In recognition of National Stroke Awareness Month, observed in May, this piece was done to aid persons with this problem. A stroke is a serious, life-threatening medical condition, that occurs when the blood supply to part of the brain is cut off. They are a medical emergency, and urgent treatment is essential, since the sooner a person receives treatment for a stroke, the less damage is likely to happen.

Why do strokes happen?

Like all organs, the brain needs the oxygen and nutrients provided by blood to function properly. If the supply of blood is restricted or stopped, brain cells begin to die. This can lead to brain injury, disability and possibly death.

There are two main causes of strokes:

• – ischaemic – where the blood supply is stopped due to a blood clot, which accounts for 85% of all cases.
• – haemorrhagic – where a weakened blood vessel supplying the brain bursts.

There is also a related condition known as a transient ischaemic attack (TIA), where the supply of blood to the brain is temporarily interrupted, causing a “mini-stroke” that often lasts between 30 minutes and several hours. TIAs should be treated seriously, as they are often a warning sign, that you’re at risk of having a full stroke in the near future.

What kind of problems do people have?

– Most people will have some problems with movement after a stroke.

– Most movement problems are caused by weakness in your muscles. It’s common for a whole side of            your body to be weak after a  stroke, but you may have weakness in just one arm or leg.

– Muscle weakness affects how well you can move your body. Sometimes it can be severe, restricting              your ability to move   parts of your body. This is called paralysis.

Other things that can affect your movement include:

• 

  – Drop foot – this is when your toes catch on the ground when you step forward, because the muscles that lift them, are weak.

• – Problems with stamina – you may find it difficult to keep moving for a long time. So if you have been active for a while, and start to feel tired, you may find that you become more clumsy, and find it more difficult to control your movements.
•  – Spasticity – this happens when your muscles become very stiff and tight, making it difficult to move your arms and  legs.
•  -.All of these problems can affect your balance, making you feel dizzy, or unsteady. This can make moving around, and  reaching for objects, even more difficult.

Will things get better?

It is possible for problems with movement and balance to get better. Most people see significant improvements within the first few months. After this, recovery usually slows down, but many people continue making improvements, becoming fitter and stronger for a long time after stroke. If you’re unable to move for a long while after, the time it takes for balance problems to improve can be affected. So it’s best to attempt moving again, as quickly as possible.

Treatment

 It depends on the type of stroke you have, including which part of the brain was affected, and what caused it. Most often, strokes are treated with medication. This generally includes medicines to prevent and remove blood clots, reduce blood pressure, and reduce cholesterol levels. In some cases, surgery may be required to treat brain swelling, and reduce the risk of further bleeding, in cases of haemorrhagic strokes.

 Physiotherapy can help you with movement and balance problems after a stroke. A physiotherapist can help you to practise the things you

find difficult, such as standing or walking, to help strengthen your muscles, to make them work more efficiently. They can also help you to work on your balance, and do exercises to help improve your stamina or dizziness, if you need it. Physiotherapy can also help with spasticity.

The amount of physiotherapy needed, and the exercises you do, will depend on the types of problems you have. The physiotherapist will assess your problems and recommend suitable activities for you. If you have drop foot, it may be suggested that you try an ankle-foot orthosis. This is a type of brace that supports you ankle, so that you can support your weight safely. Functional electrical stimulation (known as FES), can also be used to treat drop foot. This is a device that uses small electrical pulses, to make the weak muscles in your leg and foot, work.

The Podiatrist’s Role

As a podiatrist, it is important to ascertain the cause of the stroke from the medical history. If vessel disease is the underlying pathology, there is reason to assume similar vascular manifestations are occurring in the lower extremity. Podiatrists also have a role in examining and treating the biomechanical complications that cerebrovascular  (CVA) victims often have. Symptoms which may affect the foot and its biomechanics include muscle atrophy (wasting), paralysis (loss of nerve control and sensation), or paraesthesia (altered sensation). These symptoms can often lead to foot drop, which is a secondary condition.

Other Therapies

Massage therapy, along with guided exercise and stretches, aid tremendously in recuperation.

                                          Your feet mirror your general health . . . cherish them!