Understanding Paralysis: The Impact Of Ischemic Strokes

A stroke is a medical emergency that can be fatal and often results in paralysis. Paralysis is a condition where a person loses the ability to move their muscles. In most cases, stroke paralysis affects the opposite side of the body to the area of the brain that has been damaged by the stroke.

Ninety per cent of stroke patients experience paralysis in one form or another. Ischemic strokes, which are caused by blood clots blocking blood flow to the brain, are one of the three types of stroke that can result in paralysis.

Passive exercises can help stimulate the brain and activate neuroplasticity, even when the patient cannot move their muscles on their own

An ischemic stroke occurs when a blood clot blocks blood flow to the brain, causing a disruption in the transmission of neural impulses between the brain and the muscles. This can lead to paralysis, which is the inability to move one's muscles. Paralysis can affect one side of the body or both, and it can be temporary or permanent depending on the extent of brain damage.

Passive exercises can be beneficial for stroke patients experiencing paralysis. These exercises involve moving the patient's limbs through a range of motions without requiring their muscle exertion. This can be done by a therapist, a machine, or even the patient's own body parts. Passive exercises help prevent stiffness in the joints, stretch the muscles, and maintain or increase the range of motion. They are particularly useful for patients with spasticity, which affects 17 to 38 percent of stroke survivors.

Even when a patient cannot move their muscles voluntarily, passive exercises can still stimulate the brain and promote neuroplasticity. Neuroplasticity is the brain's ability to form new neural connections and pathways, compensating for the damage caused by a stroke. The brain has a natural ability to heal itself through neuroplasticity, and this process can be enhanced by providing specific cues and stimulation.

Passive exercises, such as moving the legs in a walking motion, can activate neuroplasticity and help the brain create new pathways for movement. This is especially effective when combined with active exercises, such as standing upright and balancing on one leg. The repetition of certain movements or activities retrains the brain, forcing it to create new neural connections. The more the brain is stimulated by practicing these tasks, the easier they become, and the faster the recovery process.

It is important to start rehabilitation as soon as possible after a stroke, as the brain is most receptive to neuroplastic changes during the initial stages of recovery. The first three to four months are crucial, with most rapid improvements occurring within this period. However, improvements are still possible beyond six months, and patients can continue to recover function for up to 18 months or more with the right rehabilitation.

Mental practice involves visualising yourself performing an action, which helps to activate neuroplasticity without requiring physical movement

An ischemic stroke occurs when a blood clot blocks the blood flow to the brain, usually caused by the accumulation of fat deposits inside a blood vessel. This can lead to paralysis, which is a condition where a person is unable to move their muscles. Paralysis often affects the opposite side of the body to the stroke, and 90% of stroke patients experience some form of paralysis.

Neuroplasticity is the brain's ability to change and adapt due to experience. It is the process of the brain changing its structure and function in response to damage or learning. Mental practice can help to activate neuroplasticity and aid stroke recovery without requiring physical movement. Mental practice involves visualizing actions in order to improve one's ability to perform them. For example, a person recovering from a stroke can use mental practice to regain mobility in limbs that they have lost control of.

Mental practice can be applied to various domains, including sports, music, and workplace skills. It can help to improve performance and increase confidence by making unfamiliar situations feel less scary. Additionally, it can help identify knowledge gaps and potential obstacles. Mental practice works because the brain treats visualized actions similarly to actions performed in reality, although there are some neurological differences.

The benefits of mental practice are most notable for experienced individuals, particularly when it comes to physical tasks. This is because novices may not be familiar enough with the task to construct an accurate mental representation. However, mental practice can still be beneficial for beginners, provided they are familiar enough with the skill to visualize it properly and avoid instilling bad habits.

Overall, mental practice is a valuable technique that can complement physical practice and rehabilitation for stroke patients. By visualizing actions, individuals can improve their ability to perform them and activate neuroplasticity, aiding in stroke recovery.

Electrical stimulation can be applied to the affected muscles to help them contract and initiate movement

An ischemic stroke occurs when a blood clot blocks the blood flow to the brain. This can cause paralysis, which is the inability to move one's muscles. Paralysis often affects the opposite side of the body to the stroke.

Electrical stimulation can be used to aid muscle recovery after an ischemic stroke. This involves sending electrical impulses to generate a muscle contraction, which can help with pain or produce visible movement. Electrical stimulation can be performed by a therapist or at home with the correct equipment.

There are several types of electrical stimulation used in stroke recovery:

• EMS (Electrical Muscle Stimulation)
• NMES (Neuromuscular Electrical Stimulation)
• FES (Functional Electrical Stimulation)
• TENS (Transcutaneous Electrical Nerve Stimulation)
• SES (Sensory Electrical Stimulation)
• ETS (EMG Triggered Stimulation)
• RETS (Reciprocal EMG Triggered Stimulation)

NMES is the most common form of electrical stimulation therapy for stroke patients. It generates a muscle contraction, resulting in the movement of a joint. Benefits include improved muscle strength, increased range of movement, and reduced spasticity.

FES is a form of NMES that promotes functional activity, such as grasping a utensil or reaching for a door handle.

TENS is used for pain relief and does not elicit a motor response.

SES is a low-level stimulation to excite the sensory system, helping to reduce spasticity in the arm and improve sensation and neglect.

ETS uses recovering movement from the stroke patient to trigger electrical stimulation during joint movement, increasing patient participation.

RETS helps stroke patients relax overactive muscles before providing electrical stimulation to the opposing muscle. This is useful for patients whose hands regularly close into a fist, as it helps them learn to relax their grip.

Electrical stimulation can be beneficial for stroke recovery, particularly in reducing swelling and stimulating muscle activation. It is often used to work on foot drop, wrist extension, finger extension, shoulder subluxation, and elbow extension.

However, electrical stimulation should not be used by those with a pacemaker, uncontrolled epilepsy, uncontrolled atrial fibrillation, or during pregnancy.

Acupuncture can be combined with electroacupuncture to stimulate the brain and body

An ischemic stroke occurs when a blood clot blocks the blood flow to the brain. It can cause paralysis, which is the inability to move one's muscles. Acupuncture is a form of traditional Chinese medicine that involves the use of thin needles to stimulate specific pressure points in the body. Electroacupuncture is a modified form of acupuncture that uses two needles and passes a mild electric current between them. This current provides more stimulation than needle twirling or other hand manipulation techniques.

• Electroacupuncture can be used to address a range of symptoms and health issues, including chemotherapy-related nausea, arthritis, and acute pain.
• In traditional Chinese medicine, health depends on the flow of "qi" (energy) in the body. Electroacupuncture stimulates the points linked to symptoms to help restart the flow of qi, which is believed to promote the body's natural ability to heal itself.
• Electroacupuncture can be used to stimulate the release of endogenous opioids, which can inhibit inflammatory and neuropathic pain.
• Electroacupuncture has been found to be more effective than manual acupuncture in reducing inflammation and has been shown to decrease systemic factors of inflammation by stimulating the hypothalamic-pituitary-adrenal axis and improving blood flow.
• Electroacupuncture can also be used to treat Bell's palsy, a form of facial paralysis, and has been shown to stabilize symptoms and facilitate better clinical outcomes when used during the acute phase.
• In addition, electroacupuncture can be used as an adjunct to managing poststernotomy pain and has been found to reduce pain and improve pulmonary function.
• Electroacupuncture has also been studied for its potential in treating infertility and Parkinson's disease.
• The frequency of electrical stimulation in electroacupuncture can induce the gene expression of specific neuropeptides in the central nervous system, which can result in the release of endorphins and enkephalin, contributing to pain relief.
• Electroacupuncture can also increase the release of serotonin and norepinephrine, which can decrease glutamate release and inhibit N-methyl-D-aspartate receptor subunit GluN1 phosphorylation, ultimately alleviating pain.
• Furthermore, electroacupuncture can inhibit the release of pro-inflammatory cytokines and stimulate the release of anti-inflammatory cytokines, which can help reduce inflammation and pain.
• Electroacupuncture has also been found to be effective in treating visceral pain by modulating mast cells, substance P, vasoactive intestinal polypeptides, and tumor necrosis factor-alpha function.
• Additionally, electroacupuncture can activate the sympathetic nervous system, which can enhance the migration of opioid-containing cells to an inflammatory site, increasing the release of endogenous opioids and reducing pain.

In summary, acupuncture combined with electroacupuncture can stimulate the brain and body by addressing various health issues, modulating the release of neurotransmitters and cytokines, and activating the sympathetic nervous system. These mechanisms contribute to the therapeutic effects of electroacupuncture in reducing pain and inflammation and promoting healing.

Mirror therapy can help trick the brain into thinking the patient is moving their affected hand

An ischemic stroke occurs when a blood clot blocks blood flow to the brain. This can cause paralysis, which is the loss of muscle movement. In fact, 90% of people who have had a stroke experience paralysis in one form or another.

Mirror therapy is a treatment method that can help stroke patients recover movement in their affected limbs. This technique involves placing the affected limb behind a mirror, with the mirror positioned so that the reflection of the functioning limb appears in place of the hidden one. The patient then performs symmetrical movements with the functioning limb, such as clapping. The patient's brain is tricked into thinking that the affected limb is also moving, as it sees the reflection of the functioning limb. This therapy can help retrain the brain and improve motor function.

Mirror therapy has been shown to be particularly effective when combined with conventional rehabilitation methods. For example, clinical studies have found that mirror therapy, in conjunction with other treatments, can improve arm function, daily activities, and reduce pain after a stroke. However, it is important to note that the effectiveness of mirror therapy may vary, and more research is needed to fully understand its potential.

Overall, mirror therapy is a promising approach that can help trick the brain into thinking the patient is moving their affected hand, aiding in the recovery process after an ischemic stroke.

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