A stroke (apoplexy) is an acute circulatory disorder of the brain, usually caused by a vascular occlusion, more rarely by a bleeding. Hemiplegia (affected arm and/or leg of one half of the body), speech disorders or visual impairment can occur. Depending on the location of the circulatory disorder, various symptoms are possible. After intensive medical treatment, if possible in a hospital with a so-called “stroke unit”, rehabilitation measures such as physiotherapy, occupational therapy and speech therapy are started very early.
- Stroke
- Stroke symptoms
Treatment
There are several concepts for physiotherapeutic treatment of a stroke with hemiplegia, including the Bobath concept, PNF (proprioceptive neuromuscular facilitation) and Vojta physiotherapy. The Bobath concept starts in the acute hospital and integrates the nursing staff, therapists and the patient’s relatives in a 24-hour concept. The main aim is to improve the patient’s symptoms by stimulating normal movements and influencing abnormal muscle tension (flaccid or spastic).
The aim of the PNF treatment method is to improve the coordination of nerve and muscle. Diagonal and three-dimensional movements, mostly with the healthy side, are used to transfer the activity to the affected side. This transfer is based on movement patterns that are stored in the brain and which one wants to activate. Vojta therapy also draws on innate movement patterns that can be triggered by stimulating certain points on the body. The aim is to trigger these movement reflexes in order to create new muscle and nerve functions.
Aims of physiotherapy
The goals of physiotherapy depend on the individual severity of the symptoms and how much time has already passed after the stroke. If hemiplegia is present, in most cases it is still flaccid in the first days after the stroke. In this phase, the focus is on stimulating the affected side in order to promote areas of the brain that are still intact.
It is also important to prevent thrombosis or pulmonary embolism when the patient is bedridden. In the further course of treatment, the patient’s independence in everyday life should be achieved as much as possible. To this end, the perception of the affected side is trained, everyday movements are practiced and any spasticity (excessive muscle tension) that may have occurred is treated.
