Stroke is a medical condition in which the flow of blood towards the brain is poor and causes the death of certain cells. There are two common types of stroke: 

1. Ischemic- due to lack of blood flow
2. Hemorrhagic- due to bleeding

Signs and symptoms of stroke 

Problems with movement
Inability to feel  on one side of the body
Problems understanding or in speech
Vertigo
Loss of vision
Difficulty in carrying out everyday activities
Role of Physiotherapy for Patients with Stroke

The main focus of physiotherapy is to help you use your arms and legs to regain as much strength and movement as possible. 
If you have one-sided paralysis, correct positioning is important to prevent spasm or injury.
It helps you to sit up as this will help you avoid blood clots in your legs, improve your breathing and help you recover quickly.
If you are unable to move, you may be given chest physiotherapy to keep your lungs free of infection.
What does a Physiotherapist do?

A physiotherapist advises you on how you should be positioned when lying or sitting, and how often you need to be moved.
Motivates you to be actively involved in your physiotherapy sessions to help you relearn normal patterns of movement
Decides when you should begin to start walking and what equipment is needed to move or support you
Provides therapy to strengthen your limbs and teach you how to move again as independently as possible
Takes care of the fact that no complications should arise and you have a smooth recovery.
Treatment Techniques:

Strength Training: It is evident that strength training can improve upper-limb strength and function without increasing tone or pain in individuals with stroke.
Gaming: Goal orientated computer gaming has proven to significantly reduce upper limb impairment in stroke survivors.
Virtual Reality: Virtual reality training has been shown to be effective in restoring upper limb motor impairments and motor-related functional abilities.
Mirror Therapy: Mirror therapy has been shown to have a beneficial effect on motor control and function compared to conventional therapy.
Robot-Assisted Therapy: It has been shown to have a beneficial effect on motor recovery and function.
In the upper extremity with severe impairment and/or poor prognosis for recovery, Chedoke McMaster Stroke Assessment (CMSA) of Arm and Hand < Stage 4) treatment should focus on maintaining a comfortable, pain-free, mobile arm and hand. Engage in repetitive and intense use of novel tasks that challenge the stroke survivor to acquire necessary motor skills to use the involved upper limb during functional tasks and activities. Engage in motor-learning training including the use of imagery.

Stroke - How Physiotherapy Can Help With It?

Blood pressure is one of the vital life signs in medicine, which, along with other vitals is widely used to assess the overall health of the patient. High blood pressure is very dangerous as normally it has no symptoms or signs and can fluctuate almost instantly. But, it could be managed. High blood pressure is said to be of higher than 120 (systolic) and 80 (diastolic).

A nap in a day might help in lowering blood pressure. According to certain research findings, people who sleep in the daytime had regular blood pressure as compared to people who do not sleep or do not have a short nap. Napping can effectively help lowering blood pressure. It helps the blood to control stress hormones and also helps the nervous system to keep a person healthy.

Daytime napping surely helps in boosting energy levels and efficiency throughout the day. Blood pressure increases after a nap caused by the body s normal circadian rhythm (for influencing and regulating sleep-wake pattern for a healthy cycle in a day). At the time of the morning, the body releases hormones such as noradrenaline and adrenaline. If the blood pressure increases too high, it could cause harmful effects. Blood pressure is usually lower at night while a person is sleeping. The blood pressure begins to increase a few hours before a person wakes up. The blood pressure continues to increase during the day, normally extreme in the mid of the afternoon. The blood pressure starts dropping again in the evening and late afternoon. Sleep helps the blood to regulate stress hormones.

Napping, since it helps in lowering blood pressure, definitely helps in reducing the risk of Sleeping for about seven to eight hours in the night might play a vital role in the prevention of high blood pressure. New research suggests that an afternoon nap is as productive as consuming a pill for lowering the blood pressure. Scientists have found that the people who take a midday nap are more likely to drop their blood pressure as compared to adults who don t take a midday nap and stay awake. Napping, since it helps in lowering blood pressure, definitely helps in reducing the risk of cardiovascular events like a stroke or a heart attack. It is as effective as other lifestyle changes, according to credible researches in medicine. It is interesting to note that napping, even when it reduces the blood pressure by 2 mm Hg only, reduces the risk of cardiovascular events by 10%.

Napping is a sort of shortcut and an effective method for lowering the blood pressure and could also be easily adopted and does not cost anything. Short midday sleep is important for our well-being. And, we can utilize this simple information very effectively for its potential health-related benefits simply by managing our daily schedule.

Napping & Low Blood Pressure - How Can Former Help Latter?

In addition to pumping blood to various organs, the heart also has its own blood supply, through which it receives its oxygen and nutrient supply. In patients with coronary artery disease and atherosclerosis, there is a narrowing of the blood vessels which reduces the amount of blood flow to the target organs, including the heart. 

When this happens in the heart, there is chest pain due to overexertion of the heart muscles. There could be two patterns to this chest pain. With regular exertion like exercise, there would be chest pain, and most patients are familiar with this pattern.

This is known as angina pectoris or stable angina. In some people or in some instances, chest pain occurs which is sudden and not of a predictable pattern. It could be related to extreme exertion or stress. This is known as unstable angina and can lead to heart attack and be life-threatening.

Stable angina or angina pectoris has a stable, predictable pattern which most patients get familiar with over a period of time and learn to manage. Read on to know more about the signs and symptoms and management techniques.

Signs and symptoms: Stable angina usually occurs after a round of physical exertion. The patient feels a feeling of tightness in the chest which feels like the chest being squeezed. The pain can gradually spread to the shoulder, arms and even the neck. The pain can also be induced by eating, exposure to cold, emotional stress. It lasts for about 15 minutes and is relieved by rest and sublingual nitroglycerin. The pain intensity does not change with position or coughing. In addition, the patient may also experience shortness of breath, fatigue, profuse sweating, nausea, and dizziness.
The patient may be able to detect signs on further testing including ECG, echocardiography and stress testing. Features like cardiomegaly, altered ejection fraction would be detected based on the severity of the disease.

Treatment: Immediate treatment to relieve the pain includes resting and sublingual nitroglycerin. On an ongoing basis, the treatment would include 3 approaches   lifestyle changes, medications, and surgery.

Lifestyle changes: Regular exercise, smoking cessation, reduced fat intake, reduced alcohol consumption, weight loss, and stress management are some lifestyle changes to be made to improve symptoms.
Medications: A number of medications would be used depending on patient s symptoms. Aspirin to prevent clotting, medications to control blood pressure and cholesterol and diabetes.
Surgery: In patients with advanced coronary artery disease, revascularization methods may be required, which includes angioplasty and coronary bypass.
In a person with known risk factors, it is advisable to have regular checkups so that the disease progression can be controlled and symptoms managed with minimal intervention.

Predictable Chest Pain Pattern - What Does It Indicate?

The new epidemic that has taken the world by storm is obesity. The proportion of obese people is increasing and the age of onset of obesity is decreasing gradually.

There is an optimal weight for a given height of a person. Obesity is when a person's weight is 20% more than the optimal weight. It brings with it a host of other health conditions, as it impairs the body s overall functioning.

Diabetes 2: In a normal person, food gets broken down into glucose to provide the required energy for the body using insulin. The body s inability to produce sufficient insulin to convert the excessive amount of sugar in the body leads to diabetes. Growing to be a leading cause of early death, diabetes brings with it a host of complications affecting almost all systems and parts of the body including stroke, kidney disease, blindness, and death. Diabetes and obesity have a direct correlation and can be prevented and managed by eating a balanced diet, losing weight, exercising, and having a healthy lifestyle.

Heart problems: An increased BMI also ups the risk for coronary heart disease (CHD), where the blood vessels are narrowed due to constant accumulation of fat in their inner walls. This gradually reduces the blood flow through these and may when complete cut-off happens, it could result in heart attack or stroke, affecting the heart or the brain. There could also be cases where the heart fails to pump sufficient blood to the rest of the body, affecting their effective functioning. Obese people also have a higher blood pressure than people who maintain a good BMI.

Breathing problems: One of the main causes of labored breathing is excessive weight. The condition called sleep apnea which is sudden bouts of absence of breathing during sleep is very high in obesity. It can cause snoring, daytime sleepiness, increase the risk of heart disease and stroke. In people with sleep apnea, weight loss is one of the first and most recommended therapies. Asthma and general breathing disorders are also higher in obese people.

Abnormal body cholesterol: Obese people also tend to have abnormally higher levels of body fat, especially the bad cholesterol, which again leads to coronary disease. It is a vicious cycle with one leading to the other and aggravating the other.

Osteoarthritis: Added weight leads to pressure on the hips, knees and lower back. There is added wear and tear and pain, which further limits movement.

Cancer: Some cancers, of the colon, endometrium, kidney, pancreas, gallbladder, breast and esophagus are more prevalent in obese people.

These are just some, there are more. The best way to avoid all these is to watch your weight.

Obesity - How It Increases Your Risk of Different Diseases?

Be it burgers, bagels, muffins, sandwiches or simple toasts, bread has made headway into the diets of a huge portion of the populace. Although a staple diet for many since time immemorial, the consumption of bread has increased extensively in the recent past. But, which type of bread should we intake to incur the best health impacts is a question that bothers many. The general assumption is that the wholegrain variety is the best alternative. However, the barrage of marketing tactics makes it impossible to distinguish the best variety from the others. 

There are a whole lot of myths surrounding the best variety of bread and you must choose wisely before settling for one particular type. It is expedient to look beyond the overt appearance or the name of the bread, one needs to be wary of the ingredient before taking a call.

Mostly, white bread is made out of refined flour which is often striped off essential nutrients and fibers. To worsen the situation, white bread is often bleached with certain chemicals to enhance its appearance.
Certain assumptions deem brown bread as the healthier option. Unfortunately, it isn't true always. More often than not, brown bread is simply white bread with artificial coloring added to it or is caramelized. They essentially add no surplus nutritional value.

Similarly, multigrain bread can often mislead the consumers about its health impacts. Unlike whole wheat bread, multigrain breads are usually chemically treated with softened grains. This does not effectively recover the lost nutrients of the bread.

Whole wheat bread has more pronounced health benefits. It contains more wheat germ and fibers in comparison to the more processed varieties of bread. Having evaded the toxic additives, it has relatively healthier effects on our blood sugar levels.

As you realize that the bread that you eat does not necessarily affect your health favorably, wisdom lies in seeking out the least harmful variety. In that context, rye bread or spelt bread contains greater amount of minerals. Besides, bread made from barley, oats and millets have greater mineral content than the commercially hybridized varieties and promote better health.

Brown Bread Vs White Bread Vs Whole Grain?

Somebody in the world suffers a stroke every two seconds. Stroke affects physical as well as mental health gravely. It can be a life- altering situation leading to new limitations overnight. Such limitations can be physical or mental, affecting mobility and cognition. According to psychologists, cognitive functions of the brain encompass speech, language, functional memory, spatial- motor systems, ability to switch between tasks, executive functions like task organization, attention, and being able to employ tools and symbols.

When the stroke strikes, it irreversibly damages a part of the brain. It happens due to hemorrhage or blocked supply of blood. However, the brain can be trained and taught compensatory strategies. These compensatory strategies consist of attention increasing activities that require neurological utilities. These activities and exercises are formed in a way to improve the memory. Both pictorial and hearing skills are engaged in these activities.

Memory, attention span, and executive activities are dependent on each other and any problem regarding these affects an individual s daily life. That is why to improve the complete mental capacity, exercises are required. These exercises help to improve memory and attention span. In cognitive rehabilitation, goals are set as per the requirements of the patient and treatment is then followed. This requires some plans and strategies to carry out daily activities. These plans may consist of planning and analysis of the task.

The recovery varies from individual to individual depending upon the restoration of the damaged neurological functions supporting specific cognitive area. However, there are very limited types of treatments for cognitive rehabilitation, mostly generic treatments which depends on doctor s experience.

Evidence is found by researchers which supports the cognitive rehabilitation after stroke, in which the areas discussed are smaller than the issues faced by the stroke survivors. The studies fail to talk about the long-term results and common treatments for daily tasks. It is now really important for us to have a serious innovation in the field of cognitive rehabilitation with the amount of stroke patients increasing day by day.

Before one going for rehabilitation, he/ she should ensure that why they need it and what are their needs that are to be fulfilled through rehabilitation. Experts recommend rehabilitation so that patients are able to lead as normal lifestyle as possible post stroke strikes them.

Who are more prone to stroke?

Old age people, alcoholics, people with high cholesterol levels, active smokers, Diabetic patients, people who consume drugs, people suffering from Hypertension, patients going through transient ischemic attack (TIA) are all very much prone to a stroke.

It is also very important to consult a doctor after stroke. He will advise you the best possible way to treat the problem. 

Take away

Stroke these days can happen to anyone which although largely depends upon the age factor, but one's lifestyle can also make him/her the target of stroke. There is cognitive rehabilitation which can help a person to recover post stroke through activities and exercises and change in lifestyle. It is important for an individual to consult a doctor if he/she finds any difficulty in carrying out daily activities with one side of the body.

Cognitive Rehabilitation Post Brain Stroke!

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