Welcome to Best Stroke Physiotherapy Service in Kolkata

Complications or impairment after stroke depending on the size of the stroke and what part of the brain was affected and also types of stroke ( eg, Hemorrhagic Stroke , Ischemic Stroke, transient ischemic attack Brain  steam stroke ).

Sensation:

Sensation is frequently impaired on the hemiplegic side. Impairments are reported in about 53% of stroke patient.

Impairments of sensation includes

1.    Superficial sensation

2.    Deep sensation

3.    Proprioceptive sensation: Proprioception, otherwise known as kinaesthesia, is your body’s ability to sense movement, action, and location without any visual cues . without proprioception, we would not able to move without thinking about next step. Proprioception allows you to walk without consciously thinking about where to place our next feet.

In one study it is shown that about 44% of stroke patient effected by impairment of proprioceptive sensation causing significant difficulties in balance, postural control and motor function impairment.

• Pain:

Stroke can result in severe headache or neck and face pain and shoulder pain is most common pain for stroke survivor. Subluxation and rotator cuff weakness is the primary cause of shoulder pain.

Lesion to posterolateral thalamus and spinothalamic system of brain (Back side of our brain) can cause thalamic pain.

Thalamic pain is a constant, burning pain with intermittent sharp pains. Sometimes pains can be triggered by simply stroking the skin, pinprick or contact with heat and cold.

Stroke survivor also suffered from pain due t alter muscle tone ,spasticity or swelling .

• Vision Impairments:

 Stroke can cause visual field deficits, double vision, or other visual disturbances

Aphasia or other Speech disorders:

Damage to parts of your brain responsible for language may cause aphasia. This condition impairs the expression and understanding of language, as well as reading and writing. Aphasia may occur along with other disorders that impact speech, like apraxia (being unable to perform tasks that were familiar before the stroke) and dysarthria (difficulty speaking).

• Weakness:

Weakness or paresis is found in 80 to 90 percent of all patients after stroke and is a major factor in disability. Patients are unable to generate force necessary for initiating and control movement .

This degree of weakness is related to the location and size of the brain injury and varies from a complete inability to achieve any visible contraction of muscle.

• Alteration of Muscle:

Flaccidity or Hypotonicity is present immediately after stroke and is due primarily to the effects of cerebral shock. It is generally short-lived lasting a few days or weak. It is generally persisted in small number of patients.

Spasticity (hypertonicity) emerges in the 90% of the patients and occurs on the side of the body opposite of the lesion.

• Abnormal Synergy Pattern:

Abnormal and highly stereotyped synergies movement emerges with spasticity. In synergies abnormal movement pattern patient is unable to do and isolated joint movement without producing movement of others joint of same limb.

Her the patient is severely limited in the ability to adapt movements to required task or as per environmental demand.

• Altered Motor Programming:

Motor parexis is the ability is planning to execute and coordinated movement.  Lesion to the Frontal cortex, left inferior parietal lobe and corpus callosum can produce motor apraxia. In motor apraxia individual struggles to execute learned and purposeful movement despite having normal strength, coordination and sensation.

• Postural control and balance:

Balance is disturbed following stroke with impairments in steadiness, symmetry, and dynamic stability common. Problem may exist when reacting to a destabilizing external force (Reactive postural control) or during self-initiated movements. (Anticipatory postural control).

Disruption of central sensorimotor processing lead to an inability to adapt postural movements according to the environmental demand.

• Perception and cognition:

Cognitive deficit are presents with lesion involving the cortex and include impairments in alertness, attention, orientation, memory or executive function.

Memory disorder includes impairments in immediate recall, short-term or long-term memory.

Dementia can result from multiple small infracts of the brain, termed multi infract dementia.

Delirium is also known as acute confessional state can result from number of factors following stroke.

Emotional Status: 

 Lesion of the brain affecting frontal lobe, hypothalamus and limbic system can produce several emotional changes. It is also known as emotional dysregulation. Here 18% of cases is characterised by emotion outburst with crying or agitation.

• Depression:

Depression in extremely common, occurring in about one third of stroke cases. It is characterized by persistent feelings of sadness accompanied feelings of hopelessness, worthless or helplessness. Depressed patient may also experience loss of energy or persistent fatigue, an inability to concentrate.