Stroke's Devastating Impact: Losing A Leg To Blood Clots

A stroke can affect any part of your body, and its impact can range from mild to severe. While some people may not experience any physical effects, others may experience several. One of the physical effects of a stroke is muscle weakness, which can occur in the arms, legs, hands, and feet. This can lead to difficulties in walking and getting around, as the stroke may damage parts of the brain that coordinate movements. Specific issues include weakness, spasticity, foot drop, changes in feeling, tiredness, coordination problems, and balance issues. While recovery can be frustrating, there are ways to improve mobility and regain strength and balance. Rehabilitation nurses, physical therapists, and occupational therapists play a crucial role in this process, offering specific plans and exercises to help individuals regain their abilities.

Muscle weakness and spasticity

A stroke can cause muscle weakness and spasticity, which can affect a person's ability to walk and move around. The effects of a stroke can leave one side of the body paralysed or weakened, impacting a person's independence.

Muscle weakness is a common physical impact of a stroke, and it can affect the legs, hands, and arms. The impact can vary, ranging from mild to severe. Some people may experience no physical effects, while others may have several. It is important to get rehabilitation and support to aid in recovery and improve independence.

Spasticity is a symptom of certain neurological conditions, causing muscles to contract all at once and affecting movement and speech. It is caused by damage to nerve pathways within the brain or spinal cord that control movement and stretch reflexes. Spasticity can range from mild muscle tightness to severe, painful, and uncontrollable stiffness and spasms. It can affect muscles in any part of the body but is most common in the leg muscles.

After a stroke, muscles may become limp and feel heavy, a condition known as flaccid or low tone. In the weeks or months following, the muscles may shorten and become very tight, a condition called spasticity or high tone. These changes in muscle tone can affect joint stability and movement, making it difficult to walk and move around.

Rehabilitation and treatment for muscle weakness and spasticity are crucial to improving strength and balance. Physical therapy, medication, and botulinum toxin injections are common treatments for spasticity. Additionally, assistive devices such as canes, walkers, or wheelchairs can help with mobility and independence.

Foot drop

• Gait training with assistive devices
• Braces and orthotics
• Electrical stimulation
• Surgery (rare)

Two of the most common treatments are:

• Bracing with an ankle-foot orthosis: This device supports the ankle and foot, helping the foot clear the ground during walking. It can improve walking speed, balance, posture, safety, and confidence. However, rigid materials can limit air circulation and reduce the ability to feel the walking surface, affecting balance.
• Functional electrical stimulation (FES): FES involves sending small pulses of electrical stimulation to the nerve that controls the muscles lifting the foot. This treatment can improve walking speed and distance, reduce energy expenditure, and decrease the number of falls. FES is a preferred option for many stroke survivors as it makes them feel steadier and more balanced. However, it is not suitable for patients with cardiac pacemakers or defibrillators.

Rehabilitation and support are crucial for individuals experiencing physical effects after a stroke. While recovery is typically fastest in the initial months, improvements can continue for years. It is important to work closely with a rehabilitation team to regain strength, balance, and independence.

Loss of sensation

A stroke can cause loss of sensation in the legs, which can make it very difficult to walk and get around. This is because the brain and body perform a series of complex movements when walking, and a stroke can damage parts of the brain that coordinate these movements. If you cannot feel your leg and foot, it is challenging to know how to move them. You will rely more on your vision to compensate for the loss of feeling, which is tiring and requires a lot of concentration. This can also make you less aware of your surroundings, increasing the risk of slips, trips and falls.

Vision is an important part of balance, and vision problems are common after a stroke. It can be harder to adjust your posture and movements to maintain your balance if you cannot see clearly. This can lead to bumping into things or stumbling.

After a stroke, rehabilitation nurses, physical therapists, and occupational therapists will be key to your recovery. They will help you regain any abilities you lost and come up with a specific plan to help you. You may need to start relearning basic tasks, like getting out of a chair or into bed safely. A physical therapist will also recommend exercises to rebuild strength and balance and ease pain.

There are also mobility aids that can help with balance problems, such as a simple walking stick, which can improve stability and your confidence, especially when walking outside.

Tiredness and dizziness

While a stroke does not directly cause leg loss, it can lead to severe physical impairments that affect the legs and feet. These impairments can include muscle weakness, spasticity, and foot drop, which can make walking and getting around extremely challenging.

Vision plays a crucial role in maintaining balance. Vision problems, such as difficulty focusing, double vision, or eye movement issues, can further contribute to balance difficulties. As a result, you may find yourself relying more on your vision to compensate for the loss of sensation in your legs, which is tiring and requires intense concentration.

Additionally, side effects of medications commonly prescribed after a stroke, such as high blood pressure medication, can also cause dizziness or weakness. It is important to discuss any concerns about medication with your doctor or pharmacist.

To manage tiredness and dizziness, it is recommended to keep your home well-lit, free from clutter, and organised in a way that minimises the need to walk around furniture. Regular eye tests and wearing prescribed glasses can also help improve vision and reduce the risk of falls.

Balance and coordination problems

A stroke can affect your balance and coordination in several ways. Firstly, it can cause weakness on one side of your body, making it difficult to balance and coordinate movements. This weakness may be mild or severe and can affect a small area or one side of your whole body. In some cases, you may not be able to move certain muscles at all. This can make it challenging to perform basic tasks such as getting out of a chair or getting into bed.

Secondly, a stroke can affect the way your brain controls balance. You may feel unsteady or uncoordinated due to damage to the parts of your brain that coordinate movements. Brain signals can become scrambled, leading to a disconnect between your mind and muscles. This can result in a condition called ataxia, which makes it difficult to control smooth movements. Your limbs and body may feel shaky, and your arms or legs may miss their target, making it challenging to maintain your balance when sitting or standing.

Vision problems are also common after a stroke and can further impact your balance. These issues can include difficulty focusing, double vision, and eye movement problems. If you have hemianopia, or a missing part of your field of vision, you might not see obstacles in your way, increasing your risk of falling. Vertigo, a spinning or moving sensation, can also occur if the stroke happens in the cerebellum or brainstem, the areas that control balance.

Additionally, loss of sensation in the affected side of your body, particularly your legs, can affect your balance. Without the ability to feel where your leg and foot are, it becomes challenging to coordinate your movements. You may rely more on your vision to compensate for the lack of feeling, which requires a lot of concentration and is tiring. As a result, you may become less aware of your surroundings, increasing the risk of slips, trips, and falls.

To address balance and coordination problems after a stroke, rehabilitation nurses, physical therapists, and occupational therapists can provide support. They will create a specific plan to help you regain strength and balance and improve your coordination. This may include balance retraining exercises, such as maintaining your balance while sitting or standing, step-ups, and practising reaching for objects. Canes, walkers, wheelchairs, and special braces like an ankle-foot orthosis (AFO) can also provide support and improve your stability.

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