SECTION 2: STROKE 

WHAT IS STROKE?

A stroke is a medical condition that occurs when the blood supply to part of the brain is interrupted, causing some problems with brain function.

What are the main types of stroke?

There are two main types of stroke:

  1. Ischaemic stroke, caused by a blocked blood vessel in the brain (85% of all strokes).
  2. Haemorrhagic stroke, caused by bleeding in the brain (15% of all strokes).

What are the effects of stroke?

Strokes affect different people in very different ways. Often people have different levels of disability depending on where the stroke takes place in the brain, and how much the brain is affected. In general, a stroke which affects one side of the brain leads to symptoms in the opposite side of the body.

A stroke may result in:

• Weakness in the arms and legs.

• Changes in trunk, arm and leg muscles to be spasm muscles or to be floppy muscles.

• Balance problems.

• Problems with speaking, understanding, reading and writing. 

• Swallowing problems.

• Problems with bowel and bladder control.

• Pain and headaches.

• Fatigue – tiredness that does not go away.

• Problems with speech, memory and thinking (sometimes this is called aphasia).

• Eyesight problems.

• Numbness and/or pins and needles.

• Neglect of one side of the body.

*More information is available at the following link, https://www.stroke.org.uk/what-strokehttps://www.chss.org.uk/stroke-information-and-support/

WHAT IS NEGLECT?

Neglect of one side of the body affects some (but not all) stroke survivors. We can define people who have neglect after their stroke as people who have difficulties recognising one side of their body. If you have neglect, you need to improve your attention and awareness of your affected side. 

HOW TO INCREASE THE AWARENESS OF YOUR NEGLECTED SIDE?

There are many things that you can do to improve the awareness of your ‘neglected’ side. 

• Place any commonly used items such as the phone or TV remote control on a table beside your affected side to encourage you to look and reach for them on that side.

• While seated, ensure that your back is straight and your shoulders level.

• If you can try and use your affected hand during daily activities.

WHAT IS POST-STROKE FATIGUE?

It is normal for people to feel tired, but fatigue after stroke (post-stroke fatigue) is different from normal tiredness. Fatigue after a stroke does not go away with rest and is unrelated to how active you’ve been. 

Very little is known about why people get post-stroke fatigue and there is no specific treatment for managing this symptom.

If fatigue is a problem for you speak to staff in the hospital or your GP at home to check that your fatigue isn’t due to another medical condition. Some medications also cause fatigue so that’s worth asking about too.  

Exercise can also help fatigue so ask your physiotherapist.

 *More information is available at the following link https://www.stroke.org.uk/what-stroke/common-problems-after-stroke/tiredness-and-fatigue

SHOULD I EXERCISE IF I FEEL TIRED (FATIGUE)?

It is important to recognise your fatigue, both when exercising and in everyday life. It is best not to ‘work through’ your fatigue as you may feel worse, often for a few days afterwards.

However, avoiding exercise and activity is not the answer. Doing so can lead to a cycle of inactivity, where already weak muscles that aren’t used become weaker. These muscles become less efficient and require more energy to carry out tasks. This makes exercise and participating in general activity even more difficult and tiring.

The good news is that exercise can help your fatigue. It allows you to build your muscle endurance and strength to help you remain as fit and active as possible. 

WILL YOUR BALANCE BE AFFECTED AFTER STROKE?

Balance problems occur in some people after stroke. People with affected balance are a bit lopsided when they are sitting and might feel unsteady or dizzy when they walk. Balance problems can also results in falls, which, as well as potentially causing injury can affect people’s confidence.  Balance can be a problem after stroke due to one or more reasons:

• Weakness in the arms and legs.

• Changes in trunk, arm and leg muscles to be spasm muscles or to be floppy muscles.

• Loss of sensation/feeling.

• Neglect of one side of the body.

• Loss of concentration when walking

• Eyesight problems.

• Another medical condition or as a side effect of medication.

*More information is available at the following link, https://www.stroke.org.uk/sites/default/files/balance_problems_after_stroke.pdf

 

WHAT TO DO TO AVOID A FALL?

There are many things that you can do to avoid a fall. There are some examples:

  • Use any walking aids or splints that you have been given by your physiotherapist or other health care professional. 
  • Avoid walking on a wet surface.
  • Change your home arrangements, lift loose rugs and carpets. Keep door and passageways clear.
  • Avoid talking when walking, so as not to distract your attention.
  • You may need some adaptation in your home; often occupational therapists can help you with this.
  • Wear good supporting footwear.
  • Ensure you do any balance exercises you have been given by the physiotherapist.

*More information is available at the following link, https://www.stroke.org.uk/sites/default/files/balance_problems_after_stroke.pdf

DOES EXERCISE HELP PEOPLE WITH STROKE?

Yes, exercise plays an important role in rehabilitation programmes for people with stroke to improve their physical and mental ability. In addition, exercises can benefit people with stroke: 

•             Improve the efficiency and strength of muscles.

•             Improve circulation and fitness.

•             Improve bone density.

•             Improve appetite.

•             Improve social life.

•             Improve general well-being, and feel good factor!

•             Improve mental ability.

•             Reduce the chance of having another stroke.

•             Lower blood pressure and cholesterol level.

•             Improve sleep.

•             Help with weight control.

•             Improve the immune system.

•             Improve body image and self-esteem.

*More information is available at the following link, https://www.stroke.org.uk/sites/default/files/exercise_and_stroke.pdfhttp://selfhelp4stroke.org/

 

WHAT OTHER THINGS HELP AS WELL AS EXERCISE?

In order to reduce your risk of stroke and keep healthy, it is important to:

  • Stop smoking.
  • Eat healthily.
  • Be active.
  • Watch your weight.
  • Drink less alcohol.
  • Remember to take your prescribed medicines.