Introduction
Cerebrovascular disease or the term stroke is used to describe the effects of an interruption of the blood supply to a localised area of the brain. It is characterized by rapid focal or global impairment of cerebral function lasting more than 24 hours or leading to death (Hatano, 1976). As such it is a clinically defined syndrome and should not be regarded as a single disease. Stroke affects 174-216 people per 10,000 population in the UK per year and accounts for 11% of all deaths in England and Wales (Mant et al, 2004). The risk of recurrent stroke within 5 years is between 30-43%. One problem is that the incidence of stroke rises steeply with age and the number of elderly people in the UK is on the increase. To date people who experience a stroke occupy around 20 per cent of all acute hospital beds and 25 per cent of long term beds (Stroke Association, 2004). The British Government now identifies stroke as a major economic burden on the National Health Service (DoH, 2002).
Fifty percent of stroke survivors will experience some residual impairment (physical and cognitive), which is devastating to the individual and their families (Rudd et al, 2002). It is therefore vital for patients and resources that maximum functional recovery is achieved as fast as possible. The physiotherapist has a key role to play in the management of stroke patients, through assessment, prevention strategies, acute management and recovery. This essay aims to critically discuss physiotherapeutic management and examine how it has and may be influenced by a number of factors (e.g. type of organized system for the delivery of post stroke care, setting of therapy, evidence based practice from which National Guidelines are produced etc). The first stage is to outline stroke pathology, of which forms the basis of appropriate management.
Pathology
There are two major stroke sub groups, those resulting from infarction (ischemic stroke) and those resulting from haemorrhage (intracerebral and subarachnoid). Each of the types can produce clinical symptoms that fulfil the definition of stroke. The types often differ with respect to survival and long-term disability, from recovery in a day to incomplete recovery, severe disability and death (Warlow et al, 2001).
Ischemic stroke is the most common type of stroke, which accounts for approximately 85% of all cases (Rudd et al, 2002). It affects 35 people per 100,000 of the population per year (Coull et al, 2004).
Ischemic Stroke is caused due to a blood clot in an area of the brain, leading to loss of neural function if last for more than 24 hours. In the United States, ischemic stroke affects 2.7% of men and 2.5% of women of age range 18 years and older. In addition, it has reported that annually about 610,000 and 185,000 of new strokes and recurrent strokes cases occur in US1. Moreover, it has reported that patients who have suffered from a stroke have more chances of recurrent stroke, Myocardial infarction, and death from vascular causes2. One of the risk factor of ischemic stroke is formation of plaque in the blood vessels causing blood clot3. Several randomized trials have also reported that antiplatelet medications are efficient in preventing recurrences of stroke in patients who had an incident of ischemic stroke. Antiplatelet medications for preventing recurrences of stroke are aspirin, combination of aspirin and extended-release dipyridamole, and clopidogrel alone4. It ha...
Stroke occurs when the blood supply to the brain is blocked or condensed. Blood works to transport oxygen and other beneficial substances to the body’s cells and organs, as well as the brain. There are two main types of strokes that are known as Ischemic strokes and Hemorrhagic strokes. When the blood vessels that provides for the brain becomes congested, is it referred to as ischemic stroke, the most common stroke within adults. Blood clots, a cluster of blood that sticks together, are the cause of Ischemic strokes. Ischemic strokes also takes place when arteries become backed up with plague, leaving less blood to flow. Plague is cholesterol, calcium and fibrous and connective tissue that sticks to the walls of blood vessels. Ischemic strokes eternally damage the brain and cause a person's body to no longer function habitually.Some risk factors that may increase stroke are high cholesterol, diabetes, high blood pressure, and obesity. Some stroke factors are also due to old age or having a family that has a history of strokes. Men are more likely to have a stroke but the most st...
Scientists are on the brink of doing the unthinkable-replenishing the brains of people who have suffered strokes or head injuries to make them whole again. If that is not astonishing enough, they think they may be able to reverse paralysis. The door is at last open to lifting the terrifying sentence these disorders still decree-loss of physical function, cognitive skills, memory, and personality.
It is frequently expressed by stroke patients and caregivers that they have not been afforded the suitable information related to stroke, treatments, or post discharge management and recovery, and that the information conveyed is perceived as insufficient and complex. The problem is that there is a failure of healthcare professionals in identifying the learning needs of stroke patients associated with a deficiency in knowledge of just how to access and communicate this crucial information. Indeed, while patient education can be time consuming and nurses may not be properly trained in stroke education it is a nursing duty to provide these teachings to patients and caregivers prior to discharge. This paper will propose an educational plan intended to train, assist, and support nursing staff responsible for stroke patient education, in providing accurate, individualized, guideline based stroke education to patients and families prior to discharge. This plan
A stroke can happen at any age but for patients who are 55 and older, their risk factor will increase due to age and physical activity. “While stroke is common among the elderly, a lot of people under 65 also have strokes”(“About Stroke” page 1). Also at risk are African Americans because of other health issues that can trigger a stroke, for example: high blood pressure, diabetes and obesity. Caucasians and Hispanics are also at. Not only does Ethnicity and age play a factor, but so does other health conditions. Patients who suffer from high blood pressure, diabetes, heart disease, obesity, alcohol and drug
Strokes seen in the hospital out of 70 percent of those strokes are ischemic strokes, the remaining 30 percent is a mixture of experiencing a hemorrhagic stroke or transient ischemic attack.
... J. (2009). Heart disease and stroke statistics--2010 updated: a report from the American Heart Association. Journal of the American Heart Association. doi:10.1161/CIRCULATIONAHA.109.192667
An older person who has had a stroke may simply want rehabilitation to be able to dress or bathe without help. Sometimes physical therapy is required for management of chronic conditions that otherwise would be very expensive to treat using prescription medication.Advantage of physio therapies it has long-term health benefits.One of the smartest reasons to use physical therapy is that it provides a
This module has enabled the author to understand the concept of vulnerability, risk and resilience in relation to stroke. Therefore, it will contribute to her professional development and lifelong learning (NES, 2012). Additionally, the author has gained evidence based knowledge of person-centred care, compassion and self-awareness; all of which can be used to inform future practice (Miller, 2008). Consequently, she will be able to provide the appropriate level of care that can make a difference to a person’s recovery.
Stroke survivors or anyone with chronic illness and health providers remain hopeful and “realistic” by counting on each other. The patients while being realistic about the outcome of their disease, stay hopeful that each of their health care providers will give them the appropriate care and will make sure that they can live with their disease in the best way possible.
“Time is brain” is the repeated catch phrase when addressing the treatment and management of stroke (Saver, 2006). Access to prompt and appropriate medical care during the first few hours of stroke onset is critical to patient survival and outcomes. Recent changes in the guidelines for acute stroke care released by the American Heart Association (AHA) and the American Stroke Association (ASA) have improved patient access to treatment. Stroke treatment now follows the model of myocardial infarction treatment. Hospitals are categorized into four levels based on stroke treatment capability. The most specialized treatment is available in comprehensive stroke centers followed by primary stroke centers, acute stroke-ready hospitals, and community hospitals. The use of telemedicine now enables even community hospitals, with limited specialized capabilities, to care for stroke patients. Telemedicine puts emergency hospital personnel in contact with neurologists providing expertise in the evaluation of a stroke patient and determination of their eligibility for treatment with thrombolytic medication (Jefferey, 2013).
Traditional physiotherapy has been focusing on the restoration of sensorimotor function (e.g., Muscle strength, movement coordination, spasticity, balance) and performance in certain daily activities such as ambulation. However, relatively less attention is paid to community integration after stroke, which involves several important elements, including participation in activities at home or a homelike setting, engagement in productive activities, and establishment and enjoyment of a social network9. Apart from Concentrating on body and individual dimensions and promoting physical recovery and assisting in activities of daily living, a major challenge in stroke rehabilitation is to minimize psychosocial morbidity and to promote the reintegration of stroke survivors into their community. Despite favorable exercise methods having been achieved for people with stroke, questions remain as to why such exercise benefits are not necessarily linked to good levels of community participation. It may be that rehabilitation efforts need to be refined to achieve a satisfactory level of community.
Cerebrovascular Accident a) Overview - definition and the effects of the stroke on the body A stroke is a serious, life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. (http://www.nhs.uk/conditions/Stroke/Pages/Introduction.aspx) This condition is a common cause of death and disability, especially in older people. Some predisposing factors include: • hypertension • atheroma • cigarette smoking • diabetes mellitus It occurs when blood flow to the brain suddenly interrupted, causing hypoxia. The effects include paralysis of a limb or one side of the body and disturbances of speech and vision.
The animals that stroke primarily affects are humans. This is likely caused by risk factors that humans attain, such as cigarette smoking, high blood pressure, diabetes, high blood cholesterol, a poor diet, stroke occurring in ancestors, and physical activity/obesity. Stroke has is also starting to become recognized in cats, dogs, and rabbits. According to the World Health Organization, 15 million people suffer from a stroke worldwide every year. Of the people diagnosed, 5 million die and 5 million are permanently disabled. In the United States, 795,000 suffer from stroke annually. 85 percent of the diagnosed strokes are ischemic and 15 percent of them are hemorrhagic As for the humans diagnosed, three fourths of the people that suffer from a stroke are elderly (over the age of 65). This is caused by raising cholesterol levels and the narrowing of arteries as someone ages. Ethnicity, as well as age can also affect a person’s risk to fall victim to a stroke. Africans have a much higher risk of death from a stroke than Caucasians do. This is partly because blacks have greater risks of high blood pressure, diabetes, and obesity. Research suggests Africans may carry a gene that makes them more salt sensitive, inevitably increasing the risk of high blood pressure. Fortunately, research is still being done to prevent stroke. Rats and mice are primary animal subjects for studying this deadly
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...