Sunday, February 23, 2020

Dealing with the Five Disabilities Resulting from Stroke Part I


The following is Part 1 of a 2 part series, posted six years ago in the July issue of the now discontinued StrokeNet Newsletter, titled Dealing With Five Disabilities Resulting from Stroke by Walt Kilcullen.  Part 1 deals with two of the five disabilities. Part 2 will be posted next week. 
By Walt Kilcullen
Part 1.
I. Movement dysfunction and paralysis
II. Sensory dysfunction

The degree of motor damage and cognitive damage as a result of a stroke varies greatly from patient to patient because of the part of the brain affected or damaged and how badly the brain was damaged. In this article, I have examined the first two of five categories of disabilities and how a survivor can deal with each. The other three will be discussed in September.

I. Movement dysfunction and paralysis: If a stroke happens on the left side of the brain, it will affect the right side of the body. A left brain stroke will affect the right side of the body.

Paralysis can be on either side of the body. It can be of the foot and leg, the arm and hand, or both. If there is total paralysis, there is no treatment to improve or reverse that condition.

Dysphagia, or difficulty swallowing, occurs in some patients but is usually greatly reduced or cured early on by a speech therapist.

Ataxia affects the body’s ability to coordinate movement which leads to difficulties with body posture, balance, and walking.

Spasticity or tone “is a condition where muscles are stiff and resist being stretched. It can be found throughout the body but may be most common in the arms, fingers or legs. Depending on where it occurs, it can result in an arm being pressed against the chest, a stiff knee or a pointed foot that interferes with walking. It can also be accompanied by painful spasms.” (Stroke: A Stroke Recovery Guide, a publication of the National Stroke Association, p. 52).

Treatment Options for partial paralysis, ataxia, and spasticity

● A combination of physical therapy, occupational therapy, and medication is standard treatment.

● Exercises for strength, balance, coordination, stretching, or range of motion can be helpful.

● A brace on the affected leg to provide support and to correct foot drop is often prescribed.

● Injection of Botox into the affected area to relax the muscles by blocking the nerve activity that creates the stiffness has proven to be helpful in some patients.

● Baclofen Therapy has been successful for some patients in treating severe spasticity. Baclofen is injected into the spinal fluid using a surgically places pump.

● Constraint Induced Movement Therapy has been under experiment and has shown great promise. It is designed for patients who have arm weakness and spasticity, but the patient must have some ability to move the hand. If you are interested in this research, Google: CIMT Edward Taub.

● Research is in progress using stem cells, and transcranial magnetic stimulation with the goal of reversing at least some of physical damage done by stroke

II. Sensory dysfunction: In some stroke patients, pathways for sensation are damaged resulting in pain in the side or the limb being blocked. Decreased feeling in the limbs, numbness or burning in the limbs and pain are examples of sensory dysfunction.

Decreased feeling usually in the limbs can occur but is not common.

Tingling, numbness, or burning usually in the limbs can occur but is not common.

Pain is the most troubling sensory problem because it is more frequent than the other sensory problems and it is usually more debilitating. Pain is often caused by nerve damage, or sometimes from lack of movement.

Treatment options for sensory dysfunction:

●  Decreased feeling, tingling, and burning in the limbs is very difficult to treat especially because what works for one patient may not work for another. Some patients report that continuous light exercise brings relief. Acupuncture, heat application, meditation, and prescribed medications are also reported by some to give relief.

● Pain is also difficult to treat because pain after a stroke can occur in various parts of the body. I wrote an article in the July, 2013 issue of the newsletter where I give tips on reducing pain. Yoga and meditation can help relax and teach the patient to breathe properly.

● Progressive Muscle Relaxation (PMR) is a step-by-step technique that helps the patient become aware of muscle tension and reduces the tension through a systematic approach that reduces pain. You can look at the PMR web-site to see visuals that will walk you through the PMR exercises.

● The Trigger Point Therapy Workbook: Your Treatment Guide For Pain Relief by Clare Davies has received nothing but good reviews on Amazon. Readers should give this a try.

● Chronic pain deserves treatment by a pain management specialist, and/or acupuncturist.
Part 2 of this article will be posted next week.

Areas covered will be:

III. Problems with Language
IV. Problems with Memory and Reasoning
V. Problems with Emotion


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