Stroke, which is defined as a Cerebrovascular Event (CVO) in medicine, is defined as the occlusion or rupture of one or more of the vessels that feed the brain, as a result of which certain parts of the brain are deprived of oxygen and, as a result, brain damage develops. The effects of a stroke vary depending on the area of the brain where the damage occurred. In some cases, it causes only minimal muscle loss, while some conditions require immediate intervention and may even result in loss of life. (2)
What is Hemiplegia?
Hemiplegia is defined as the loss of neurological and physical function in a certain part of the body due to stroke. (1) This situation, which is confused with stroke by definition, is actually a picture that occurs as a result of stroke. The vast majority of strokes result in neurological manifestations with a decrease in muscle strength, and hemiplegia is the most common nervous system finding in this neurological picture.
What are the Symptoms of Hemiplegia?
The findings observed in a hemiplegic patient indicate brain damage. it varies according to the region, but the most common symptoms can be listed as follows: In hemiplegia affecting the arms, spasticity is usually accompanied by flexion contraction in the form of bending at the elbow, while extension contraction, which can be explained as the desire to move towards the opposite direction of the knee joint, is observed in the legs. This state of the disease is often described as spastic hemiplegia.
What are the Causes of Hemiplegia?
Hemiplegia is a picture that occurs as a result of stroke. Conditions that cause stroke can also be listed as causes of hemiplegia. In addition to non-modifiable risk factors such as age, gender, family history of stroke, and genetic predisposition due to race, many systemic diseases can also cause problems such as occlusion or rupture in cerebral vessels, and thus stroke. The main causes that increase the risk of stroke and lead to the picture of hemiplegia are as follows:
- Age: 75% of patients with a history of stroke in the world are over 65 years old. Therefore, age is defined as the most important risk factor for stroke. The risk of developing a stroke doubles for every 10 years after the age of 55, even in healthy individuals. For this reason, routine neurological controls are recommended for every individual in their 50s, even if they do not have any systemic disease or family-based genetic predisposition. can cause problems such as clogging. This causes circulatory disorders in the brain vessels and an increase in the risk of stroke is observed as a result of insufficient nutrition of the brain cells. Among the heart diseases, the most treatable and treatable factor that increases the risk of hemorrhagic (bleeding-related) stroke is a kind of rhythm disorder called atrial fibrillation. Atrial fibrillation increases the risk of stroke approximately 5 times, and 1 out of every 4 strokes seen in individuals over the age of 80 develops due to arrhythmia. Considering that approximately 70% of strokes caused by atrial fibrillation can be prevented with the use of oral blood thinners, the person diagnosed with heart disease It is also extremely important in terms of neurological health that patients continue their routine cardiological controls. (6)
- Diabetes: Diabetes Mellitus (DM) increases the risk of occlusion in the arteries and predisposition to other risk factors such as hypertension, obesity, and hyperlipidemia. In this case, the risk of stroke increases 1.8 times in men and 2.2 times in women. (6)
- Hypertension: Development of clots in the cerebral vessels and as a result, the decrease or complete cessation of blood flow to the brain is defined as ischemic stroke. In the presence of hypertension, the risk of ischemic stroke increases 4 times. Approximately 60% of strokes develop due to hypertension, and it is observed that the risk of stroke is reduced by approximately 40% with proper antihypertensive treatment. (6)
- Smoking: Cigarette addiction is a harmful habit that greatly affects the entire vascular structure of the body, circulatory system, lung tissue, oxygen saturation of the blood, in short, the functioning of all body cells. It increases the risk of stroke about 2 times. However, with the cessation of smoking, the risk of stroke decreases rapidly and it is possible to return to normal within 2-4 years. (6)
- Nutrition Containing Animal Food: A person's lifestyle and eating habits are also effective on stroke and its related complications, as in all diseases. It can be said that a plant-based diet especially supports the vascular structure, while at the same time it reduces the risk of obesity and diabetes and prevents serious diseases such as stroke. . Regular exercise supports the person both physically and mentally and reduces the incidence of vascular diseases such as CVO, as well as serious psychiatric disorders such as Alzheimer's.
What are Hemiplegia Diagnostic Methods?
The diagnosis of hemiplegia is usually made by clinical examination. The patient with a history of stroke shows spasticity and related contractions in some parts of the body, and signs of deterioration in sensory motor functions and perception. In addition, uncontrollable muscle movements, tremor in the muscles of the affected area, inability to perform complex events such as walking and speaking, muscle stiffness and related problems. I develop body aches. Many such findings indicate the presence of post-stroke hemiplegia.
How to Plan the Recovery Process of Hemiplegia?
After the patient with a history of stroke is stabilized by emergency health interventions, a detailed neurological examination is performed. each muscle mass is evaluated in detail. Body parts that develop hemiplegia are determined by considering all findings such as spasticity, rigidity, tremor, and loss of sensation. Accordingly, a treatment program is created. Physical therapy and rehabilitation interventions in hemiplegic patients constitute the first step of the recovery process. The aim of physical therapy is to maximize muscle strength and coordination in order to ensure and maintain normal joint movements and protect muscle functions.
How is Hemiplegia Rehabilitation Provided?
The primary treatment option for all types of hemiplegia is to maximize muscle strength with physiotherapy applications. During these applications, the patient should be evaluated in terms of mental, mental and psychosocial aspects as well as physical and neurological aspects, and physical therapy applications and rehabilitation care should not be considered separately. Appropriate physical therapy interventions are planned for the hemiplegic muscles, along with exercises aimed at strengthening the intact extremity. In the acute phase, the hemiplegic muscles are strengthened and muscle loss is prevented with passive, active-assisted, active, active-resistive and progressive-resilient exercises in accordance with the condition of the muscles. During this period, it is aimed for the patient to gain the ability to sit in bed. First of all, the patient is given exercises such as turning or straightening in bed with the help of a rope. The physical therapy phase of the patient is planned according to the clinical condition and, if clinically appropriate, the knee lock Parallel bar stage consists of lifting, weight bearing, weight transfer, balance and gait training. It should be known to what extent the patient does not receive treatment, to what extent he adapts to the planned exercises and what kind of expectations he has from the treatment. It is one of the critical points for the correct hemiplegia treatment that this whole process is handled holistically with expert physiotherapists and experienced rehabilitation centers. For the correct treatment of hemiplegia, which is one of the most common consequences of stroke, you can consult neurologists who are experts in their fields and choose experienced rehabilitation centers.
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