Best Stroke Physiotherapy In Delhi NCR.

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What Does Stroke Mean?

According to WHO stroke is def inedas “acute onset of neurological dysfunction due to abnormality in cerebral circulation with resultant signs and symptoms that corresponds to involvement of focal area of brain lasting more than 24 hours”. Stroke is also known as “cerebral vascular accident”, “brain attack” or “apoplexy”.

Stroke Recovery

As per National Stroke Association:

  • 10% of stroke survivors recover almost completely
  • 25% recover with minimal impairment
  • 40% experience moderate to severe impairments that require special care
  • 10% require care in a nursing home or other long-term facility
  • 15% die shortly after the stroke
  • Approximately 14% of stroke survivors experience a second stroke in the first year following a stroke
Stroke Recovery Success Story

Patient: Mr. Amit Sehgal, 65 years old

Mr. Amit Sehgal suffered a severe stroke that left him unable to walk or perform daily tasks. Despite undergoing numerous physiotherapy sessions at various healthcare facilities, he felt discouraged and helpless.

Upon a family friend’s recommendation, Mr. Amit sought help at Dr. Chakshu’s Arunalaya Healthcare, renowned for its innovative stroke rehabilitation approach. The team conducted a thorough assessment and developed a personalized rehabilitation plan tailored to his needs. This plan included advanced physiotherapy, rehabilitation therapies, and speech therapy.

Utilizing cutting-edge techniques and state-of-the-art equipment, the dedicated therapists at Arunalaya encouraged Mr. Amit throughout his journey. His determination, combined with expert care, led to remarkable progress.

Over the following months, Mr. Amit regained control of his limbs, relearned how to walk, and improved his speech. With minimal assistance, he eventually regained his independence.

Mr. Amit’s inspiring recovery became a beacon of hope for other stroke patients and highlighted the effectiveness of personalized care and advanced pain management in rehabilitation.

Risk Factors
Risk factors for stroke are classified into:
  1. Modifiable risk factors:
    • Cigarette Smoking
    • Physical inactivity
    • Obesity
    • Diet
  2. Unmodifiable risk factors- Age, sex, family history of stroke etc. that result in following events leading to stroke:
    • Heart disease.
    • Diabetes mellitus.
    • Peripheral vascular disease.
    • Raised haematocrit level.
    • End stage renal disease.
    • Women with early menopause and those taking hormone therapy with oestrogen and progesterone.
    • Pregnancy.
Pathophysiology
  • Ischemia that results from vascular occlusion, as in ischemic stroke, or from the hematoma, as occurs in hemorrhagic stroke, leads to cerebral infarction due to the unavailability of oxygen and glucose to brain tissues.
  • The frank blood that accumulates in the brain acts as a toxic agent, triggering brain inflammation and subsequently producing ischemia as a result of capillary compression due to the mass of accumulated hematoma, as well as pressure exerted by inflammatory edema.
  • Complete occlusion to brain substance causes severe damage with a zone of infarction.The area surrounding this zone consists of cells that are alive but metabolically less active, termed ischemic penumbra. Within minutes neurons within the ischemic core tissue die, but majority of neurons in the surrounding penumbra survive for a slight longer
  • Without timely reperfusion, cells in the prenumbra die ceasing neuronal activities causing expansion of the
  • The ischemic cascade that results from progressive cellular damage, leads to release of excess neuro transmitters( glutamate and aspartate) causing disturbance of energy metabolism and anoxic This results in an inability of brain cells to produce energy, particularly adenosine triphosphate (ATP).
  • Following the onset of stroke, cerebral oedema begins within a few minutes and reaches its peak by about 4 days, however it mostly disappears by 2-3 weeks.The resulting cerebral oedema, causes a raised intracranial pressure and may cause contralateral/caudal shift of brain structure. Due to raised intracranial pressure, level of consciousness is altered(stupor/coma), pulse pressure is widened, heart rate is increased and respiration also become irregular. There also occurs vomiting, unreacting pupils and papilledema.
  • A stroke happens when there is a loss of blood flow to part of the The brain cells cannot get the oxygen and nutrients they need from blood, and they start to die within a few minutes. This can cause lasting brain damage, long-term disability, or even death.
Symptoms of Stroke

Early warning signs of stroke as per the American Heart and National Stroke Association include:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking or understanding.
  • Sudden trouble seeing in one or both eyes.
  • Sudden severe headache with no known cause
  • Sudden trouble walking, dizziness, loss of balance or co-ordination.
  • Spasticity and stiffness in muscles, painful muscle spasms
  • Trouble articulating words (dysarthria)
  • Neglect or inattention to sensations on one side of the body
  • Lack of awareness about the effects of a stroke
  • Swallowing problems (dysphagia)
  • Bowel or bladder control issues
  • Emotional difficulties (emotional lability)
  • Depression
  • Challenges with daily tasks
Rehabilitation
  • To restore lost abilities as much as possible
  • To prevent stroke-related complications
  • To improve the patient’s quality of life
  • To educate the patient and family about how to prevent recurrent strokes
  • Promote re-integration into family, home, work, leisure and community activities

Factors for successful rehab-

  • how early rehabilitation begins
  • the extent of the brain injury
  • the survivor’s attitude
  • the rehabilitation team’s skill
  • the cooperation of family and caregiver

Basic Principles of Rehab-

  • To begin as possible early (first 24 to 48 hours)
  • To assess the patient systematically (first 2-7 day)
  • To prepare the therapy plan carefully
  • To build up in stages
  • To include the type of rehabilitation approach specific to deficits
  • To evaluate patient’s progress regularly

Rehab management-

  • Mobility
  • Activity of daily living
  • Communication
  • Swallowing
  • Orthosis
  • Shoulder pain
  • Spasticity
  • Cognitive and perception
  • Mood
  • Bowel and bladder incontinence

 

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