Stroke's Impact: Full-Body Weakness And Recovery Challenges

A stroke is a life-threatening medical emergency that occurs when there is an interruption in blood flow to the brain. This can be due to a blocked artery or bleeding in the brain, resulting in brain cells dying from a lack of oxygen. The effects of a stroke depend on the location and extent of the damage to the brain tissue. While some people may not experience any physical effects, others may have mild or severe impacts, including muscle weakness and fatigue. In some cases, a stroke can lead to paralysis on one side of the body, affecting movement and balance. The impact of a stroke on an individual's physical capabilities highlights the importance of early treatment and rehabilitation to improve the chances of recovery.

Paralysis and muscle weakness

A stroke can cause paralysis and muscle weakness throughout the body, depending on which part of the brain is affected. The brain is the central organ of the human nervous system and controls motor and sensory functions throughout the body. When messages cannot travel properly from the brain to the muscles, paralysis and muscle weakness can occur.

The impact of a stroke on the body varies from person to person and can range from mild to severe. Some people may experience paralysis on one side of their body, while others may have no physical effects at all. The left side of the brain controls the right side of the body, and the right side of the brain controls the left side. If there is significant damage to the left side of the brain, for example, paralysis may occur on the right side of the body.

Physical changes after a stroke can include muscle weakness, fatigue, problems with balance, and foot drop, which is difficulty lifting the front part of the foot. Weak muscles can add to movement and balance problems, and rehabilitation is often required to improve these issues.

The faster a person receives medical treatment for a stroke, the more likely they are to recover without disability. Early treatment and rehabilitation can improve recovery, and many people regain a lot of their physical abilities.

Problems with bladder and bowel control

A stroke can affect the part of the brain that controls the bowels and bladder, leading to incontinence. Incontinence is the loss of control of the bladder and bowel. Urinary incontinence can manifest as urgency incontinence, nocturia, nocturnal enuresis, functional incontinence, stress incontinence, reflex incontinence, or overflow incontinence. Faecal incontinence can be caused by damage to the brain area controlling the bowel, or by constipation or diarrhoea.

Bladder and bowel problems are common after a stroke, and many people recover quickly. However, for those with long-term issues, treatments and support are available to help manage daily life. Treatments include dietary changes such as increasing fluid and fibre intake, bladder and bowel re-training, pelvic floor exercises, and medication. Practical tips include planning toilet access when out, carrying a change of clothes and a hygiene kit, and finding a daily routine that works for you.

If you are a carer for someone with bladder and bowel problems after a stroke, you should be offered advice on how to help them. It is important to seek treatment, as most bladder and bowel problems can be improved.

Bladder problems can include:

• Urinary incontinence: the loss of bladder control.
• Urinary frequency: needing to use the toilet more often.
• Urge incontinence: the sudden urge to urinate.
• Nocturia: waking with an urgent need to urinate.
• Nocturnal incontinence: needing to urinate several times during the night or wetting the bed.
• Functional incontinence: difficulty reaching the toilet or removing clothes in time.
• Stress incontinence: leaking urine when coughing, sneezing, or laughing, due to weak or damaged pelvic floor muscles.
• Reflex incontinence: passing urine without realising it, due to the stroke affecting the brain area that senses bladder movement.
• Overflow incontinence: bladder leakage due to being too full, often caused by urine retention or loss of feeling in the bladder.

Bowel problems can include:

• Faecal incontinence: uncontrolled bowel movement, caused by brain damage, or constipation or diarrhoea.
• Constipation with overflow: large stools blocking the bowel, allowing liquid stools to leak around them.
• Faecal impaction: dry, hard stools collecting in the bowel, pressing on the bladder, and causing frequent urges to empty it.

Dysphagia (swallowing problems)

Dysphagia, or difficulty swallowing, is a common symptom following a stroke. It occurs when there is an issue with the coordination of the many muscles and nerves involved in the act of swallowing. This can cause food or liquid to enter the airway and settle in the lungs, leading to serious complications such as infection or pneumonia.

There are three types of dysphagia: oral, oropharyngeal, and esophageal. Oral dysphagia occurs when the problem is in the mouth, where the jaw, teeth, and tongue work together to tear food into smaller pieces. Oropharyngeal dysphagia happens when the tongue pushes food to the back of the throat, and the voice box closes to prevent food or liquid from slipping into the airway. Esophageal dysphagia is when the esophagus squeezes food or liquid down in a wave-like motion until it reaches the stomach.

The signs of dysphagia include coughing or choking when eating or drinking, bringing food back up, a feeling of food being stuck in the throat or chest, and a gurgly, wet-sounding voice when consuming food or drink.

Dysphagia can be treated through medication, lifestyle changes, and other medical therapies. Speech-language pathologists can assess an individual's ability to swallow and provide treatment if necessary. Treatment options may include swallowing therapy, injecting muscle relaxants, and surgery to widen the oesophagus.

Emotional and personality changes

Experiencing a stroke can lead to a range of emotional and personality changes. These changes are often caused by damage to the brain, but can also be a response to the life adjustments that come after a stroke.

Emotional Changes

Depression is a common emotional change that occurs in the first year after a stroke. This can manifest as:

• Feeling sad most of the time
• Difficulty concentrating
• Difficulty managing everyday life
• Difficulty sleeping
• Loss of interest in activities, food, or weight changes

Anxiety is another emotional change that can occur after a stroke, either on its own or with depression. People experiencing anxiety may:

• Feel worried or frightened most of the time
• Find it difficult to calm down
• Experience intense panic
• Have recurring thoughts that increase anxiety
• Avoid situations that cause anxiety

Personality and Behavioural Changes

• Irritability
• Aggressiveness
• Apathy or lack of motivation
• Repetitive behaviour
• Disinhibition
• Impulsiveness

In addition to these emotional and personality changes, a stroke can also lead to physical changes and changes in thinking, memory, and perception. The impact of a stroke varies depending on the individual and the part of the brain affected.

Cognitive changes

A stroke can cause a wide range of cognitive changes, depending on which part of the brain is affected and the extent of the damage. Here are some of the possible cognitive changes that can occur:

Problems with Communication, Speech, and Language

A stroke can affect the part of the brain that controls speaking, reading, and communication. This can lead to difficulties in finding the right words, understanding what others are saying (aphasia or dysphasia), weakness in the muscles that help with speech (dysarthria), and problems with writing due to a weak writing hand or issues with thinking or seeing.

Changes in Thinking and Memory

Strokes can impact a person's ability to think, remember, understand, plan, reason, and problem-solve. They may experience issues with short-term memory, orientation (knowing the day and time), and attention span. Cognitive therapy can help individuals cope with these changes and improve their focus and concentration.

Emotional and Personality Changes

Emotional and personality changes are common after a stroke. Individuals may experience depression, anxiety, irritability, aggressiveness, apathy, repetitive behaviour, disinhibition, and impulsiveness. These changes can be caused by damage to the brain or be a response to the life adjustments and challenges brought on by the stroke.

Behavioural Changes

A stroke can result in behavioural changes, such as a slow and cautious behavioural style or a quick and inquisitive behavioural style. These changes are often associated with the side of the brain affected by the stroke.

Changes in Perception

Perception refers to how an individual sees, hears, and feels the world. After a stroke, perception can be altered, leading to changes in how one feels contact, pain, heat, or cold on the side of the body affected by the stroke. It can also cause difficulties in performing certain movements, recognising shapes and objects, and problems with vision.

It is important to note that the impact of a stroke on an individual's cognitive abilities can vary, and early treatment and rehabilitation can significantly improve recovery.

Frequently asked questions