Life after Stroke and Stroke Rehabilitation 

Keely MacLean

Clinical Exercise Physiologist (Student)

22/11/22 

 

A stroke is something that we don’t see coming but it can have profound and sometimes lasting effects. We as Exercise Physiologists tend to shape our rehabilitation methods around something called ‘neuroplasticity’, so what is it and why is it so important?

 

What is a stroke?

A stroke occurs when there is either a partial or full blockage of blood supply to the brain. If the brain doesn’t receive oxygen and nutrients via the blood, brain cells will start to die. Some brain cells can last up to a few hours with only partial blood supply, and if blood supply is returned soon after the stroke occurs these cells may recover.

 

What are the types of stroke?

1. Ischaemic Stroke

This is when the blockage in the artery is caused by a blood clot. This can form anywhere in the body and travel to the brain via the bloodstream.

2. Haemorrhagic stroke

A stroke may also occur due to bleeding from a burst or broken artery. Blood then leaks into the brain like a bruise and results in injury to that region of the brain. This may be in the brain itself (intracerebral) or under the membrane surrounding the brain (subarachnoid)

 

Effects of stroke

Everyone will be different when it comes to the effects of a stroke, but there are some common effects:

 

MOVING AND WALKING

• One side of your body may be weak or not move at all
• You may have difficulty planning and coordinating movement
• Your muscles may be stiff and tight, or floppy and loose
• You may feel off balance, unsteady or dizzy
• Changes to your hand, arm and shoulder are common

 

COMMUNICATION

• You may find it hard to think of the right word
• You may use the wrong word or sound
• You may have difficulty understanding what someone is saying
• You may have trouble interpreting written words

 

THINKING, MEMORY AND JUDGEMENT

• You may find it hard to pay attention
• You may find it hard to plan an action or do things in the right order
• You may find it hard to problem solve

 

PERSONALITY AND BEHAVIOUR

• You may feel irritable, aggressive or lash out
• You may act without thinking

 

VISION AND SENSE

• You may have visual field loss, blurred or double vision
• You may have an altered ability to feel touch, pain or temperature change.
• You may feel overwhelmed by busy, noisy environments as the brain may be less able to filter out unnecessary sensory information
• You may have decreased perception of objects or even parts of your body and ignore things that are on the side of our body affected by stroke.

 

Apart from the physical effects of stroke there are also many common emotional effects including anxiety, anger, emotional lability (when your emotional responses seem out of proportion), depression, fatigue and relationship changes.

 

WHAT WILL REHABILITATION ENTAIL?

The amount and type of therapy you receive will depend on your rehabilitation location. There are three types of rehabilitation:

1. Inpatient rehabilitation (in a hospital)
2. In-home rehabilitation (your rehabilitation team will provide treatment at home)
3. Community or outpatient rehabilitation (you visit a centre or hospital for therapy)

If you see an Exercise Physiologist, it’s more than likely they will focus on very high repetition practice with you

• Repetition is VITAL! Why? Because of Neuroplasticity. This is your brains ability to change and it can happen either through the damaged area of the brain repairing itself or by other parts of the brain taking over the tasks that the injured area used to do – commonly referred to as ‘rewiring the brain’.
• Practicing tasks that the damaged area of the brain was responsible for is essential to promote neuroplasticity, and these need to be practiced very often!
• Research suggests that 1000+ repetition on a particular activity/ movement are required to rewire the brain pathways that control that movement (neuroplasticity). Therefore stroke rehabilitation generally involves practicing a task many times and very often to increase the overall volume of rehabilitation.

Your Exercise Physiologist will work with you to establish SMART Goals

• It’s highly encouraged that you set specific goals throughout your rehabilitation journey, whether this is a task you would like to get back to doing (even if it is slightly different to how you once did it), or something new you’d like to achieve.

 

To find out more about how an Exercise Physiologist can assist with Stroke rehabilitation and regaining independence, call us on 3325 3678.