What is Stroke?
Stroke can be categorised into two main subtypes – ischaemic stroke and haemorrhagic stroke. The former occurs when arteries to the brain are blocked, causing a decrease in oxygen supply thus killing a lot of brain cells. The latter is caused by a ruptured blood vessel inside the brain, causing blood clots to form and compress the brain, while reducing blood supply to other areas. Both types of stroke could lead to permanent brain damage. Stroke survivors often notice various degrees of decline in motor functions, cognitive functions, as well as changes in mood and behaviour.
Causes
The causes of stroke vary for different age groups. Strokes in older patients could be caused by high blood pressure, high cholesterol and heart disease. Smoking and drinking alcohol might increase the risks. Younger adults might suffer a stroke when severe trauma to the neck in high-impact sports ruptures the cerebral artery.
After-effects
Decline in motor functions:
• Partial or total loss of motor functions of limbs, including paresis, muscle spasm, unstable gait, etc
• Uncoordinated movement and impaired movement control .
Declined cognitive functions:
• Dementia, most common for survivors who have suffered more severe trauma.
• Impaired attention.
• Short-term and long-term memory loss.
• Impaired executive functions, causing poor performance in tasks requiring planning and sequencing.
• Impaired expressive and receptive communication.
Mood and behavioural changes:
• Mood swings and impatient.
• Inflexible behaviours, seemingly more stubborn than before.
• Uninhibited and impulsive behaviours, over-reaction to minor incidents.
• Avolition, disinterested in favourite activities.
• Social withdrawal and low self-esteem.
Rehabilitation
Rehabilitation is paramount for improving the functioning and quality of life of a stroke survivor. A multi-disciplinary approach involving multiple rehab professionals can improve various aspects of a stroke survivor’s well-being.
Intervention
Physiotherapy
Physiotherapy can improve muscle strength, tolerance and control through manual therapeutic techniques that help to improve balance and gait. Electrotherapy, acupuncture and other forms of therapies can be adopted to augment rehabilitation therapy.
Occupational therapy
Occupational therapy can improve a stroke survivor’s daily functions by providing training for improving physical and cognitive functioning. Adaptive aid and home modification advice may also be provided to facilitate participation in daily activities.
Speech therapy
Speech therapy can improve communication abilities via oral muscle training, vocalising training, augmentative and alternative communication (AAC), as well as swallowing assessment and training for stroke survivors with swallowing difficulties to ensure safe oral feeding.
