Movement Quality | The After Effects of a Stroke

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Each year, nearly 800,000 Americans suffer from a stroke, resulting in approximately 160,000 stroke-related deaths.

Although the majority of stroke victims survive, they often face one or more post-stroke symptoms — including a reduction in motor function. This can significantly impact one's ability to complete everyday tasks and in turn, reduce their overall quality of life.

If you or a loved one are currently experiencing challenges following a stroke, specifically issues related to walking and/or maintaining balance, there are steps you can take to improve your circumstances.

Risk Factors and Causes of Stroke

A stroke occurs when blood circulation to the brain is cut off, resulting in a lack of oxygen and ultimately, brain cell death. This is why a stroke is also often referred to as a brain attack.

Once the brain is without blood or oxygen, brain cells begin to die within minutes, resulting in an impaired ability related to thinking, emotional control, movement, and speech.

The most frequent type of stroke is caused by a blockage of blood flow, known as an ischemic stroke. This results from one of three blockages — a clot within a blood vessel located in the neck or brain; a clot that moved from another area of the body; or the narrowing of an artery that leads to the brain.

The second type of stroke is caused by bleeding in the brain or the area surrounding the brain, known as a hemorrhagic stroke.

Although certain risk factors are out of your control, including age, family history, and gender, you can control risk factors such as smoking, hypertension, diabetes, obesity, and high cholesterol.

How a Stroke Impacts Motor Function

Stroke is one of the most common causes of physical disability around the world, and approximately 80 percent of survivors experience movement issues on one side of the body.

Most often, paralysis occurs on the side of the body that is opposite to the side where damage within the brain occurred. For example, if a stroke damaged the left hemisphere, the right side of the body will likely experience symptoms of post-stroke paralysis.

While varying areas of the brain may be damaged, resulting in a spectrum of symptoms, issues with posture, balance, and walking occur when the cerebellum is affected.

In this case, some of the most common symptoms include but are not limited to:

•         Balance issues— Issues with balance often occur after a stroke, causing dizziness and an increased risk of falls.

•         Foot drop— This common walking challenge occurs when a post-stroke victim cannot raise the front of their foot due to weakness or paralysis.

•         Incoordination— Numerous variables are at-play in regards to incoordination, including perceptual issues and vision problems, as well as the development of vertigo and ataxia (which involves abnormal, uncoordinated movements).

•         Numbness— Numbness or a tingling sensation can occur, based on impaired sensory input.

Based on these symptoms, in addition to potential vision loss and vestibular system impairment (which controls variables such as balance and spatial orientation), it can be challenging to stabilize oneself and in turn, maintain motor function.


What you can do following a Stroke to Improve your Quality of Life

As discussed above, there are many variables that impact walking issues following a stroke. That is why regaining one's mobility after experiencing a stroke is one of the most critical and significant challenges.

In order to regain mobility, specific obstacles must be addressed, which will likely relate to balance and sensation issues. Since a stroke often alters how the central nervous system works, sensory nerves are often hindered in regards to sending messages from the body to the brain, and vice versa.

This is why researchers often focus their attention on noninvasive forms of brain stimulation, with the goal to improve post-stroke gait and enhance neuroplasticity — which is the brain's ability to form new connections. The brain's capacity to do so has been verified in both animal models and humans.

Although stroke complications significantly vary in regards to severity, as well as each individual's ability to recover, learning how to walk again ispossible through targeted stroke rehabilitation.

Physical Exercises and Therapy

Motor-skill exercises and range-of-motion therapy are both ideal, helping patients improve everything from coordination to muscle strength, all which easing muscle tension.

Many post-stroke patients work with trainers and physiotherapists, focusing on individualized exercise plans. Although many of these exercises focus on the legs and feet, researchers have also found that arm exercises may also improve walking ability months, and in some cases, years after having a stroke.

As stated in this study, "Although the associated walking improvements may not be as robust as other treatment options, arm cycling training can activate interlimb networks — which contributes to rhythmic walking and coordination."

To find out more about the importance of exercise following a stroke, as well as how to incorporate more physical activity into your life, check out this resource from the Heart and Stroke Foundation.

Technology-assisted Devices and Therapies

There are a number of innovative devices available, offering the latest in research and technology. Of these devices, Naboso™ Insoles are combining plantar proprioceptive stimulation and barefoot science.

By stimulating the nerves in the bottom of the feet, these textured insoles have been shown to improve balance and posture while having a positive impact on gait patterns and overall motor control.

Another area of interest relates to ankle foot orthosis — or AFO. This approach has been shown to be significantly helpful when aiming to address complications associated with foot drop.

In this case, foot drop may be caused by damage to the nerves, weakness, or both. However, regardless of the cause, foot drop treatment tends to involve AFO in order to provide stability and actively improve gait. An example is the durable and dynamic Noodle AFO.

Electrical Nerve Stimulation

Various studies have focused on the benefits of transcutaneous electrical nerve stimulation (TENS), including this 2018 review, published in the Journal of Rehabilitation Medicine.

Based on seven randomized controlled trials, it was found that TENS is associated with a significant reduction in spasticity, as well as increased walking speed and static balance among stroke patients.

Address Symptoms that Hinder Walking Ability

Although each individual case is unique, and brain damage cannot be reversed, proactive rehabilitation efforts can help you achieve the best long-term outcome, especially in relation to walking.

The likelihood of improvement post-stroke will vary depending on the initial deficit. However, between 65 and 85 percent of stroke survivors relearn to walk within six months of their stroke.

While exercise is the common therapeutic intervention, if a patient exhibits poor posture or balance, this can make treatment strategies much more complicated.

This is why a combination of therapy options are recommended, especially those that are not independent of one another. For example, Naboso™ Insoles target some of the most problematic post-stroke symptoms so that patients are able to improve walking ability.

By helping patients restore function and improve variables such as balance, through the stimulation of the nervous system, this type of innovative technology is changing lives.

Learn more about neuro rehabilitation here, so that you or your loved one can reconnect to the most important foundation in relation to walking — the foot. This technology can also support those living with multiple sclerosis and Parkinson's.