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Not long ago, on October 29th, we saw that both news and social media talked about World Stroke Day. On that day, we remember the more than 13.7 million people that suffer from a stroke every year worldwide. According to Dr. María Alonso de Leciñana, Coordinator of the Cerebrovascular Disease Study Group at the Spanish Neurological Society, stroke is also the second cause of death around the world, being responsible for over 5.5 million deaths every year. And, it is also important not to forget about the more than 80 million people worldwide who have some sort of sequel as a consequence of having suffered from a stroke. Few people know that stroke is the main cause of disability in adults and the second cause of dementia.
These numbers can give us an idea of the magnitude of the problems related to this health condition. But, what is a stroke? Many of us have heard about this health condition in the media but, many do not know what it really means to have a stroke. First of all, it is important to mention that there are different types of stroke.
Types of Stroke
First, we need to know what exactly is a stroke and what are some of the warning signs that this health condition gives us. The word “stroke” refers to “the act of hitting or striking someone; a blow”. And these words are the best way to explain the sudden manner in which this health condition appears. Normally, a stroke takes place because of an interruption of blood flow to an area in the brain. Depending on the brain zone that is affected by this interruption, it is possible to lose the brain functions and capabilities associated with that area. There are two main types of stroke:
Ischemic Stroke: in this type of stroke, one or several brain blood vessels break, flooding brain tissue with their blood brain tissue, as a result, asphyxiating it.
Hemorrhagic Stroke: in this case, one of the brain arteries is obstructed which results in an interruption of the blood flow to a particular brain area or zone. This interruption is the reason why the required oxygen and nutrients do not reach a particular brain zone, damaging it or even causing its death.
Some of the main symptoms of a stroke are:
- loss of vision
- general malaise
- difficulties speaking
- continuous headaches
Rehabilitation After a Stroke
Keeping all this in mind, rehabilitation after a stroke becomes extremely important. The goal in this case will be to try to recover any functionality lost by the patient as a consequence of the stroke. To do this, it is important to take advantage of the neuroplasticity that occurs to reorganize cortical structures once patients become clinically stable.
Moreover, any functionality that cannot be recovered during the rehabilitation process will be balanced with training on compensation skills, in order to make patients as autonomous as possible. This is why it is very important that rehabilitation involves multiple disciplines. That is, to involve rehabilitation professionals from different clinical areas working together towards the same goals and objectives. People who have suffered a stroke will see how the sequels they suffer can be physical (affecting their ability to move or control their body), cognitive (affecting their ability to pay attention, memorize or reason) or communicative (affecting their ability to communicate). A multidisciplinary rehabilitation treatment will normally involve a clinician specialized in each of these areas. There is a significant amount of evidence showing that multidisciplinary rehabilitation is more effective.
Cognitive Rehabilitation Exercises - Stroke
It is also important to keep in mind the different factors that can affect the rehabilitation process after a stroke and that, as a result, will have a direct influence on the recovery obtained. There is strong clinical evidence that shows that the earlier the rehabilitation process starts, the greater the functional recovery the patient will be able to obtain.
On the other hand, the intensity of the received treatment is also very important in order to obtain the best possible recovery after a stroke. When we say “intensity” we refer to the number of times per week that patients will participate in rehabilitation sessions and also, the duration of each of them. During the early stages of the rehabilitation process, like the ones that take place immediately after a stroke, a greater treatment intensity will also result in a greater functional recovery for patients. However, it is also important to “not do too much” because this could have the opposite effect of what is desired. A multidisciplinary rehabilitation team will have all of these factors in mind when designing a treatment plan for their patients.
This is because the physical and cognitive rehabilitation exercises available in Rehametrics were designed to make it easier for rehabilitation professionals to work in a multidisciplinary manner.
Cognitive Stimulation for Stroke
In the previous section we saw that an “intensive” treatment can help obtain a better functional recovery after a stroke. However, in order to quantify the definition of intensity, we should make sure that the rehabilitation treatment received consists of, at least, three hours per day. But above all, to ensure a greater recovery, on top of receiving that many hours of rehabilitation per day, it is also important that cognitive stimulation is provided to patients. Cognitive stimulation after a stroke allows rehabilitation professionals to focus on the recovery of the different cognitive functions of each patient.
Many times an incomplete recovery of cognitive functions can have a direct effect on motor functions and, as a result, on patient autonomy. Although we normally do not think of cognitive stimulation having an effect on our motor capabilities, in reality it does. If the capability to focus on an object or a task is affected after a stroke, it will not matter if we recover arm function because regardless of that, it will be difficult to use that recovered function to eat or get dressed, for example. Cognitive stimulation is a necessary part of rehabilitation that enables us to obtain a more complete recovery.