Editor’s note: House Calls runs every other Thursday. Today’s column is written by Beverly Sutter, physical therapy supervisor at Sutter Coast Hospital.
The term “stroke” is often used to describe a cerebrovascular accident (CVA) — a sudden, crippling, sometimes fatal occurrence.
Although young people, even children, occasionally suffer strokes, they most typically affect older people. When a stroke occurs, the blood flow through one or more blood vessels of the brain is disrupted. If the disruption is severe and prolonged enough to deprive brain tissue of blood and oxygen, the involved tissue will cease to function and die.
The warning signs of a CVA or stroke include dizziness; unsteadiness; sudden falls; temporary dimness or loss of vision, particularly in one eye; temporary loss of speech or trouble in speaking or understanding speech; or sudden weakness or numbness of the face, arm and leg on one side of the body.
Many major strokes are preceded by transient ischemic attacks (TIAs) or “mini strokes.” They may even be a cause of dementia.
Silent strokes are different from mini strokes, which are noticeable but last only for minutes or hours. A silent stroke is generally found incidentally during an MRI of the brain. When patients are asked if they remember having a stroke, they are often surprised, having never exhibited any symptoms. A recent study showed that by the age of 69, approximately 10–11 percent of people who consider themselves “stroke-free” have suffered at least one that can be seen on MRI.
When researchers looked at MRI scans performed several years later for signs of silent stroke — when the participants were an average age of 70 — they found that the moderate-to-heavy exercisers were 40 percent less likely to have suffered a silent stroke than the non-exercisers.
The risk factors for a stroke are hypertension, heart disease, diabetes, cigarette smoking, physical inactivity, obesity, excessive alcohol consumption and increased blood cholesterol and lipids. People should take responsibility for their health and decrease risk factors.
Rehabilitation following a strike typically includes physical therapy, occupational therapy and speech therapy. Rehabilitation typically starts as soon as the patient is medically stable, usually within 72 hours of onset. The location and size of the ischemic process, the nature and functions of the structures involved, and the availability of collateral blood flow all influence the symptoms seen and the recovery rate. An effective rehabilitation program should seek to prevent or lessen secondary impairment and provide a safe and effective environment for the relearning of functional skills.
Physical therapy goals typically include improving range of motion, strength and the ability to walk safely. Occupational therapy goals typically include improving one’s ability to do normal activities such as dressing, grooming and eating. Speech therapy goals typically include improving respiration, facial functions, swallowing and chewing.
The goal is to make survivors as independent and productive as possible and to prevent additional strokes.