
A stroke occurs when the brain is deprived of oxygen, which can happen due to a blocked blood vessel (ischemic stroke) or bleeding in the brain (hemorrhagic stroke). This often results in paralysis or weakness on one side of the body, affecting the arm, hand, leg, and foot muscles. Spasticity, characterised by stiff or rigid muscles, is a common post-stroke condition that makes movement difficult. It can lead to joint issues and muscle shortening, causing the hand to clench into a tight fist. Proper arm care and rehabilitation, including physical therapy and exercises, are crucial to prevent and treat these problems. Recovery from a stroke is highly variable, and while some individuals regain full function, others may always have some level of disability.
Characteristics | Values |
---|---|
Paralysis | Loss of use of the arm and hand |
Weakness | Muscles may become limp and heavy |
Spasticity | Uncontrollable muscle tightness and stiffness |
Shoulder subluxation | Partial dislocation of the shoulder joint |
Pain | Stiff, swollen and painful shoulder, hand or wrist |
Difficulty with daily tasks | Bathing, eating, dressing |
What You'll Learn
Paralysis or weakness on one side of the body
A stroke occurs when the brain is deprived of oxygen, which can happen if a blood vessel to the brain gets blocked or if there is bleeding in the brain. This can cause paralysis or weakness on one side of the body, which happens to about 80% of people. This usually occurs on the opposite side of the body from where the stroke occurred in the brain.
Spasticity can affect joint stability and movement, and if left untreated, it can lead to joints in the arm and leg becoming stuck or frozen in an abnormal and painful position, known as contracture. It is important to handle, move, and position an affected limb carefully to avoid injury to joints, muscles, and ligaments.
Treatment for paralysis or weakness on one side of the body may include physical therapy, occupational therapy, botulinum toxin injections, splints or orthotics, and oral medications. Physical therapy may involve stretching exercises to improve the range of motion and blood flow, as well as exercises to rebuild strength in the affected arm or leg. Occupational therapy can help individuals relearn daily living skills such as dressing, showering, cooking, and cleaning.
Assistive devices such as canes, walkers, or wheelchairs may also be needed to improve mobility and independence. These devices should be fitted to the individual's needs and used safely under the guidance of a healthcare professional.
Stroke and Cardiomyopathy: Right Hemisphere Risk Factor?
You may want to see also
Shoulder subluxation
The risk of shoulder subluxation can be mitigated by proper arm care and positioning. This includes techniques such as:
- Using a sling or harness to support the arm and prevent further damage
- Placing the arm in a correct position, such as on a pillow when lying down or on a table when sitting up
- Using assistive devices such as lap trays or pillows to support the arm
- Seeking guidance from a physical therapist on safe exercises to improve strength and flexibility
In addition to proper positioning and support, there are other treatments for shoulder subluxation, including:
- Electrical stimulation of the muscles, which can help prevent subluxation and reduce pain in the acute phase
- Botulinum toxin injections to reduce muscle tightness
- Constraint-induced movement therapy, which involves using the affected arm more and the unaffected arm less
- Biofeedback exercises to help regain mobility and reduce pain
Stroke Inducement: Can Humans Cause Strokes in Others?
You may want to see also
Muscle spasticity
Spasticity is caused by damage to the brain, which blocks messages between the muscles and the brain. This damage affects the balance of signals between the nervous system and the muscles. The condition usually affects the elbow, wrist, and ankle. If left untreated, spasticity can lead to adverse effects such as overactive reflexes, pressure sores, and chronic constipation. It can also cause joints in the arm and leg to become stuck or frozen in an abnormal and painful position, known as contracture.
There are several treatments available to manage and recover from spasticity. Oral medications, such as muscle relaxers, can be prescribed to block the neurotransmitters that cause muscle tightening. However, these medications affect all muscles and may have side effects such as drowsiness. Injected medications, such as botulinum toxin or Botox, can target specific muscles and block the chemicals that trigger muscle contractions. While Botox can have side effects like soreness and rash, it can also reduce the risk of spasms and spasticity, enabling patients to participate in physical therapy.
Stretching exercises are an important part of managing spasticity. These exercises help prevent stiffness in the joints, increase and maintain the range of motion, and reduce muscle spasms. For those with mild to moderate spasticity, stretching exercises may be performed unassisted, while those with more severe cases may require additional interventions. Anti-spasticity orthoses, such as dynamic splints, can also be used to relieve pressure on the joints and provide a prolonged muscle stretch.
In severe cases of spasticity, where the tendon has permanently shortened, surgery may be necessary to release or lengthen the tendons and remove tension. Surgical procedures are typically considered a last resort when other treatments have failed, and the spasticity is causing significant pain or limiting the patient's independence.
Visiting a Stroke Patient? Try These Helpful Tips
You may want to see also
Electrical stimulation therapy
ES has a range of uses and benefits, including:
- Strengthening weak muscles
- Increasing range of motion
- Reducing spasticity
- Improving motor control
- Reducing shoulder subluxation
- Reducing pain associated with shoulder subluxation and spasticity
- Improving sensory and proprioceptive awareness
- Improving the effects of botulinum toxin for spasticity management
ES is particularly recommended for the treatment and management of shoulder subluxation, which is a common issue after a stroke. Shoulder subluxation is a partial dislocation of the shoulder joint, which can cause pain and reduced range of motion.
ES can also be used to treat hemiplegia and hemiparesis, spasticity and gait issues, edema, and swallowing problems (dysphagia).
There are several types of ES:
- Neuromuscular electrical stimulation (NMES) – this involves sending electrical impulses to the muscles to imitate signals from the nervous system, causing the targeted muscle to contract.
- Functional electrical stimulation (FES) – a type of NMES commonly used in stroke rehabilitation, often combined with functional movements such as lifting the foot or grasping an object.
- Transcutaneous electrical nerve stimulation (TENS) – used to treat and manage post-stroke pain by sending impulses to nerve cells to block pain signals.
- Interferential current (IFC) – similar to TENS and used for pain reduction, using a different frequency.
It is important to note that ES should not be used for certain individuals or conditions, such as those with pacemakers or other implanted electrical devices, or those with numbness or decreased sensation. It should also not be used over open wounds, tumours, or the front of the neck.
ES is most effective when used in conjunction with other rehab techniques and exercises, and should be administered by a qualified health professional such as a physiotherapist or occupational therapist.
Body Temperature Fluctuations: Post-Heat Stroke Evenings Explained
You may want to see also
Constraint-induced movement therapy
CIMT is based on the theory of 'learned non-use', which suggests that people who have had a stroke may rely more on their unaffected arm and hand, and gradually use their affected arm and hand less and less. This can lead to further impairments. By restraining the unaffected arm and hand, CIMT encourages the use of the affected arm and hand, promoting adaptive brain rewiring and potentially improving motor function.
CIMT can be an intensive treatment, with some protocols involving forced use of the affected arm and hand for up to 90% of waking hours for two weeks. It is not suitable for everyone, and may be frustrating for some people. It is also specific to a certain population, and is not designed for people who experience paralysis or weakness in both arms or legs.
Strokes and OT Therapy: Weekly Sessions for Recovery
You may want to see also
Frequently asked questions
A stroke occurs when the brain is deprived of oxygen, which can happen if a blood vessel to the brain gets blocked or if there is bleeding in the brain. This causes some brain cells to die, which can result in paralysis or weakness in the muscles of the arm, shoulder, leg, hand, or foot.
Symptoms can include painful muscle spasms, stiffness, and difficulty stretching the muscles of the arm, hand, leg, and ankle. The arm may be in a folded position against the chest with a curled wrist and fingers, and the foot may be pointed.
Treatments include physical therapy, stretching exercises, oral medications, electrical stimulation therapy, injections of botulinum toxin, and occupational therapy to re-learn life skills.