What is Paralysis?
Paralysis is the loss of muscle strength in certain parts of the body as a result of damage to the brain, spinal cord or peripheral nerves in the face, arms and legs. Due to reduced or complete loss of muscle strength, many motor functions, especially movement, are impaired. Depending on the area of the affected nerve, the person may experience loss of movement on the right or left side of the body or below the waist or only in the hand. They may not be able to see, speak, swallow or urinate.
Strokes can occur at any age and gender due to different causes. While it rarely resolves spontaneously within hours, in the vast majority of cases it requires diagnosis and treatment by neurology, neurosurgery and physical therapy and rehabilitation specialists. Early diagnosis and treatment increases the chances of complete recovery.
Why does a stroke develop?
Paralysis is caused by damage to the brain, spinal cord or peripheral nerves. This damage can be congenital (cerebral palsy, spina bifida, charcot marie tooth etc.) or acquired. Trauma, vascular problems (stroke), infections (transverse myelitis, facial paralysis, etc.), autoimmune diseases (multiple sclerosis, Guillian Barre Syndrome, etc.), tumors and degeneration are among the causes of paralysis. Some medications and toxins are also known to affect the function of nerves and can cause paralysis in rare cases.
Stroke is one of the most common causes of stroke. It develops due to blockage or rupture of brain vessels. It is characterized by loss of muscle strength on the right or left side of the body (hemiplegia).
Paralysis secondary to spinal cord injury most commonly develops due to trauma. Unfortunately, spinal cord injury and paralysis of the lower back muscles (paraplegia) due to traffic accidents are still among the most common causes of hospitalization in our country.
Brain damage in the first years of life, when brain development continues, causes the clinical picture called cerebral palsy.
How is a stroke treated?
Treatment of stroke requires a multidisciplinary approach and should be tailored to the individual needs of the patient. Therefore, it is important that physical therapy and rehabilitation specialists, physiotherapists, occupational therapists, speech-language pathologists and other healthcare professionals collaborate in the treatment of individuals with stroke. In addition, educating and supporting family members and caregivers who will take care of paralyzed individuals increases success. The goal is to live as independently as possible with the highest quality of life.
Treatment of stroke can vary depending on the patient's condition and the cause of the stroke. In general, however, the following methods can be used to treat paralysis:
- Therapeutic exercises: Therapeutic exercises can be used to strengthen the muscles in the paralyzed area, increase flexibility and improve mobility.
- Electrotherapy In order to prevent muscle atrophy (melting) until the nerve healing is completed, the muscle is electrified from the outside with electrodes to make it contract.
- Robotic rehabilitation: With the help of high-tech robots, virtual reality and games supported by artificial intelligence added to traditional rehabilitation methods, treatment time after stroke can be shortened and the chance of success can increase.
- Occupational therapy (occupational therapy): Occupational therapy is applied to increase sensory input after stroke, to improve hand and finger grip strength and manual skills, and to exercise activities of daily living such as eating, dressing and undressing.
- Speech and language therapy: Speech therapy is applied to help the patient express themselves correctly in speech and language disorders caused by paralysis; swallowing rehabilitation is applied to teach safe swallowing techniques in patients with swallowing problems.
- Exercises to improve cognitive functions: In order to improve cognitive functions such as memory, attention, problem solving, etc. resulting from paralysis, treatments that improve thinking and decision-making skills can be applied.
- Neuromodulation techniques (TMS, tDCS, spinal cord pacemaker, etc.) can be used to accelerate reconstruction after brain and spinal cord injury.
- Hydrotherapy One of the most effective methods in stroke treatment is in-water exercises. Water helps the treatment by reducing the weight of the body with its buoyancy. Accompanied by a hydrotherapist, effective and safe exercises can be performed against the resistance of water.
- Orthotics and walking aids: For people who cannot complete functions such as eating and walking with their existing muscle strength, orthoses made by taking personalized measurements for arms and legs can be used. Canes, walkers or wheelchairs can be used to help walking.
- Community-based therapies: A variety of therapies can be provided to help the person with stroke to perform activities of daily living more independently.
- Medications: People with stroke may be prescribed various medications to reduce spasticity, control pain or manage mental conditions such as depression.
- Surgical intervention Depending on the cause of the stroke, surgical interventions may be required to promote early or late recovery or to prevent or treat complications.
The duration of treatment after a stroke depends on the patient's age, health status, type and severity of the stroke. Starting treatment early and preventing complications increases the chances of cure. Physical therapy and rehabilitation may last 2-6 weeks. Depending on the severity of the stroke and the area affected, 1-4 hours of treatment per day may be required. The rehabilitation program after stroke is planned and implemented by a multidisciplinary team under the leadership of a physical medicine and rehabilitation specialist. Before the treatment, the physical and cognitive functions of the person are evaluated by specialists, goals and treatment plan are determined. Periodically, assessments are repeated and the program is updated. Goals and the course of treatment are regularly shared with the patient and family.
Frequently Asked Questions About Stroke Rehabilitation
- Which physical therapy and rehabilitation methods are applied in stroke patients?
The post-stroke physical therapy and rehabilitation program is individually planned and implemented by a multidisciplinary team under the leadership of a physical therapy and rehabilitation specialist. The content and duration of post-stroke treatment varies according to the patient's age, health status, type and severity of stroke.
- What should we do when we see a person paralyzed by a stroke?
Stroke is a serious condition that requires urgent intervention. In order to increase the chance of survival of the person who has had a stroke, it is necessary to intervene quickly and correctly. For this, 112 health teams should be called as soon as possible and help should be requested.
- How to strengthen the arm of a stroke patient?
Patients undergo specially designed exercise programs to strengthen the arm. These exercises are usually designed to increase muscle strength, restore mobility and are personalized. Adding robotic treatments to traditional methods increases the chances of success.
- Can a paralyzed patient walk?
If the paralysis is due to brain or spinal cord damage, the patient may be able to walk as before with the contribution of rehabilitation, in parallel with the recovery of the nerve. If the nerve does not heal completely, the patient can walk without support with personalized assistive devices and new arrangements.
- Can a person recover from a stroke?
Paralysis depends on the patient's state of health and the type and severity of the stroke, but can be completely reversible with the right treatment.
- When will the paralyzed arm recover?
The recovery process varies depending on the severity of the symptoms. Of course, the treatment methods also determine the process.
- Why does the paralyzed arm hurt?
After a stroke, electrical signals cannot be transmitted normally in the damaged nerve and the person may feel pain.
