World Stroke Day- What you should know about Stroke?
We celebrate Mother’s Day, Father’s Day and Friendship Day for our personal relationships and also celebrate Environment Day, Water Day and Earth Day for the safety of our planet. Nowadays more people are becoming aware of Diabetes Day, Obesity Day, etc. but it is natural that people from the medical fraternity or their patients celebrate these more as compared to other people. It is also true that history lovers celebrate Revolution Day, Paleontology Day and days based on various historical moments in their countries and the list never ends here, but today I am going to tell you all something about World Stroke Day which was on 29th October. To learn more about this day, let me share with you some information on stroke, its causes and symptoms, its associated myths and its treatment from the perspective of a practicing physiotherapist.
What is Stroke?
Stroke, in clinical terms, also called hemiplegia is a paralysis of one side of the body. In simple terms, in stroke half side of your body (upper limb and lower limb) does not work. Movement is not possible on one side. Many times, there are sensory affections as well where the person cannot feel sensation (touch, pain or temperature) on the affected side. Stroke is also associated with many other symptoms such as speech problems, facial paralysis on lower side of the face, etc. Now let us talk about all these symptoms in great detail.

Image- A stroke patient attending to stand and walk
Myths about Stroke:
§ A stroke patient cannot perform his activities of daily living as he used to perform earlier.
§ Stroke is incurable and irrecoverable.
§ Patients suffering from stroke need to be bedridden their entire life.
§ God is angry on you or wants to punish you and hence you got stroke (in India at some remote places such myths are still brought by people in the name of spirituality).
§ Stroke paralyzes you for life and you can never lead a regular and normal life.
§ Using paralyzed or affected side can cause more harm.
§ There should be no movement of affected side.
§ Applying oil and massaging the affected upper and lower limb will cure stroke.
§ Stroke patients can never sit, walk or climb stairs.
The above are a few common myths about stroke. There are many more myths depending upon how aware you are about them, but these myths are more commonly observed by us in clinical practice.
Causes and Symptoms of Stroke
Stroke can be caused due to a blood clot in the artery which supplies blood to your brain. This clot stops the blood flow to certain areas of brain and hence the symptoms occur. This type of stroke is called ischemic stroke. Another important cause of stroke is in hypertensive (high blood pressure) patients, when the blood pressure shoots up in the artery of brain, the artery bursts and the blood spreads to different areas of brain. This type of stroke is called hemorrhagic stroke.
Our brain comprises different areas for different functions of the body. Due to the affection at certain areas of brain the following symptoms occur:-
1. Motor paralysis- Paralysis of upper and lower limb muscles of affected half side occurs and hence movement becomes difficult. Lifting up of arm and leg in initial acute stage is not possible at all. But in chronic stage as the spasticity arises (which we shall talk about further) atlas there is a gain of some amount of range.
2. Aphasia- This term means problems in speech. People having stroke tend to have slurred speech when the speech area in the brain is affected. This also occurs if the tongue muscles are paralyzed. Many a times the patient is able to speak very fluently but the perception and understanding of speech is lost.
3. Sensory involvement- Stroke patients can have sensory issues if sensory area in brain is involved. Fine touch, pain, temperature recognition sense can be gone in acute phase. Many a times, patient do have hypersensations like tingling or lot of itching and pain on the affected half side.
4. Cognitive and Perceptual problems- Stroke patients can have perceptual defects as in understanding and interpreting what someone is saying. Confusion can occur when multiple questions are asked or when it comes to multi-tasking. Usually in people having stroke, memory is not affected unless the memory changes are due to old age.
5. Facial paralysis- On the affected half, the lower side of the face which involves mouth and tongue get paralyzed. Drooling of saliva on that side, difficulty in chewing of food on that side can occur due to facial paralysis.
6. Spasticity/ Hypertonia- Increase in tone of muscles occur once stroke patients enter their chronic phase and pass over acute phase. Sometimes, development of tone can occur in acute period itself depending upon recovery of brain.
What you can do!
A patient having stroke despite of their age, is grossly affected mentally because they are going through a lot. Just imagine a person being able to do all of their daily activities and the next day nothing just because of an attack of stroke! So as a family member, friend or a relative you can do the following things for them-
1) Mental support
Sometimes we all need is someone to understand us. If we need support, these patients definitely deserve to have a supportive surrounding for them to gain themselves back. It is important to understand their pain, not physical pain but emotional pain too. It is necessary to understand what they are going through.
2) Encouraging them
A constant encouragement that they will recover always gives them hopes and faith in themselves and hence boosts their confidence too. It is really really important that any patient should never ever give up on themselves. How much ever people around lose confidence in them or start feeling pity about them, they should never feel sorry about themselves and rather prove the world that they can still lead a great life.
3) Letting them know importance of exercises (physiotherapy)
Exercising is very important to recruit all the paralyzed muscles. If a stroke patient doesn’t exercise and stays bedridden, they can suffer a lot of complications because our body is meant for movement. No movement and within days the muscles wasting starts taking place. Physiotherapy can help a lot here to improve their function, improve recruitment of muscles in a right way, gain the lost strength of muscles and get back to their normal life.
4) A proper rehabilitation
Rehabilitation is a broad term which simply means getting yourself back on your regular life. Stroke patients need an aggressive rehabilitation with respect to their amount of paralysis and affection. Rehabilitation with respect to speech and their occupation is very important. Here lots and lots of physiotherapy training, occupational therapy for getting back to all original functions and speech therapist to recover aphasia (speech problems) is very important.
5) Making them independent
The more a stroke patient uses their affected side, the better and faster are their chances of recovery of that side. As I mentioned all the above myths, it is important to change perception of stroke in our mind. A stroke patient can totally lead a normal and a very regular life without affection of their job or their daily activities. The schedule might change, ways of doing things can change. Like for eg- A person suffering from stroke might have to travel by a car or a car rather than travelling by bus or a local train. They also might need help when it comes to fine activities, changing clothes or bathing but for these activities modifications can definitely be done. And hence they can very well do what they want to.
So my dear friends, if you are suffering from stroke or if you know someone who has stroke, you don’t have to worry at all. I hope this article helps. I really wish that every stroke patient recovers very very soon and get back to their life perfectly!
-Dr Natasha Tungare (PT)
