The onset of a stroke can be a very frightening experience for patients and loved ones. I know from my personal experience working in an acute stroke ward in Chelsea Westminster Hospital (CWH). However, physiotherapists can be an essential pillar of support in your recovery journey, both emotionally and physically. There are two types of strokes (haemorrhagic and ischaemic) and both result in a loss of blood supply to cells in the brain. The acronym FAST is a helpful way to quickly identify if you or someone you love is experiencing a stroke, as early intervention and subsequent treatment is vital to reducing the symptoms.
Physiotherapy starts right from the beginning in the hyper acute stroke unit (HASU) in a hospital and should continue at every step of your ongoing journey. There are multiple symptoms that can result from a stroke, coinciding with the fast acronym such as facial paralysis, arm weakness, numbness and speech impediments. However, with the support of a thorough physiotherapy assessment, you can identify the key areas of disability and create a personalised rehabilitation plan with your physio. For example at CWH we often used creative tools such as body diagrams, for patients with speech issues, to help identify areas of pain or numbness.
After your initial assessment and identification of limitations, your physiotherapy sessions will consist of strengthening weakness in limbs; a common symptom of strokes that usually affects one side of the body. A gold standard recommendation of 45 minutes per day is advised to rehabilitate stroke symptoms and promote independence and function. Depending on the level of weakness rehabilitation techniques can range from using helpful adjuncts such as electrical muscle stimulation to promote movement in paralysed limbs, to resisted exercises that build upon retained muscle strength and function. As well as this physiotherapy plays a key role in identifying ways to adapt movements to promote or maintain a level of independence important to you. This method is known as compensation. Visual impairments and cognitive impairments are also addressed during sessions through similar methods of compensation or creative activities to stimulate the brain's neural connections. I recently played a very competitive game of “connect four” with one of my stroke patients.
Physiotherapy is essential throughout all stages of stroke rehabilitation and the principles instilled throughout should be considered a lifestyle change. Education is a large part of a physiotherapist's role, stretching beyond anatomical knowledge into health, diet and lifestyle factors that will support you further. It is common for physiotherapists to integrate family and/or friends into sessions to broaden education and expand assistance with exercises or activities of daily life in a safe way. Ultimately the physical, educational, psychological and emotional support physiotherapists can offer through your stroke rehabilitation journey is extremely valuable.
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