A stroke is a circulatory disorder in parts of the brain. As a result, different regions of the brain are no longer sufficiently supplied with oxygen and nutrients. The consequences manifest themselves in severe impairments, which depend on the extent and location of the brain damage. After heart disease and cancer, stroke is the third most frequent cause of death and the most frequent cause of long-term disability in Germany. Other terms are apoplex or cerebrovascular insult.
Gait training
After a stroke, the ability to walk is severely impaired or impossible in two out of three patients, so they have to learn to walk from scratch. In particular, patients with hemiplegia or extensor spasticity with a tendency to splayfoot have difficulty walking. Before gait training in the sense of correct walking can begin, basic requirements such as good postural control and balance, sufficient motor control and muscle strength in the lower extremity must be trained.
Appropriate exercises should be started as early as possible, preferably within the first 3-30 days after the stroke. Then, at least 15-30 minutes of gait training should be done every day. In many rehabilitation facilities, gait training is robotically supported.
It allows the patient to exercise with belt support and weight relief. The advantage of this is that the patient can start walking at an early stage and can practice the gait phases correctly with the correct weight transfer. Alternatively, the gait training can also be done between a bar, on a running trainer or with two persons for securing. In addition to the practical gait training, the so-called “Mental Practice” should be carried out: The patient imagines the individual movements of walking purely cognitively. Studies have proven that this imagination alone in the brain activates the corresponding brain areas and has positive effects on actual walking.
Symptoms
The symptoms of a stroke depend on the location and extent of the vessel occlusion. For example, if a stroke occurs in the frontal lobe of the brain, personality changes can occur in addition to concentration disorders and disturbances in motor control. If, on the other hand, the cerebellum is affected by the stroke, the affected person has difficulties in balance and coordination.
If the brain stem is affected by the stroke, the stroke is particularly life-threatening. This is because the brain stem regulates the heart rate and breathing rate. These examples are intended to illustrate that every stroke has different symptoms.
However, the most common symptoms are as follows: Paresis (paralysis), sensitivity disorders, balance disorders, aphasia (disturbance of speech comprehension and word formation), apraxia (difficulty in performing specific movements and actions), memory disorders, ataxia (gait disorders) and visual disorders. A rough distinction is made as to whether the stroke occurred in the left hemisphere (=dominant hemisphere) or in the right hemisphere (non-dominant hemisphere). This distinction is important because the symptoms always occur on the contralateral (= opposite) side to the stroke.
If a stroke occurs in the left hemisphere, the patient is paralyzed on the right side. Patients with a stroke in the left hemisphere of the brain often suffer from hemiplegia, aphasia (speech disorder), hemianopsia (visual impairment with hemiplegic visual field loss) and slowed information processing. In addition, a reduced tolerance for frustration and compulsive tendencies often occur. If, on the other hand, the stroke is localized in the right hemisphere of the brain, in addition to hemiplegia, a neglect (neglect of one half of the room or body), memory disorders, concentration problems and emotional instability often occur.
- Stroke symptoms
- Physiotherapy according to Bobath
- Physiotherapy coordination and balance training
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