Physiotherapy In Stroke
Stroke Facts and Figures
- Stroke is Australia’s second biggest killer after coronary heart disease and a leading cause of disability.
- 1 in 6 people will have a stroke in their lifetime. These people are someone’s sister, brother, wife, husband, daughter, son, partner, mother, father… friend. Behind the numbers are real lives.
- In 2012 about 50,000 Australians suffered new and recurrent strokes – that is 1000 strokes every week or one stroke every 10 minutes.
- In 2012 there were nearly 130,000 or 30% of stroke survivors under the age of 65 in the community. [In 2012 there were over 420,000 people living with the effects of stroke and 30% of these people were of working age.]
- In 2012 there were over 420,000 people living with the effects of stroke. This is predicted to increase to 709,000 in 2032.
- Stroke kills more women than breast cancer and more men than prostate cancer.
- 65% of those living with stroke also suffer a disability that impedes their ability to carry out daily living activities unassisted.
- In 2012, the total financial costs of stroke in Australia were estimated to be $5 billion.
- The estimate of $49.3 billion in burden of disease costs for stroke is comparable to the $41 billion burden of disease costs that Deloitte Access Economics estimated for anxiety and depression in 2010.
- The FAST test is an easy way to recognise and remember the signs of stroke. Using the FAST test involves asking these simple questions:
| Face | Check their face. Has their mouth drooped? |
|---|---|
| Arm | Can they lift both arms? |
| Speech | Is their speech slurred? Do they understand you? |
| Time | Time is critical. If you see any of these signs, call 000 straight away |
What is a Stroke?
A Stroke is defined as an acute neurological deficit lasting more than 24hrs and is caused by a cerebrovascular aetiology. The translation? Neurological symptoms that last for more than 24hrs that can be attributed to changes in the blood supply to the brain. Strokes can be subdivided into either;
- Ischaemic
- a reduction of the blood supply to the brain caused by a blockage or narrowing of the arteries that supply the brain.
- approximately 85% of strokes are ischaemic
- Haemorrhagic
- the rupture of a blood vessel in the brain which increases the pressures inside the skull and can therefore limit the delivery of oxygen rich blood to brain tissue
- approximately 15% of strokes are haemorrhagic
Just like your muscles, brain tissue relies on a constant blood supply to deliver enough oxygen. In fact, did you know that the brain uses more than 20% of the bodies blood and oxygen? With such a large oxygen demand, any prolonged interruption can lead to cell damage and eventually cell death.
The brain is divided into several areas that control different functions. These include how you move your body, receive sensory messages (such as touch, sight or smell), use language and think. Because different arteries supply different areas of the brain, where the brain is damaged will determine which functions are affected.
Every stroke is different. Each person affected by stroke will have different problems and different needs. The way in which you might be affected depends on where in the brain the stroke happens and how big the stroke is. A stroke on the right side of the brain generally causes problems on the left side of the body. A stroke on the left side of the brain causes problems on the right side of the body. Some strokes happen at the base of the brain and can cause problems with eating, breathing and moving.
So is it all doom & gloom?
Good news, there are always continuing advances in the management of stroke. The use of clot busting drugs and advances in surgical procedures can have a large impact on the severity of symptoms following stroke. Other advances in neuroscience include the discovery that the brain has the ability to change. It has the ability to develop new connections between neurons. This potential for change in the brain and nervous system is termed 'Neuroplasticity'. It's this neuroplasticity that physiotherapy aims to capitalise on. Through repeated practice of tasks and the promotion of functional movements, those who have suffered a stroke can make remarkable improvements in their functional capacity. Rehabilitation that may include gait retraining, task specific training that focuses on reach and grasp, postural alignment, muscular strength & endurance exercises, and spasticity management are all areas that a physiotherapist plays a role.
Physiotherapists working in the neurological field have advanced skills in analysing deficits and clinically reasoning strategies to maximise their patients rehabilitation and ultimately improve their quality of life. Common conditions physiotherapists encounter in neuro include Stroke, Cerebral Palsy, Multiple Sclerosis, Guillain-Barrè Syndrome, Traumatic Brain & Spinal Cord Injuries and Parkinson's Disease.
So why the article on Stroke?
My name is Luke and I'm currently in my final year of the Master of Physiotherapy program at Flinders University. Exposure to all areas of physiotherapy, which includes neurological physio, are part of the course. Before covering the material last semester, I had a poor understanding of neurological conditions and the impact they can have. I believe that sharing information about common conditions helps to increase everyone's health literacy and helps dispel myths. Over the next two months I have the exciting opportunity to be working at the Royal Adelaide Hospital in their acute neurological wards. It's sure to be a challenging time but I'm looking forward to building on my knowledge in the neurological physiotherapy area.
Australian Sroke Foundation (2014) Retrieved from
https://strokefoundation.com.au/health-professionals/tools-and-resources/facts-and-figures-about-stroke/
AIHW 2013. Stroke and its management in Australia: an update. Cardiovascular disease series 37. Cat. no. CVD 61. Canberra: AIHW.
