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Cerebral vascular accidents (CVAs), commonly referred to as strokes, are serious medical events that can lead to physical and cognitive impairment – and even fatality. According to the CDC, every year in the United States greater than 795,000 people suffer a CVA with approximately 610,000 of these being new strokes. Furthermore, strokes are the leading cause of long-term disability and often result in impaired mobility. In this article, we’re here to help you understand what a stroke is, what occurs after a stroke, and how physical therapy can help maximize functional mobility during the rehabilitation process.
What is a stroke?
A stroke is when there is a blockage or rupture of blood vessels within the brain that disrupts the blood supply to the brain. This disruption of blood flow results in tissue death within the brain. Depending on which part of the brain the stroke occurs in will determine the location, nature, and severity of the impairments that occur in response to the tissue damage. There are two main types of strokes, ischemic and hemorrhagic.
Ischemic Stroke
An ischemic stroke occurs when there is a blockage of a blood vessel within the brain. It is the most common type of stroke, accounting for approximately 87% of all strokes. These blockages occur from blood clots or in the presence of fatty buildup along the blood vessel walls – the latter being the most common reason.
Hemorrhagic Stroke
A hemorrhagic stroke occurs when a blood vessel within the brain ruptures, causing blood to collect in areas of the brain it should not be which results in tissue damage. High blood pressure is the most common culprit of hemorrhagic strokes due to the stress it places on the vessels.
Transient Ischemic Attack (TIA)
A transient ischemic attack (TIA) is often called a mini-stroke. While that definition is not completely inaccurate, better terminology would refer to a TIA as a warning stroke, as about 15% of all strokes are forewarned by a TIA. TIAs are small blockages that typically only last for 5 minutes to 24 hours at most. However, TIAs are extremely serious and require medical attention. About 1/3 of individuals who experience a TIA will have a more major stroke within a year. Fortunately, medical providers can work with patients who have had a TIA to identify the cause before they go on to suffer a more serious stroke.
Signs of a TIA include:
• Weakness, tingling, numbness on one side of the body
• Sudden headache without a cause
• Dizziness
• Changes in vision such as blurriness or double vision
• Slurred speech or difficulty comprehending speech
Signs of a TIA and those of a stroke are extremely similar and difficult to differentiate between. That is why it’s always important to see a healthcare provider urgently if you experience any of them. The acronym FAST is used to recognize symptoms of a stroke and provide early intervention as soon as possible.
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Stroke Rehabilitation
The brain is a very complex and amazing organ. After a stroke, your brain and body have to relearn how to do many activities that were once effortless. Neuroplasticity refers to the brain’s ability to create new neural connections that replace the ones that were damaged. Depending on the severity and location of the stroke, a patient might need speech therapy, occupational therapy, physical therapy, or a combination of the three to help facilitate the formation of these new neural connections. Additionally, the amount of time and level of care a person will require is unique to each situation. There are multiple types of rehabilitation that vary in setting, duration, and intensity – your healthcare providers will discuss which options are best for you.
The role of your physical therapist in stroke rehabilitation is to help you gain back as much mobility as possible. This involves gait training, muscle strengthening, balance training, practicing functional tasks, improving endurance, and sometimes providing you with adaptive equipment or orthotics. Physical therapists can specialize in neurological conditions, earning the title of neurologic clinical specialist (NCS). Other activities your therapist might incorporate into your plan of care include aquatic therapy, body weight supported gait and balance training, virtual reality activities, and sometimes even functional electrical stimulation to the affected muscles.
For caregivers or those who have loved ones that have suffered a stroke and are looking for more resources, check out our blog, 10 Pieces of Advice to Give Your Family When You’ve Had a Stroke.
Stroke Prevention
Maintaining a healthy and active lifestyle decreases your risk of heart disease and stroke by promoting cardiovascular health. Eating a healthy diet, participating in daily physical activity, and reducing your stress levels are all part of a balanced overall wellness routine. Additionally, working with a qualified health professional to quit smoking will also decrease your risk of stroke. Small, sustainable changes can make all the difference and drastically improve your cardiovascular health.
How Can OneStep Help?
Physical therapists are a great resource for those who have suffered a stroke as well as anyone looking to improve their fitness and cardiovascular health. At OneStep, our physical therapists are highly skilled at treating patients with neurological diagnoses, such as a stroke, and will perform a thorough evaluation to determine if digital physical therapy is the appropriate fit for each patient and their unique goals. Your OneStep PT will create a personalized program to meet your needs and guide you every step of the way. Download the OneStep app today to connect with a licensed physical therapist who is here to support you no matter where you are on your journey so that you can reach your goals.
References:
Stroke Facts. CDC. Updated April 5, 2022. Accessed May 16, 2022.
About Stroke. CDC. Updated May 4, 2022. Accessed May 16, 2022.
What is a TIA. America Hear Association. Updated December 20, 2018. Accessed May 16, 2022.
Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation. 2022;145(8):e153–e639.
Deutsch J. Physical Therapy Guide to Stroke. ChoosePT by the APTA. Updated April 24, 2021. Accessed May 16, 2022.
