15^th December 2023

Hello and welcome back to our blog, Therapy WA Talks! Here we will give an insight into what it is we at Therapy WA do, shining a spotlight on all thing’s physiotherapy, the weekly happenings of our therapists and giving our amazing clients a voice.

Therapy WA is a WA owned and ran mobile physiotherapy service servicing the Perth Metro area. Our focus is on making physiotherapy accessible to all, with a patient-centred, functional, and fun approach.

This week, we have decided to talk about a condition that we see very often in our caseload and hope to inform our readers on the details surrounding stroke – what recovery can look like and what physiotherapy can do to help it. I think we all know or know of someone who has had a stroke, and we will start by saying that stroke often looks different on everyone, with hugely variable symptoms and recovery following. For some people unfortunately stroke can be fatal, where for others an excellent recovery is possible. We realise although we hear about stroke all the time, many people may not know the physiological causes behind it, symptoms and issues following and the rehabilitation options available post-stroke. We hope you enjoy reading.

Stroke is a serious medical condition that occurs when there is a disruption in the blood supply to the brain, leading to damage of brain cells. It is a medical emergency that requires immediate attention. In this blog post, we will explore the causes, symptoms, risk factors, and preventive measures associated with stroke.

What is a Stroke?

A stroke, also known as a cerebrovascular accident (CVA), can be classified into two main types: ischemic and haemorrhagic.

1. Ischemic Stroke: This type occurs when a blood clot blocks an artery, reducing blood flow to the brain.
2. Haemorrhagic Stroke: This type happens when a blood vessel in the brain ruptures, causing bleeding within the brain.

Causes of Stroke:

1. Ischemic Stroke Causes:

1. Thrombotic Stroke: Caused by a blood clot that forms within the arteries supplying blood to the brain.
2. Embolic Stroke: Results from a blood clot that forms elsewhere in the body and travels to the brain.

1. Haemorrhagic Stroke Causes:

1. Intracerebral Haemorrhage: Bleeding within the brain tissue due to a ruptured blood vessel.
2. Subarachnoid Haemorrhage: Bleeding in the space surrounding the brain, often caused by a ruptured aneurysm.

Symptoms of Stroke:

Recognising the symptoms of a stroke is crucial for seeking immediate medical attention. Remember the acronym FAST:

1. Face Drooping: Is one side of the face drooping or numb?
2. Arm Weakness: Is one arm weak or numb?
3. Speech Difficulty: Is speech slurred or hard to understand?

If you observe any of these signs, it’s time to call emergency services.

Risk Factors for Stroke:

Several factors increase the risk of stroke, including:

1. High Blood Pressure: The leading cause of strokes.
2. Smoking: Increases the risk of blood clots.
3. Diabetes: Raises the risk of cardiovascular diseases.
4. High Cholesterol: Contributes to the formation of plaques in arteries.
5. Obesity: Increases the likelihood of developing other risk factors.

Prevention of Stroke:

Adopting a healthy lifestyle can significantly reduce the risk of stroke:

1. Maintain a Healthy Diet: Focus on fruits, vegetables, whole grains, and lean proteins. Limit salt and saturated fats.
2. Regular Exercise: Engage in physical activity for at least 150 minutes per week.
3. Control Blood Pressure: Regular monitoring and management are crucial.
4. Quit Smoking: Smoking is a major risk factor for stroke; quitting reduces the risk.
5. Manage Diabetes: Keep blood sugar levels in a healthy range.
6. Limit Alcohol Consumption: Moderation is key.

Stroke is a serious medical condition, but awareness, timely intervention, and lifestyle modifications can significantly reduce the risk. Recognising the symptoms, understanding the causes, and addressing risk factors are essential steps towards stroke prevention. If you suspect a stroke, remember to act FAST and seek immediate medical help.

Ok, so now that we know a little more about the causes of stroke, this is where we as physiotherapists may come in.

Physiotherapy for Stroke:

A stroke can have a profound impact on an individual’s life, affecting their mobility, coordination, and overall quality of life. Physiotherapy plays a crucial role in the rehabilitation process, helping stroke survivors regain strength, improve mobility, and enhance their overall well-being. Now that we have talked about the pathophysiology of stroke, we will now delve into the significance of physiotherapy in stroke recovery and explore the various techniques and exercises employed by physiotherapists and what is available to our clients at Therapy WA.

Understanding Stroke Rehabilitation:

Rehabilitation after a stroke is a comprehensive process aimed at restoring function and promoting independence. Physiotherapy, a key component of stroke rehabilitation, focuses on addressing physical impairments and optimising the individual’s ability to perform everyday activities.

Goals of Physiotherapy in Stroke Rehabilitation:

1. Mobility Improvement: Physiotherapists work to enhance mobility by addressing issues such as muscle weakness, stiffness, and loss of coordination.
2. Strength Building: Stroke survivors often experience muscle weakness on one side of the body, known as hemiplegia. Physiotherapy includes targeted exercises to strengthen weakened muscles.
3. Balance and Coordination: Stroke can affect balance and coordination. Physiotherapists employ exercises to improve these skills, reducing the risk of falls.
4. Range of Motion: Joint stiffness is common after a stroke. Physiotherapy helps restore and maintain a full range of motion in affected joints. Joint pain is also common, namely in the affected shoulder. This can be treated with physiotherapy treatments such as manual therapy and soft tissue massage, reducing pain.
5. Gait Training: Walking difficulties are a common challenge post-stroke. Physiotherapists work on gait training to improve walking patterns and overall stability.

Techniques and Exercises:

1. Passive Range of Motion (PROM): Physiotherapists may start with passive exercises, moving the affected limbs gently to maintain flexibility and prevent contractures.
2. Active Range of Motion (AROM): As the client progresses, they engage in active exercises, moving their limbs independently to improve strength and coordination.
3. Manual Therapy and Soft Tissue Massage: Clients may often experience pain following stroke. This can be treated by your physiotherapist using techniques to improve mobility and muscle tightness, reducing pain.
4. Strength Training: Targeted resistance exercises help build strength in weakened muscles, focusing on both the affected and unaffected sides.
5. Balance and Coordination Exercises: Activities such as sitting unsupported, standing with feet together, on one leg, weight shifting, and proprioceptive exercises help improve balance and coordination. This will be targeted towards the individual client and their specific needs and abilities following their stroke and will look quite different for everyone.
6. Functional Tasks: Physiotherapy includes practicing real-world activities, such as getting in and out of bed or climbing stairs, to improve practical independence.

As mentioned above, here at Therapy WA stroke patients form a large part of our caseload. This is sometimes immediately after they have been discharged from hospital or rehab centre, or sometimes several years following their stroke. Following initial referral, we will come to the client’s home, complete a thorough initial assessment and get working right away on functional goals and treatments to allow the client to achieve these goals. This may be initially centred around pain management, and moving towards mobility, independence in the home, getting back to hobbies and recreational activities and overall improvement of quality of life and getting back to the things you or your family member enjoyed prior to stroke.

We will also devise a personalised home exercise programs to complement our sessions. These programs empower stroke survivors to continue their rehabilitation independently, promoting long-term recovery.

Physiotherapy is a cornerstone of stroke rehabilitation offering hope and tangible progress to survivors, and we at Therapy WA are here to help with an empathetic, fun, and holistic approach. Through physiotherapy treatment, targeted exercises, personalised treatment plans, and a focus on functional improvement, physiotherapists contribute significantly to the journey of recovery after a stroke.

We hope you have enjoyed this glimpse into stroke and physiotherapy, and what Therapy WA can do to help. As always, every person will present differently, and every client will be assessed and treated individually according to their needs, with a personalised and goal-centred approach. Stroke recovery looks very different for everyone, and most importantly we will guide and support you through this most challenging time with encouragement, motivation, and a listening ear. We know it is tough, but we are here to help.

Please reach out if you have any questions lisa@therapywa.com.au

Take care and talk soon 🙂