What is a stroke
A stroke is when the brain cannot get enough blood, either due to a blocked or burst artery. Blood carries oxygen and nutrients to the brain, and when the brain cannot get enough of these, brain cells can get damaged or die.
There are two types of stroke
Ischaemic - when an artery in the brain gets blocked by a clot, causing part of the brain to lose blood supply. This can cause damage and injury to that part of the brain. This is the most common type of stroke.
Haemorrhagic - when an artery breaks or bursts either directly in the brain, or on the surface of the brain. This can also cause damage and injury to the brain.
Symptoms and what to do
The Stroke Foundation recommends learning these most common signs of stroke and getting medical attention FAST.
F - Face: is one half of the person’s face drooping? Ask them to smile, does half of their mouth droop?
A - Arm: can the person lift both arms and hold them there? Is one arm weaker and more difficult to lift?
S - Speech: is their speech slurred? Are they more difficult to understand? Do they understand you?
T - Time: time is critical. If you see any of these signs, call 000 immediately.
Stroke is always a medical emergency - the longer you wait to get medical attention, the greater the risk of brain damage.
Risk factors
The following can increase the risk of having a stroke:
Type 2 diabetes
Hypertension (high blood pressure)
High cholesterol
Atrial fibrillation or other irregular heart beats
There are many more risk factors for having a stroke - if you’re concerned about your risk, speak to your GP and get their advice.
Preventative measures
There are many things you can do to reduce your risk of having a stroke. These include:
Remaining physically active
The Australian Physical Activity Guidelines suggest, for adults less than 64 years old, completing moderate to vigorous physical activity for 30 minutes on most days, preferably all days.
This exercise can be anything, as long as it gets your heart rate up, a little out of breath and feeling warm. Some ideas can include:
Brisk walking
Swimming
Strength training
Dancing
Physical activity improves your heart health and reduces the risk of developing the risk factors for stroke.
Eating healthy
Your diet has in impact on many risk factors for stroke, for example:
obesity/overweight increases the risk of heart disease and high blood pressure
Too much salt increases blood pressure
The Australian Dietary Guidelines recommend eating:
Lots of fruits and vegetables (different colours and types)
Grains and cereals, like pasta, rice and bread.
Lean meats, chicken, fish, eggs, tofu
Diary products like milk, yoghurt and cheese
It is also recommended to limit intake of saturated fats, sugar, and salt.
Quit smoking
Smoking doubles your risk of having a stroke, and the more you smoke, the greater the risk of having a stroke.
Smoking increases the risk of a clot developing in your blood and blocking an artery supplying blood to the brain. It does this by:
Making your blood more sticky
Increasing your blood pressure
Reducing the amount of oxygen carried in your blood
Stopping smoking significantly reduces the risk of a stroke - within one month, your blood pressure returns to a normal range and the risk of stroke can reduce by up to 50% after one year of not smoking.
Avoid alcohol
Alcohol increases your risk of high blood pressure, irregular heart beat, uncontrolled diabetes and increased weight (common risk factors for stroke).
Limiting alcohol intake reduced the risk of developing these conditions.
Rehabilitation and the journey after stroke
After someone has a stroke, they can experience a wide range of effects. Some common effects include:
Hemiplegia (one sided weakness) in the face, shoulder, arms, hand, trunk and leg.
Difficulty speaking, understanding language, reading or writing
Personality changes
Fatigue and brain fog
Incontinence
Difficulty swallowing, eating and drinking
Vision loss or blindness
There is support available for anyone experiencing these changes, which can include help from a Physiotherapist, Speech Pathologist, and/or Occupational Therapist, to help you get back to daily life.
How can a Neurological Physiotherapist help
A Neurological Physiotherapist is specially trained to understand neurological conditions, including a stroke, and support a person to do exercises that support the brain’s recovery, both in the short term and long term after a stroke. These exercises utilise your brain’s neuroplasticity - your brain’s ability to recover and rewire after injury. This is crucial to recovery and improving function after stroke.
A Neurological Physiotherapist will work with you to conduct a thorough assessment into impairments and function and develop treatment goals that are meaningful to you to create an individualised treatment plan.
Rehabilitation with a Neurological Physiotherapist may involve:
Exercises to strengthen the shoulder, arms, trunk, and leg on the weakened side
Retraining balance to improve sitting, standing and walking safety and independence
Exercises to improve sensory loss and perceptual deficits
Prescription of orthoses and assistive technology, like a walking aid or wheelchair, to improve function and independence
A Bespoke Physiotherapy, our team of Physiotherapists are highly trained in a variety of different therapeutic approaches, including Bobath and Feldenkrais, to support motor recovery after stroke.
If you’re interested in neurological rehabilitation after a stroke for yourself or a loved one, please call Bespoke Physiotherapy for a discussion on how we can support you.
References
https://strokefoundation.org.au/about-stroke/learn/what-is-a-stroke
https://www.health.gov.au/sites/default/files/australian-dietary-guidelines.pdf
Shahid J, Kashif A, Shahid MK. A Comprehensive Review of Physical Therapy Interventions for Stroke Rehabilitation: Impairment-Based Approaches and Functional Goals. Brain Sci. 2023 Apr 25;13(5):717. doi: 10.3390/brainsci13050717. PMID: 37239189; PMCID: PMC10216461.
