Stroke; It is one of the leading neurological diseases that causes high mortality and long-term disability all over the world and has a risk of recurrence, and it is a disease that negatively affects not only the patient but also the entire patient's family. It is the third most common cause of death worldwide, after coronary heart disease and cancer. According to the definition of WHO (World Health Organization), STROKE is a clinical syndrome characterized by the rapid onset of signs and symptoms of focal cerebral function loss without any apparent cause other than vascular causes.
The brain constitutes 2% of the body weight. It is one of the most metabolically active organs in the body and requires a rich blood flow to provide this activity. Approximately 20% of the blood pumped into the peripheral circulation with each heartbeat is used by the brain. The brain meets its metabolic needs with this blood. The brain's own tissue does not have the ability to store oxygen and glucose. For this reason, stopping of cerebral blood circulation for 6-10 seconds causes reversible neuronal changes and loss of consciousness in the person.
2 Within minutes, all activities of the brain stop.
After 5 minutes, irreversible changes occur.
In more understandable words. Stroke is the inability of the arteries feeding the brain to transmit blood flow from the heart to the brain due to reasons such as blockage or bleeding, and as a result, the brain tissue undergoes necrosis.
WHAT ARE THE RISK FACTORS;
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Age (approximately 70% of stroke survivors are over 65 years of age.
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Hypertension
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Diabetes
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Smoking and Alcohol Use
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Excessive stress
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Sedentary life style
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Addictive substances
WHAT IS HEMIPLEGIA?
Hemiplegia is a vascular syndrome that develops as a result of pathological changes in cerebral circulation and is characterized by neuromuscular dysfunctions in one half of the body (right or left). Damage to the left side of the brain affects the right side of the body, and damage to the right side affects the left side of the body. world Although hemiplegia, one of the most common brain and nervous system disorders in humans, is more common in middle age and older people, all age groups are at risk.
YOU MAY BE INTERESTED IN Which Group Does Your Headache Belong To?
Hemiplegia Symptoms;
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Right or right side Feeling of numbness in the face, arms and legs on the left side, numbness, stiffness in the tissue, loss of strength or movement or decrease in movement functions,
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Spasticity, combined reactions
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Difficulty in walking and standing and balance disorders,
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Sensory-perception disorders,
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Having difficulty in speaking (aphasia)
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Partial dependence in daily life activities
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Memory loss,
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Having difficulty perceiving the concepts of place and time
HEMIPLEGIA REHABILITATION
Since stroke develops suddenly, poses serious life-threatening risks, and usually creates a lifelong disability, it requires high-level health care, good disciplinary coordination and rehabilitation from the very first moment. It would be wrong to consider stroke patients only with their physical problems. In addition to physical problems, mental problems, daily living activities, language and speech problems, and most importantly psychological problems must be evaluated and addressed by experts. For this reason, physiotherapists, physical therapists, neurologists, social workers, psychologists, occupational therapists and speech-language pathologists should work collaboratively in hemiplegia rehabilitation.
POST-STROKE PHYSICAL THERAPY AND REHABILITATION
There are various concepts that have been created and accepted worldwide in hemiplegia rehabilitation (such as Bobath, Margaret Johnstone, Restrictive Intensified Movement Therapy, Robot Assisted Treatment Approaches, Virtual Reality Treatment). The common aim of these concepts is to return the patient to his/her former life as much as possible. is to be able to return and adapt.
Neurological recovery in stroke occurs at most in the first 3 months, but more slowly. It is known that it can last up to the first 6 months, and very rarely up to 1 year. 80% of motor recovery occurs within the first 3 to 6 months. Studies have reported that 85% of stroke survivors develop hemiplegia, and 55-75% of stroke survivors develop upper extremity function limitation. The goal in stroke rehabilitation is; It is to provide the individual with the highest level of functional independence and increase the quality of life despite existing disabilities. It is also important to start physical therapy and rehabilitation practices of hemiplegic patients at an early stage. Caused by hemiplegia in delayed treatments;
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Bone resorption
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Orthostatic hypotension (caused by immobilization)
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Edema
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Joint limitations, contractures
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Shoulder subluxations
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Pressure sores
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Inflammation in the veins
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Different complications such as impaired intestinal functions may occur.
What does a physiotherapist apply?;
Each physiotherapist evaluates the patient with the concepts he/she uses and prepares a treatment plan appropriate to the patient's level. . But in the first place, the aim should be to prevent complications. Inhibition of spasticity and gaining normal movement patterns accompany this sequence.
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POSITIONING :Correct positioning of the hemi (affected side) extremity must be done by a physiotherapist and these positions must be taught to the patient's relatives. While positioning prevents pressure sores (bed sores), it regulates blood flow and reduces the risk of a 2nd stroke
If the patient has a pressure sore, the position should be changed every half hour or every 2 hours.
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INHIBATION OF SPASTICITY
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PROTECTION OF JOINT RANGE OF MOTION
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GAINING NORMAL MOVEMENT PATTERNS
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BALANCE TRAININGS (static and dynamic balance)
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WALKING TRAINING
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WHEEL LEFT CHAIR, cane, walker etc. USAGE TRAINING
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If necessary, personalized ORTHOTICS RECOMMENDATIONS
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SENSORY GAIN
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If there is a loss of swallowing function, SWALLOWING REHABILITATION
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Speech Problem for SPEECH THERAPY
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For memory effects COGNITIVE REHABILITATION
Just as every disease is personal, every treatment should be personal, regardless of the concept it is based on. For this reason, after having a stroke, people should start rehabilitation practices as soon as their specialist physician allows. Early intervention increases our chances of providing the best returns to patients. Be sure to consult your physician and physiotherapist for your post-stroke physical therapy and rehabilitation service.
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