Stroke PPT For IHT Student ,, presented .. Refat

Institude of health Tecnology ,Bogura.

1. STROKE REHABILITATION Presented by : Md. Refat Uddin GOVT IHT BOGURA Dept. O f Physiotherapy FT: National Institute of Neurosciences & Hospital Reg No. 48913

2. Prevalence The World Health Organization (WHO) estimates that 15 million people suffer a stroke each year, with 5 million dying and 5 million permanently disabled.

3. Definition: Stroke is defined as rapidly developed clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than of vascular origin . ( WHO- in 1978 )

4. TYPES: There are 2 main types of stroke: Ischemic Stroke Haemorrhagic Stroke Transient Ischemic Attacks (TIAs ), Also referred to as mini - strokes

5. Rehabilitation Team Physiatrist Neurologist Physiotherapist O ccupational therapist S peech and language therapist R ehabilitation nurse Prosthetist and Orthotist Phycologist Nutritionist Social Worker Patient & Family member

6. A Case Of Ischemic Stroke Patient name : Mr. X Age : 35 y Gender : Male Profession : Teacher Medical History : As described in prescription Affected Side – Right side Hemiplegia Muscle tone – Spastic Muscle power – Grade 3 Gait – Scissor Gait

7. Assessment Muscle Tone- Muscle tone is the amount of tension (or resistance to movement) in muscles. ROM - Range of motion is  the capability of a joint to go through its complete spectrum of movements .  Pain - Pain  is a distressing feeling often caused by intense or damaging stimuli.  Balance - Balance  is the ability to distribute your weight in a way that lets you stand or move without falling. Functional ability - Functional ability is the actual or potential capacity of an individual to perform the activities and tasks that can be normally expected.  Posture – Posture is the position in which someone holds their body when standing or sitting Gait - A  gait  is a manner of limb movements made during locomotion. 

8. Goals Of Stroke Rehabilitation - Physiotherapy Short term goals -The goal of short term rehabilitation is to help patients make their best possible recovery and regain their highest level of function as quickly as possible. Long term goals The long term goals can help to do everyday activities independently as much as possible. - Some types of problem treated by physiotherapy after a stroke include muscle stiffness and spasticity, problems with movement and balance, and joint pain

9. Physiotherapy management of Ischemic Stroke : Bed Positioning of the patient - Supine , side lying, prone lying, rolling ,Lying to sitting, sitting to standing.

10. Prevent bed sores C hanging positions every 2 hours

11. Prevent Deep Vain Thrombosis TA stretching Elevation of the limb ROM exercise of the affected limb

12. Respiratory Care Breathing exercise Postural Drainage Active cycle of breathing Spirometer

13. Transfer of the Patients

14. Exercise for Stroke Patient Range of Motion (ROM) exercise Passive ROM exercise Active Assisted ROM exercise Passive ROM exercise Aerobic Exercise Walking Cycling Swimming Strengthening exercise Active Exercise Active Resisted exercise Resisted exercise Weight bearing exercise

15. Range of Motion Exercise

16. Gait Training Walking in parallel bar Walking frame Standing frame Hoist Parallel bar

17. Walking frame Standing frame Hoist

18. Balance and co-ordination programme Siting balance -Lying to siting with support ,without support -Sitting with support, without support - Sitting to standing with support ,without support Standing balance - Side stepping - One leg standing - Heel to toe standing - Straight line stepping

19. Balance Exercise

20. Pain Management of Stroke Thermotherapy - Hot compression - IRR Electrotherapy - TENS

21. Comments