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Things we all need to know about stroke

Only a person who has survived a stroke survivor can really understand what it’s like living post stroke although that does not always mean that we can’t help and relate to the warrior within. During these difficult times with Covid-19 many people will suffer a stroke or be recovering from a stroke with reduced services all over the country. It can be a long road………. warrior like!!

However, the more we understand what stroke recovery involves, the more we can help our friends, family members or loved ones recover. However, to do this it’s important to be educated about stroke and how it affects a survivor every day.

As a physiotherapist we always want to make sure that we are using the most effective evidence-based tools to rehab someone post stroke. However, the physical injuries from stroke are only one part of the rehabilitation process and rather than focusing on the physical challenges post stroke I want to look at the hidden challenges for many.

I have NOT suddenly become stupid!!

A stroke is a “brain attack” that reduces the brain of oxygen rich blood. The resulting damage post stroke may affect different skills, like language and speaking. However, this does not mean the person has lost intelligence. Rather, it means they might need more time to find the right words………. Just be patient!

Again, Be Patient!!

Recovery from a stroke can often mean relearning the simplest tasks like it was the very first time. This can be very frustrating for stroke survivors so be patient!! Be patient with when chatting to someone as memory both short- and long-term memory may be affected but remember it’s not personal if someone can’t remember your name or where you live.

If a stroke survivor nods off it’s simply the brain healing and has nothing to do with laziness.

Stroke causes damage to the brain that must be healed. Just like any injury the brain requires time to heal. When a stroke survivor is overcome with regular tiredness early in their rehabilitation it’s not because they’re being lazy. It’s because their brain is healing and requires rest to recover. Tasks that once felt effortless may require a tremendous amount of effort now.

If I need help, I will ask.

Recovering from a stroke for many requires some help from those around you, however, always remember the stroke survivor needs to do as much as they can for themselves. The reasons for this are simple movements or tasks are important for recovery, so avoid helping too much. If a stroke survivor needs help, most often hey will ask.

Emotional Fragility During Recovery

Occasionally the emotional part of the brain may be affected by the stroke, some stoke survivors may laugh, and some may cry at various times throughout their recovery and for various reasons. This does not always mean they are sad or that they are laughing at something inappropriate it’s sometimes difficult for some stroke survivors to control their emotions. It’s a condition called emotional lability. Put yourself in the shoes of a stroke survivor. If everything suddenly changed, and you had no control over it, wouldn’t you feel emotion too?

Finally, the goal for any stroke survivor is to get back to “normal” this maybe the old normal or new normal.

Please remember when you meet someone that has survived a stroke the challenges they have faced already and will face during recovery are varied from the emotional, behavioural, and even personality changes never mind the physical deficits that may occur after stroke.

We can all help by allowing stroke survivors or stroke warriors to be themselves in the now instead of what was in the past.

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Exercising at Home with Spinal Cord Injury During Covid-19

Summary

  • If you have a spinal cord injury (SCI), you can and should be physically active.
  • Your health will benefit from regular exercise after SCI.
  • Your exercise program should include three parts: stretching, aerobic exercise, and strength training.
  • Setting goals, recognising potential barriers, being prepared, and learning about resources can help you have a successful exercise program.
  • With so many options, you can find an exercise program that is right for you.

Introduction

People with SCI are more likely than the general population to have health problems related to weight gain, changes in cholesterol, and high blood sugar. People with SCI are also at higher risk of cardiovascular disease. Not being active may contribute largely to these problems.

Normal, everyday activities aren’t enough to maintain cardiovascular fitness in people with SCI. Regular exercise can help to reduce the risk of health problems after SCI.

Importance of Regular Physical Activity

  • Improves energy levels and ability to take part in activities
  • Strengthens muscles
  • Increases flexibility
  • Improves mood
  • Improves sleep
  • Decreases pain
  • Helps achieve and maintain a healthy weight
  • Improves cholesterol
  • Improves blood sugar
  • Decreases the risk of heart disease

Because of these benefits, exercise is more than just fun—it’s a form of medicine that can be a powerful tool for preventing and treating many health conditions.

Exercise Guidelines

Exercise regularly based on your abilities. Avoiding inactivity during these challenging Covid-19 times is very important. Any amount of exercise is better than no exercise. If you require assistance in anyway contact us at No Barriers to discuss your specific needs. Exercise of any form will be beneficial at this time but a combination of aerobic and strength has a better balance.

Scheduling Exercise

It is best to exercise in routines of at least 30 minutes. But even as little as 10 minutes of physical activity at a time can provide health benefits. If possible, spread out your exercises throughout the week. The more time you spend exercising, the more health benefits you’ll get!

Options for Exercising

One of the great things about exercise is that so many options exist. Exercise can occur as part of your daily routine. Exercise can be done easily in your home.

Examples of stretching include:

  • Using your standing frame
  • Using exercise bands

Examples of aerobic exercise include:

  • Rowing with exercise bands
  • Pushing your wheelchair briskly

Examples of strength training include:

  • Weightlifting
  • Using resistance bands

Occasionally you may think you need special equipment to exercise, however adapt think outside the box ask us to help there are many ways to keep fit and healthy during these times.

Choose goals that you can easily achieve but that are challenging.

If you require any help with a programme in the home email me at stephen@nobarriers.ie 

 

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Exoskeleton & Stroke Rehabilitation

Stroke is the leading cause of serious long-term disability with many survivors sustaining functional limitations in activities of daily living as a result of stroke. Many stroke survivors have long-term walking impairment due to hemiplegia or hemiparesis. Impaired ambulation due to hemiplegia or hemiparesis is associated with increased fall risk, limited community participation, and an overall decreased quality of life.

Post-stroke, the long-term goal of rehabilitation is successful reintegration into the community, with recovery of walking ability as a key functional objective. This recovery of function is achieved with progressive, task-specific, repetitive training based on the principles of motor learning and neuroplasticity. Targeted rehabilitation can help to reorganise the brain to relearn skills that may have been lost during, or because of, stroke, with the goal of helping survivors regain their independence. Rehabilitation goals may include coordinating leg movements, shifting weight to walk, or balancing during sit-to-stand transfers.

Functional Improvements

Advances in technology are changing the rehabilitation process. Robotic exoskeletons used during stroke rehabilitation assist with walking during the recovery process by providing earlier mobility and restored independence. Exoskeletons may enhance post-stroke gait training, helping to guide weight shifts and improve step patterns and cadence and enabling individuals to stand and walk over ground early in the recovery process.

For gait rehabilitation after stroke, the technology applications typically include a wearable device such as a robotic exoskeleton, with hip and knee motors providing assistance during walking. A key part of the rehabilitation process is therapy progression, and exoskeleton technology provides options to encourage progress and document improvements. The device chosen should have options for asymmetrical control of the lower limbs and facilitate pre-gait training, transfers, stepping, and balance training.

Additional Benefits

While functional improvement is the primary goal of stroke rehabilitation, exoskeleton devices also have the potential to empower and motivate patients. Initial gait training sessions in the exoskeleton often include meaningful walking time indoors and outdoors, which can improve patient morale, motivation, and enthusiasm. Over the past year using the Ekso GT exoskeleton, we have also seen increased steps per session, improved gait symmetry and balance, and improvements in functional independence throughout many patients rehabilitation.

The ultimate goal of the No Barriers Foundation is always be to maximise recovery of function to support the patient’s ability to maintain independence at home and in the community.

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Healthy Workplace = Happy Workplace

It turns out that a lack of exercise in our lives is a silent killer. The World Health Organisation lists physical inactivity as the fourth biggest risk factor for death in adults across the world.

The latest research shows when it comes to heart disease, leading a sedentary life is as great a risk factor as smoking and obesity. In fact, inactivity in terms of disease risk, is more dangerous than being overweight.

If you spend long periods of time sitting, this is particularly bad news, as it increases your risk of heart disease, obesity, diabetes and cancer. The most current research has shown that even normal weight individuals that are inactive, are at risk of developing disease. There is a molecular pathway that is essential to burning fats, that shuts down with inactivity, and that subsequently increases your risk of developing heart disease.

And unfortunately you can’t bank the benefits of exercise from your youth, hoping it will help you 40 years down the line. The ideal scenario is to have been active throughout your lifespan, but research has shown that your health can benefit from physical activity at any age, meaning it doesn’t matter when you start, as long as you start!

Physical activity performed regularly, can help to prevent and manage over 20 chronic medical conditions. These include coronary heart disease, stroke, type 2 diabetes, cancer, obesity, mental health problems and musculoskeletal conditions.

And the good news is that we can combat the negative effects of prolonged sitting (total of 8 hours or more) with regular physical activity. The reality is that hectic schedules can make it seem impossible to fit workouts into your busy week. The prospect of packing a gym bag, trudging to your local gym, working out, showering, changing, and trudging back to where you came from, can feel like a lot of effort. But when we neglect exercise, we not only put both our physical and mental health at risk, but we also negatively impact our productivity and effectiveness at work.

And you would be surprised at the number of opportunities there are in a working day, to increase your activity levels.  You can in fact accumulate activity that is beneficial to health, in lots of different ways during the day.

 

17 Ways to Be More Active at Work

– Thinking on your Feet – Why it Pays to Be Physically Active at Work Client Newsletter

– Stretching Exercises for the Workplace

– Strengthening Exercises for the Workplace

– Why Posture Matters

– Optimal Desk Posture Infographic

– Carpal Tunnel Infographic

– Preventing and Treating Carpal Tunnel Syndrome

– Carpal Tunnel Rehabilitation Exercise Sheet

As physiotherapists we can help with a wide range of issues caused by long periods of sitting at a desk, including back and neck pains, tingling in your hands, carpal tunnel syndrome, even regular headaches experienced at work.

Please get in touch through our website at www.nobarriers.ie or email hello@nobarriers.ie if you need advice.

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Add Days to Your Life AND Life to Your Days

Life expectancy is at its all-time high, the fact that so many people are living longer, well into their 80s and 90s is a wonderful ideal. However, the sad reality is that living longer doesn’t always include a good quality of life, it’s not a package deal.

Many people outlive their children and their pensions, and end up feeling like they’ve become a financial, physical and emotional burden on their families. Swallowing handfuls of pills every day, losing independence and requiring nursing care is not the way most people would choose to spend their last years.

However, there are steps you can take to reduce the risk of this outcome. Making a conscious decision to take small steps (literally) from today, could make all the difference in your life going forward.

Physical activity (PA) or exercise, when performed regularly, has been proven to prevent and help manage more than 20 chronic conditions. These include coronary heart disease, stroke, type 2 diabetes, cancer, obesity, mental health problems and musculoskeletal conditions. Sadly, you can’t bank the benefits of exercise from your youth. Ideally being active throughout your lifespan would give optimal health benefits, however research has shown the health gains achieved through PA can be attained at any time. So, it doesn’t matter when you start as long as you start!

Now we’re certainly not saying you have to sign up for an IronMan Ultra-Triathlon or become the next Crossfit Superhuman. Physical activity includes all forms of exercise, such as everyday walking or cycling to get from A to B, active play, work-related activity and active recreation; such as working out in a gym, dancing, gardening or playing active games, as well as organised and competitive sport.

Physical inactivity is the fourth leading risk factor for death. The latest research shows that a sedentary life is as great a risk factor as smoking and obesity, for heart disease risk. Sedentary behaviour is not simply a lack of activity but a cluster of individual behaviours where sitting or lying is the dominant mode of posture, and energy expenditure is very low.

Inactivity was always associated as a cause of being overweight or obese, which in turn results in an increased risk of heart disease and diabetes. However, the most current research has shown that even normal weight individuals that are inactive, are at risk of developing disease.

While you can blame it on your job or school that forces you to sit for hours in a day, you can also mitigate the negative effects with just 60-75 minutes of moderate intensity PA a day.

Regardless of your activity starting point, there are benefits to be gained for anyone who increases their activity levels. Individuals that follow the recommended physical activity guidelines have shown to have optimal health benefits of a 39% reduced risk of dying from any disease. However, anything is better than nothing – even doing half the amount of the recommended weekly activity has shown a 20% lower risk of mortality.

Regular physical activity roughly halves your chance of developing some cancers, like bowel and breast cancer. Studies have shown that people who continued to exercise once diagnosed with cancer had significantly less cancer deaths and any-cause death than those who were inactive.

 

If you’d like to know more, you can contact us for our Gold Standard Physical Activity Recommendations leaflet, along with additional exercise advice for people suffering from the following conditions, all of which can benefit significantly with regular physical activity.

 

  1. Staying Healthy and Preventing Disease
  2. COPD
  3. Depression
  4. Musculoskeletal Pain
  5. Type 2 Diabetes
  6. Cancer
  7. Dementia
  8. Falls and Frailty
  9. Inflammatory Arthritis and Osteoarthritis
  10. Heart Disease

Contact us at https://nobarriers.ie/contact/

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