survivors

Johanne Gordon

September 15, 2021

Dealing with the effects

Every 10 minutes someone in Canada has a stroke. That’s over 60,000 strokes every year with roughly 14,000 leading to death. Unfortunately, surviving a stroke often means living with debilitating effects sometimes even a disability.
However, if you’re a stroke survivor, there is still hope. Recovery after a stroke greatly depends on the physiotherapy strategy your doctor recommends. Read on to find out how this can help.

What is a stroke?

Blood helps carry oxygen throughout your body. This oxygen gives your body energy, supports the functions of your immune system, and helps to replace worn cells. A stroke occurs when there is a disruption to the flow of blood to your brain.

Once oxygen is unable to get to your brain, its cells start dying. This can occur within minutes and result in permanent damage. There are three main types of stroke:

Transient ischemic attack

This is also known as a mini-stroke. It usually lasts for a few minutes but doesn’t result in permanent damage. It temporarily causes stroke symptoms and may be a warning sign before a major stroke occurs.

Ischemic stroke

This occurs when there’s a blockage. The artery that carries blood to the brain can become blocked. There may also be a blockage of the vessels within the brain.

The blockage is often caused by plaque build-up or blood clots. This eventually leads to an ischemic stroke.

Hemorrhagic stroke

An artery can suddenly rupture and start bleeding into the brain. This can cause a hemorrhagic stroke. This causes damage to the brain and affects parts of the body controlled by that area of the brain.

Hemorrhagic strokes can result from intracranial haemorrhages, as described above. It can also result from subarachnoid haemorrhages. This is bleeding between the brain and the membrane covering it.

What effects can a stroke leave on a victim?

There can be many effects on your body after a stroke. The effects experienced depend on the area of the brain affected. Strokes can affect any of the three main parts of the brain:

  • The cerebellum or back of the brain
  • The cerebrum includes the top and front of the brain, as well as the right or left hemispheres or sides of the brain
  • The brainstem or the base of the brain, below the cerebellum

When a stroke occurs on the right side of the brain the effects include:

  • Behavioural changes
  • Left side paralysis or weakness
  • Memory loss
  • Visual problems

Strokes on the left side of the brain can cause:

  • Memory loss
  • Right side paralysis or weakness
  • Inability to write, read, or learn new information
  • Speech and language problems
  • Behavioural changes

Strokes in the cerebellum can cause:

  • Vomiting and nausea
  • Problems with balance and coordination and sometimes the inability to walk
  • Headaches
  • Dizziness

A stroke that occurs in the brainstem can result in:

  • Vision problems
  • Breathing and disruption in heart functions
  • Inability to swallow, chew or speak
  • Issues with coordination and balance
  • General paralysis and weakness

There can be a range of effects of stroke. Your physiotherapist will create a regimen to target the affected areas.

Identifying the signs of a stroke

Some of the signs of a stroke can include:

  • A severe headache
  • Numbness or weakness in certain parts of the body
  • Dizziness, loss of balance or lack of coordination
  • Trouble speaking, difficulty understanding speech, or general confusion
  • Difficulty seeing in one or both eyes

Is someone you know experiencing any of these symptoms? The Heart and Stroke Foundation of Canada says you can help save them if you act quickly. You can do this by using  the FAST acronym :

  • FACE – Is the person’s face drooping? Ask them to smile
  • ARMS – Can they raise both their arms?
  • SPEECH – Is their speech jumbled or slurred? Ask them a question that doesn’t have a one-word answer
  • TIME – If there’s an issue with any of the above, call 911 immediately

Make a note of how long you noticed the symptoms. Let the paramedics and/or doctor know as it can help with treatment.

Physiotherapy strategies in stroke recovery

Physiotherapy for stroke survivors is an important part of the rehabilitation process. It usually includes more than just physical therapy. You’ll also do emotional activities and use technology to help regulate bodily functions.
Your assessment can begin as soon as 24 hours after your stroke. It may entail your physiotherapist helping you to sit up, get out of bed and even walk. Once you leave the hospital you will transition to rehabilitative care.

Why seek a physiotherapist?

A physiotherapist has the expertise to assess the extent of the effects of a stroke on your body. Their assessment will determine the physiotherapy strategy they use for your rehabilitation after stroke. These may include the following:

Help with standing

Physiotherapy can help stroke survivors who are having problems maintaining their balance. This will include leg-strengthening exercises such as heel raises and sidestepping. The goal is to help the patient regain their balance while on both feet.

Mobility

It can be a challenge for a patient to walk independently after a stroke. There are specific movement techniques or mobility training that can help. This may include the initial use of aids such as walkers or canes to assist with mobility.

Treadmill training

According to research done at Johns Hopkins, stroke survivors that use a treadmill can significantly improve their mobility. This can occur even years after a stroke. It helps retrain their bodies and brains, and also improves their overall health.

Rhythmic cueing

Rhythmic speech cueing uses auditory rhythms to control speech rate. It helps to improve fluency and speech. It can also help with cognitive recovery.

Overground walking

Many stroke survivors have issues with mobility. This affects their ability to walk steadily. Overground walking or training can help to regulate a patient’s walking pattern.

It often involves the use of a treadmill which assists survivors who are learning to walk again.

Orthotics

Orthotics help stroke patients with stability. The use of ankle or foot orthotics helps with the efficiency of walking. It improves balance while walking and mobility.

Arm functioning

Arm functionality can also be an issue for many stroke sufferers. There are specific movements and stretches physiotherapists use on patients. These strengthen their arms, hands, and shoulders.

Constraint-induced movement therapy

Constraint-induced movement therapy or CIMT is a type of rehabilitation therapy. It involves restraining the unaffected limb. This forces the patient to use the one affected by the stroke. Continuously practising this task usually leads to greater mobility of the affected limb.

How long should rehabilitation last?

The length of your rehabilitation will depend on the severity of your stroke. The extent of the complications experienced is also a factor. Despite the quick recovery of some patients, most require long-term rehabilitation.

This can last for a few months to years after a stroke. Long term rehabilitation helps to reduce the chances of a stroke reoccurring.

Successful recovery after a stroke

Suffering a stroke can change your life. It may mean relying on others after living an independent life. However, recovery after stroke is possible.

Stroke recovery may not mean that you return to life as you know it. But you can regain some mobility and function. This can be possible with the help of a physiotherapist. Choose one that will provide you with a comprehensive assessment and physiotherapy strategy.

Elysian Wellness Centre offers a variety of therapies including physiotherapy. We can help restore and maintain your strength and functionality. Call us for a FREE consultation today!

Johanne Gordon - Registered Physiotherapist

September 15, 2021

Johanne is an experienced, fluently bilingual physiotherapist who graduated in 1992 with a Bachelor of Science in physiotherapy with magna cum laude honours from the University of Ottawa.