Stroke is damage to the brain caused by blockage or rupture of the blood vessels that supply the brain with nutrients, resulting in oxygen deprivation of the relevant part of the brain. The damage varies according to the part of the brain affected. In some patients, minor facial expressions may be affected, while in others, consequences up to death may be seen.
What is Hemiplegia?
Hemiplegia is the neurological or physical damage left in the brain after a stroke. Although hemiplegia is often confused with stroke, it is actually a consequence of stroke. The most common damage of stroke is neurologic consequences leading to loss of muscle strength and hemiplegia is the most common nervous system finding in these clinical pictures.
Symptoms of Hemiplegia
The symptoms of hemiplegia vary according to the parts of the brain that are damaged. Among the most common symptoms are the following.
Spasticity
Spasticity, usually seen in the initial stage of the disease, is a state of excessive contraction. If the arms are affected, it causes flexion of the elbow. In the case of spasticity in the legs, extension contraction is seen, which is the desire to move in the opposite direction of the knee joint. This stage of the disease is called spastic hemiplegia.
If spasticity persists for a long time, it results in stiffness of the muscles. This is called rigidity.
Dyskinesia
Dyskinesia, which develops due to prolonged muscle contraction, is involuntary muscle movements.
Tremor
Again, involuntary tremors are seen in patients with tremor, which is seen due to prolonged contractions.
Ataxia
Ataxia, which is encountered at almost every stage of hemiplegia, causes impaired coordination in speech and walking in patients. This lack of coordination can be seen in all complex movements.
Paralysis
In some patients, hemiplegia leads to complete loss of muscle strength. This is called paralysis.
Apraxia
Another symptom seen in hemiplegia patients is apraxia. Apraxia is when patients have the ability to move but lack the motor power to plan this movement.
Mental and Psychological Disorders
Some patients may also have mental disorders. In addition, psychological and psychosocial dysfunctions can also be observed in patients.
Causes of Hemiplegia
Since hemiplegia is a consequence of stroke, the factors that cause stroke are also the causes of hemiplegia. Hemiplegia can develop due to many causes.
Age
Approximately 75% of stroke patients are over the age of 65. For this reason, the risk of stroke increases with age. In fact, the risk doubles every 10 years after the age of 55. For this reason, people over the age of 50 should have regular neurological examinations.
Heart Diseases
Heart diseases increase the risk of stroke because they cause problems such as narrowing and hardening of the brain vessels. Heart diseases cause strokes, especially due to bleeding. This disease, called atrial fibrillation, is treatable. However, if left untreated, it increases the risk of stroke by 5 times. The risk of stroke can be reduced by 70% by using oral blood thinners. However, people with this arrhythmia should have regular check-ups.
Diabetes
People with diabetes are more likely to have blocked arteries, hypertension, hyperlipidemia and obesity. The risk of stroke is therefore 2 times higher in women and 1.8 times higher in men.
Hypertension
Strokes caused by partial or complete interruption of blood circulation due to the development of a clot in the brain vessels are called systemic strokes. The risk of systemic stroke is 4 times higher in hypertensive patients. For this reason, approximately 60% of stroke cases are caused by hypertension. Regulation of hypertension reduces this possibility by 40%.
Cigarette Use
Smoking, which is extremely harmful for the cardiovascular system, increases the risk of stroke by 2 times. With smoking cessation, this risk decreases to the probability seen in the normal population between 2 and 4 years.
A diet rich in animal foods
A diet rich in animal foods not only disrupts the vascular structure but also causes obesity.
Inadequate Physical Activity
Physical activity, which decreases with age, is among the factors that increase the risk of stroke.
How is Hemiplegia Diagnosed?
The diagnosis of hemiplegia is usually made by clinical examination. After a history of stroke, symptoms such as spasticity, impaired sensory-motor functioning and perception, and convulsions in various parts of the body are sufficient for diagnosis. In addition, symptoms such as tremors, body aches, and difficulty in performing complicated movements also support the diagnosis.
Hemiplegia Treatment
Treatment for hemiplegia starts immediately after the stroke has occurred. After stabilization of stroke patients, each muscle mass is checked to see if hemiplegia has developed. Muscle masses with hemiplegia are identified and treatment is planned.
The first step of hemiplegia treatment is physical therapy. Thanks to the planned studies carried out with expert physiotherapists in the field, patients' muscle strength and coordination are maximized, muscle functions are preserved, and normal joint movements are preserved and maintained. Physical therapy plans are prepared specifically for patients.
Physical Therapy
All types of hemiplegia are primarily treated with physical therapy. Patients should be evaluated not only physically and neurologically, but also mentally and psychologically before physical therapy is started, because the aim of physical therapy is to restore the muscles to their best possible condition.
Acute Rehabilitation
In the acute rehabilitation process, which is the first stage of physical therapy, passive range of motion exercises are applied for the patients' joints. The aim of treatment during this period is to improve patients' ability to sit in bed. This includes the exercises practiced in it;
- Passive
- Active assisted,
- Active,
- Active resistance,
- Methods such as progressive resistant are applied.
Chronic Rehabilitation
The next stage of physical therapy, chronic rehabilitation, aims to help patients regain their daily skills. For this reason, acute rehabilitation methods are continued during the chronic rehabilitation phase, while other methods are also applied. Additional techniques applied during the chronic rehabilitation period are as follows.
- Do not turn,
- Getting out of bed with the help of a rope,
- Knee locking
- Weighting
- Transferring weight,
- Balance
- Walking,
At this stage, different techniques can be applied according to the needs of the patients.
Nutrition of Hemiplegia Patients
Because it is a disease affecting the central nervous system and the nervous system uses glucose as fuel, it is important to keep blood glucose levels at normal levels in patients with hemiplegia. In this way, patients' cognitive health is maintained.
In order to support the treatment of hemiplegia patients, it is also important to ensure that the diet is rich in B vitamins. Patients should include green leafy vegetables, legumes, fish, red meat, dried fruits, eggs and whole wheat flour in their diet.
In order not to reduce the effectiveness of the drugs used in treatment, patients should add foods containing vitamin K to their diet. These foods include dark leafy vegetables, soybean oil, egg yolk, lentils and liver.
