When you observe stroke survivors, very often you’ll find them tight fisted with bent elbows and arms bent against the chest. These symptoms are due to brain injury from the stroke, causing muscles to contract involuntarily (shorten or flex) giving rise to stiffness and tightness. Medically, this is known as Spasticity.
When a muscle cannot complete its full range of motion, tendon and soft tissues surrounding that muscle can become tight. This makes stretching the muscle difficult. If left untreated this can become a permanent freeze into an abnormal, often painful position.
Precisely because of this reason, it is extremely important for a stroke survivor to commence physiotherapy as soon as possible after being discharged from the hospital. Physiotherapy will help to prevent Spasticity from setting in. In other words, stroke-rehab must commence as soon as the doctors deem the patient fit for discharge. Once the stroke survivor’s condition improves, Occupational Therapy will be conducted to teach the stroke survivor the basic daily living skills such as dressing, washing, bathing, feeding etc.
Here are several recommended treatments for Spasticity:-
1. Stretching Exercises.
This helps to maintain a full range of motion to prevent muscle shortening. In the early stages after a stroke, such exercises are of the passive type. This means somebody has to help the stroke patient to do the moving and stretching. It is advisable to encourage the stroke survivor to try to move even though he cannot. After some weeks, movement will begin, usually with the stronger and bigger muscles moving first. Slowly, the smaller muscles in the extremities like knuckles and fingers will start to move.
2. Wearing of Braces.
Braces help to hold muscles in proper position, thus preventing contraction. This is often recommended by the Physiotherapist. There are different types of braces for different body parts.
3. Oral Medication.
This will help in relaxing the nerves and preventing the muscles from contracting. It is best to leave such prescriptions to the Neurologist.
Medication is injected into specific muscle groups, to weaken the overactive muscles. During this period, intensive Physiotherapy is done to strengthen the muscles so that it can fight against the contractions or pull naturally. Such injections only lasts a couple of months.
5. Intrathecal Baclofen Therapy (IBT)
This is a specialized treatment and should be performed by a doctor. A small pump is surgically implanted to supply Baclofen to the Spinal Cord. This method is better than Oral Medication because it has lesser side effects.
As for which of the above Treatments are best, it’s best to consult your doctor. For IBT, a screening test will be done to determine suitability. For my wife who’s a stroke survivor, she could not take oral medication due to her blood condition. She is following a regime of physical stretching and exercises, all guided and assisted by a physiotherapist. Lately, we are considering the injection of ‘Botox’ to a particular muscle group to relax it. Apparently, the effects will last for about six months. During this time, when the spasticity in the hands or legs are loosen, doing the stretching exercises will help to strengthen the muscles which in turn can help fight against the contraction.
In conclusion, I would like to add that the brain is injured or damaged in a stroke. In some cases, the brain’s injury or damage will impair the motor-function part. In other incidents, the sensory function is damaged or both can occur. The damaged part of the brain cannot be treated, it is dead and gone. Physiotherapy can help to stimulate the undamaged part of the brain to re-connect the nerves to the damaged part and take over those function that was lost. Recent studies indicated that it is possible for stroke survivors ,who lost their motor-function for as long as seven to eight years, to regain their mobility through stimulation either through physiotherapy or electro-magnetic impulses treatment.
Don’t ever give up hope and press on with all the exercises, eat a healthy diet too!
[tags]stroke, spasticity, Intrathecal Baclofen Therapy, physiotherapy for stroke survivor[/tags]