Stroke occurs when a blood vessel in the brain is blocked or ruptures and the blood flow in the brain stops. Stroke is the third leading cause of death in the United States. It also is a leading cause of serious and long-term disability. A stroke can happen at any time to people of any race, gender, or even age. More women than men have a stroke each year. African Americans have almost twice the risk of a first-time stroke as Caucasians. About two-thirds of those who experience a stroke are over age 65. Nearly 800,000 people in the U.S. have a stroke each year.
Physical therapists provide treatments for people who have had a stroke to restore movement and walking ability, decrease disability, and improve function.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
Stroke is also called a cerebral vascular accident. Stroke occurs when a blood vessel in the brain is blocked (blood flow in the brain stops) or ruptures. It is an emergency. Blood carries a constant supply of oxygen and nutrition that the brain requires. When the blood flow in the brain is interrupted, a part of the brain does not receive enough oxygen and nutrition. This causes damage as the brain cells begin to die within a few minutes. The amount of brain cell death depends on the severity and duration of the blockage or rupture. The functions controlled by the areas with dead or damaged brain cells may be lost or limited. This may include losing the ability to:
Delaying treatment increases the risk of permanent brain damage, disability, or death.
There are two types of stroke:
An ischemic stroke is the most common type. It occurs when a blood vessel is blocked. A blood clot or a buildup of fatty deposits (arteriosclerosis) in the blood vessels that supply the brain can lead to blocked blood vessels. Ischemic stroke accounts for 87% of all strokes. The most common cause of ischemic stroke is fatty deposits lining the blood vessel walls.
A hemorrhagic stroke occurs when a weakened blood vessel leaks or ruptures. When a blood vessel bursts in the brain, blood builds up and damages surrounding brain tissue. The most common cause of hemorrhagic stroke is high blood pressure. Hemorrhagic stroke also can occur in people with a tangle of abnormal vessels connecting arteries and veins in the brain. This tangle is called brain arteriovenous malformation. AVM may disrupt blood flow and result in bleeding in the brain.
Both types of stroke damage brain cells. The damage causes symptoms that start to show in the parts of the body and functions controlled by those brain cells.
A stroke is a serious medical condition that requires emergency care. It is important to know the signs of a stroke and get help quickly if you or someone you are with shows any signs of stroke. Medical treatment is most effective when started immediately.
If you have one or more of the following symptoms, call 911 right away for an ambulance:
Emergency treatment with a clot-buster drug called t-PA can help reduce or even eliminate problems from stroke. The drug must be given within three hours of when symptoms start.
The acronym FAST is an easy way to remember the signs of a stroke. If you think someone might be having a stroke, act FAST and call 911.
FAST stands for:
F=Face. Ask the person to smile. Does one side of the face droop?
A=Arms. Ask the person to raise both arms. Does one arm drift downward?
S=Speech. Ask the person to repeat a simple phrase. Does the speech sound slurred or strange?
T=Time. If you observe any of these signs, call 911 at once and note the time that you think the stroke began.
Research shows that people with stroke who arrive at the hospital by ambulance receive quicker treatment than those who arrive by their own means.
Awareness of stroke symptoms and calling 911 are vital to enable emergency medical personnel to quickly begin stroke care and deliver advanced treatment as soon as possible.
Stroke symptoms may happen suddenly. The symptoms may vary from one person to another. Symptoms may include:
Some people experience a transient ischemic attack, called a ministroke, that produces stroke-like symptoms. TIAs do not cause permanent damage because blood flow is altered for only a short time (from a few minutes to up to 24 hours). Recognizing symptoms and seeking treatment for TIAs can reduce your risk of a major stroke.
Stroke can cause a range of long-term problems, such as:
Getting diagnosed early is linked to better outcomes for people who experience a stroke. Physicians or emergency medical personnel will assess a stroke based on the signs and symptoms. They typically consider the FAST signs for stroke. Doctors often confirm a stroke diagnosis by examining the patient, using specific tests, and taking images of the brain (usually a CT scan or MRI). The diagnosis of stroke is most difficult in the initial hours, particularly when:
Research has proven that early treatment can reduce the effects of stroke and save lives. Efforts are being made to get people suspected of having a stroke directly to a hospital stroke unit rather than the emergency department.
Physical therapists are part of the stroke recovery team. Physical therapy begins very soon after a stroke, most often while you are still in the hospital. Your physical therapist’s main goal is to help you return to your activities at home, at work, and in your community.
Evaluation is very important for guiding the treatment of stroke. Your physical therapist will conduct a thorough assessment that includes:
After conducting an exam and evaluating your condition, your physical therapist will develop a treatment plan specific to your needs, challenges, and goals. They will work with you to help you achieve the best possible quality of life. Your treatment plan will focus on:
One of the first things your physical therapist will teach you is how to move safely from your bed to a chair and do exercises while in bed. As you become more mobile, your physical therapist will teach you strengthening exercises and functional activities.
Later, your physical therapist will:
Treatment for people with stroke varies. Your specific treatment will depend on the results of your physical therapist's evaluation and on how long it's been since your stroke. Recovery from a stroke depends on:
Your physical therapist will help you regain functional skills to allow you to take part in your specific life activities.
Your physical therapist will design an exercise and strengthening program based on tasks you need to do every day. Physical therapist researchers are at the forefront of innovating many techniques for stroke recovery. Your physical therapist will select the best treatment for your specific needs from a variety of available options, such as:
Your needs will change over time, and your physical therapist may consider using other treatments and tools to assist you in your recovery, such as:
Even after the initial recovery phase in a rehabilitation facility, your physical therapist will continue to see you as needed to:
