Overview
A stroke is the result of blood vessel occlusion that interrupts blood supply to the brain. In Singapore, 26 cases of stroke occur every single day.
Without appropriate management, strokes can lead to severe impairments affecting movement, cognition, language, and sensory skills. The World Health Organization (WHO) considers stroke to be the leading cause of long-term disability.
Physiotherapy may help stroke patients by improving their functional prognosis. In other words, this therapy can aid patients restore their mobility after a stroke.
The National Institute for Health and Care Excellence (NICE) recommends that patients get at least 45 minutes of physiotherapy five days a week. NICE emphasizes that high-intensity therapy is crucial to relearn lost abilities.
When physiotherapy is showing positive results, it shouldn’t be interrupted until the patient and their therapist reach targeted goals.
In this article, we will cover the different aspects of physiotherapy in strokes to decipher the benefits of early intervention. But first, let us start with some basics.
Causes of strokes
In general, there are two types of stroke:
Ischemic stroke – It results from the occlusion of an artery that supplies an area of the brain.
Hemorrhagic stroke – It results from the rupture of an artery, which leads to bleeding inside the brain.
The first type of stroke shares many risk factors with heart attacks, including:
- Advanced age
- Blood hypertension
- Diabetes
- Smoking
- Obesity
- Dyslipidemia (high LDL, low HDL)
So, here is what happens in both types:
Ischemic stroke
A fatty plaque called atherosclerosis forms inside one of your blood vessels. As a result, the risk of blood clots increases. When a blood clot forms and travels down the artery, it reaches a point where it blocks blood flow.
Hemorrhagic stroke
On the other hand, a hemorrhagic stroke occurs when blood leaks outside of the artery. Because the brain is sitting in a confined space, nerve cells undergo high pressure and die.
The causes of hemorrhagic strokes are diverse and include:
- A ruptured aneurysm (a bulging portion of an artery)
- Arteriovenous malformation (a connection between an artery and a vein)
Signs and symptoms of strokes
The signs and symptoms of stroke vary depending on the affected area. However, it is well-established that early intervention lowers the risk of long-term complications.
With that said, here are a few common signs and symptoms of stroke:
- Confusion
- Paralysis
- One-sided numbness or weakness (e.g., arm, face, leg)
- Vision problems (e.g., double vision, blurred vision)
- Trouble walking
- Trouble speaking or understanding speech
- Loss of balance or coordination
- Dizziness
- Slurring speech
- Severe headache
Stroke Recovery Treatment
 The American Heart Association developed a classic saying – Time is Brain.
This saying explains that the longer it takes to manage a stroke, the more nerve cells will die.
Depending on the specific type of stroke, treatment will vary. For instance, if you have an ischemic stroke, here are some of the possible stroke recovery treatments.
- Clot-breaking drugs
- Antiplatelet and anticoagulants
- Mechanical thrombectomy
- Stents
- Surgery
Conversely, hemorrhagic stroke is treated with:
- Medications for blood pressure
- Coiling
- Clamping
- Surgery
The importance of early intervention in stroke recovery treatment
Researchers recommend that patients start physiotherapy 24 hours after a stroke. Initially, the therapist will focus on getting the patient out of bed and taking some short walks. Repeating these tasks aids patients in regaining movement as fast as possible.
In this field, physiotherapists will use equipment to accelerate recovery. For instance, some centres use robot-assisted devices, which help patients walk without human assistance. Others may use a treadmill to retrain walking speeds and endurance.
The latest technology that physiotherapists use is virtual reality training. This method may help patients recover faster. However, it does not replace conventional stroke recovery treatments.
The benefits of Early Support Discharge
Adopting a physiotherapy management plan shortly after getting a stroke will help patients recover faster. It will also reduce their stay in the hospital.
Early support discharge refers to allowing patients to get an early discharge from the hospital. Following the discharge, patients would receive physiotherapy sessions at home.
The benefits of an early support discharge include:
- Reduces the financial toll of stroke patients on hospitals
- Reduces the length of hospital stay
- Lowers long-term dependency
- Improves patient satisfaction
- Increases mental health scores
- Lowers the rates of admitting patients to institutional care
Long-term physiotherapy and the risk of future strokes
Long-term physiotherapy is a stroke recovery treatment that can help patients restore most of their lost abilities. However, it is also an effective tool in lowering the incidence of stroke recurrence.
Physiotherapy teams work together to support stroke survivors and achieve long-term goals. One of the most important goals is reintegrating affected patients into the local economy. Getting back to work is also a priority.
According to a study, working individuals who get a stroke are more likely to remain unemployed for up to eight years after the event. Unfortunately, this could have a devastating impact on their livelihood, especially when you consider that 25% of strokes occur in people of working age.
Some methods used in physiotherapy include:
Circuit training
Intensively repeating everyday activities to improve walking skills.
Endurance and strength training
Reduce disability and dependency.
Core stability exercisesÂ
Improve gait and balance.
By including physical therapy stroke recovery treatments in the daily routines of patients, the risk of having another stroke decreases by up to 35%.
Takeaway message
Managing strokes with physiotherapy is indispensable to recovering the lost abilities. The earlier the intervention, the better the outcome for patients. More healthcare facilities are hiring physiotherapists to start rehabilitation as soon as a stroke occurs.
We hope that this article helped you understand the role of physiotherapy in the management of stroke.
If you have any questions, concerns, or personal experiences with strokes and physiotherapy, please do not hesitate to share your thoughts via WhatsApp or you can also go to www.prorehab.sg for more information.
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