Recovery after a severe stroke. Dementia after a stroke. Sports and physical activity after a stroke

A stroke is a very dangerous disease associated with impaired blood circulation in the brain, which leads to severe ones, including loss of memory and movements, paralysis and others.

Depressing statistics

According to medicine, after a stroke during the first month, death occurs in 15-25% of people. In half of these cases, death occurs due to secondary cerebral edema. In other cases, death occurs due to many severe complications, such as:

A lot of people are wondering what is the life expectancy after a stroke, it is impossible to answer this question unambiguously, because there are no such statistics and everything is very individual. The prognosis depends on a number of factors.

According to statistics, the mortality rate after is 65%. Of those who have suffered an apoplexy, 35% of people can live more than one year.

With a more favorable prognosis. The survival rate is 75%.

Regardless of its type, the mortality rate will be much higher than after the first brain damage.

The duration and quality of life of a post-stroke patient depends on the physical health of the person, and the lifestyle that the patient led, as well as the presence of any serious chronic diseases.

A lot depends on the rehabilitation regimen and whether the causes of the pathology have been completely eliminated.

Proper nutrition and adequate medication, abstinence from smoking and drinking alcohol, as well as constant work on improving the functioning of your body are guaranteed to increase the chances of maximum recovery and a good life expectancy.

According to experts, about 30% of patients in the case of a favorable course of the disease gradually partially or completely restore impaired functions.

More than 30% of people due to a stroke have a complete or partial loss of important skills, which leads to disability. Such a person needs constant care.

If it happens, it will be much harder than the first one. At the same time, the patient's condition periodically worsens, the treatment process is delayed, and very rarely it is possible to completely restore the impaired functions.

The likelihood of a second stroke in the first year is very high. Secondary impact in almost 70% of cases leads to death. That is why strict measures should be observed in order to prevent the risk of recurrence of the pathology.

Favorable factors and not so ...

Speaking of, it should be noted favorable and unfavorable factors that play an important role.

Unfavorable factors include:

a large focus of brain damage;
localization of the lesion in the areas responsible for speech and motor skills;
poor circulation around the lesion;
elderly age;
emotional disturbances.

Favorable factors:

timely start of restoration activities;
previously spontaneous recovery of functions.

The first days after the attack

First of all, after a stroke, a complex of therapeutic measures is carried out, the purpose of which is to maintain the cardiovascular and respiratory systems. In the first few days, the patient should be in the intensive neurology unit or acute stroke unit.

Here, measures will be taken to control the work of the heart, blood vessels and respiratory organs. First of all, the following is done:

correction of water and electrolyte balance;
elimination of cerebral edema.

The patient must comply with strict bed rest. To prevent the formation of bedsores from prolonged lying, it is necessary that the mattress is even, and the sheet does not form wrinkles. The body must be treated with camphor alcohol and talc, which absorbs moisture well.

If it is impossible to swallow food, feeding is done using a probe. If a person is able to swallow, on the first day they are given juices and sweet tea. From the second day, the diet expands and you can eat light foods, such as yoghurts, broths, vegetable and fruit purees.

The duration and quality of life will depend on how many intact nerve cells remain around the lesion in the early period after a stroke, and the speed and professionalism of doctors will determine how effective the further recovery and rehabilitation of the patient will be.

To limit the size of the focus, the following drugs are prescribed:

diuretics: Mannitol, Furosemide - reduce swelling in the area of the affected tissue;
neuroprotectors: Actovegin, Cerebrolysin.

Therapeutic exercise as a way of life

- This is one of the main methods after a stroke. The goal of therapy is to return the limbs to their former strength, range of motion, restore the skills of standing, walking, maintaining balance, and self-service. The selection of exercises is performed by a specialist, taking into account the severity of the patient's condition:

With deep violations, rehabilitation starts with passive gymnastics. The movements of arms and legs are carried out by relatives or an instructor. At the same time, blood flow in the muscles is restored, and joints are developed. In no case should such rotational movements cause discomfort or pain.
At first the patient is put on the bed for several minutes, gradually this time should increase. Then he is taught to stand. When the condition begins to improve, the patient learns to sit, get up and walk without assistance. If necessary, you can use a support - a chair or a stick.
The function of the hands is restored with the help of special simulators and hand expanders. Such devices have a good effect on the functions of the muscles of the hand and the return of the skills to perform simple small movements and even writing. It will be very useful in combination with gymnastics, which helps to improve muscle tone and reduce spasticity.

Speech restoration

Speech disorders are very common with strokes. A person may experience difficulty in pronunciation, remembering words, and also in understanding someone else's speech. Violations can be completely different. The process takes place with the participation of a qualified speech therapist, and can take several years.

After a stroke, the functions of the muscles of the face and tongue may be impaired. The speech of such a person becomes slow, deaf and illegible.

The speech therapist conducts exercises during which the tongue and muscles are trained. They are best done in front of a mirror. Classes should be regular.

The patient can also do the following:

roll lips into a tube;
imitate a grin;
stick out the tongue to the maximum length;
bite the lower and upper lip in turn.

Relatives and friends need to take into account the limited capabilities of the post-stroke patient, so you should speak slowly, in simple phrases, giving him time to comprehend what he heard. You need to ask questions in such a way that he answers “Yes” or “No”.

In addition to speech disorders, very often a person experiences difficulties in the process of swallowing and chewing food due to damage to the facial muscles. That is, a person may simply not feel food in his mouth.

Special exercises help to restore the swallowing function, which activate muscle strength and improve the motor skills of the lips and tongue.

To make the swallowing process less painful, it should be easy to chew and swallow. It should not be too hot or cold. When eating, the patient should be in a sitting position.

Memory recovery

Memory recovery occurs through constant training with simple exercises. For example:

Memorizing easy children's poems. First you need to remember the line, then the stanza. Gradually, the size of the poem can increase. It is good that in the process of memorization the patient bends his fingers, so additional associations will be formed.
Replaying past events. The patient may describe the events of the past day or older events. It is imperative that the memories are only positive.
As memory is restored, you can move on to solving crossword puzzles and memorizing small texts.. Exercise can be done in any setting, such as at lunch or while walking.

The question of nutrition

Plays a huge role. If a person is overweight, or a high level of glucose in the blood is detected, dietary nutrition is prescribed.

It is very important to limit the intake of salt, sugar, fats and cholesterol, which negatively affect the state of blood vessels. Food should be rich in fiber, minerals and vitamins. It is very important to eat small meals and at least four times a day.

What not to eat:

Time for healing

This is a very topical issue that occupies both the victim himself and his relatives. Time is determined by many factors, which include:

the degree of brain damage;
the individual ability of the body to recover;
the program of rehabilitation measures that have been applied;
the patient's desire for recovery.

Very often, the treatment gives a good result after a couple of months. However, it is possible that it will be possible to restore the simplest skills only after a few years.

What to do after a stroke

It is very important to follow these simple rules:

regularly examined by your doctor;
give up all bad habits and unhealthy food;
in no case stop performing exercises in therapeutic gymnastics;
visit sanatoriums and resorts;
walk more;
avoid stress and heavy physical exertion.

A stroke is not a death sentence. Adequate treatment, a properly selected rehabilitation technique and the implementation of all medical prescriptions can speed up the recovery process and return to a full life.

It is also necessary to once again recall the importance of the positive attitude of the victim himself and the provision of psychological assistance from relatives.

A stroke is a disease of the brain that occurs due to a violation of blood circulation in it. As a result, neurons no longer receive enough nutrients and oxygen, which leads to their death.

The consequences of the disease can be different - from minor violations to death. The article will look at how long people usually live after a stroke, are there any chances for a full recovery, and how to achieve a speedy recovery.

To do this, it is important to take into account several factors at the same time.

There are two main types of stroke - ischemic and hemorrhagic. Each of them has its own causes, symptoms, consequences and predictions. Consider both diseases and compare them in terms of consequences for the patient and the degree of danger.

Hemorrhagic stroke occurs due to intoxication, lack of vitamins, inflammation in the vessels of the brain. In this situation, the integrity of the walls of blood vessels is violated, blood penetrates under the membrane of the brain and into its ventricles. Violation of the blood supply leads to dangerous consequences. Often this pathology is referred to as intracerebral hemorrhage. The disease is very difficult to treat, but if the patient learns to observe a certain discipline in terms of nutrition and treatment, he can recover.
Ischemic stroke occurs due to a violation of the patency of the cerebral vessels and the subsequent death of neurons due to the lack of oxygen. In the people, this disease was called "brain infarction." It can be triggered by a number of other pathologies - heart rhythm failure, atherosclerosis, diabetes mellitus. The greatest risk of such brain damage in people who suffer from high or low pressure, obesity.

How long you live after suffering a brain disease depends on several factors. Both hemorrhagic and ischemic strokes are a real blow not only to the brain, but also to the body as a whole, therefore, even with adequate treatment, the patient will not succeed in becoming completely healthy: recovery will be only partial.

How long do people live after a stroke

What is the life expectancy of the average person after a stroke? This question worries most people with this diagnosis. The further life of the patient, its quality and rhythm depends on the answer to this question.

After all, you will definitely have to change a number of habits and follow certain rules in order to recover as quickly as possible. Traditionally, life expectancy is not significantly reduced, although, as medical statistics show, stroke survivors generally live 3-6 years less. The average duration is about 65-70 years, provided that the doctor's recommendations are followed unconditionally.

Statistics say that life after a stroke becomes different, and for a full recovery, you have to make efforts. As for mortality, there are the following statistics:

before the age of 45, no more than a quarter of all patients who are diagnosed with this disease die;
after 50 years, the figure rises to 40%;
after 70 years, only 20% of patients can survive a stroke (without the possibility of a full recovery).

Aggravating factors

Most often, representatives of the weaker sex suffer from this disease, but it also happens in men. 40% of patients need rehabilitation measures, and 50% of this number remain disabled for life. It is especially difficult for people who are at risk. The following factors increase the risk of stroke:

hypertension;
previous microstroke (more about it)
obesity;
diabetes;
vascular diseases;
abuse of alcohol, coffee, tobacco;
increased physical activity;
emotional overstrain;
uncontrolled intake of certain groups of drugs;
pregnancy;
traumatic brain injury;
mental disorders;
old age.

To prevent ischemic and hemorrhagic stroke, if at least one of the above risk factors is present, it is necessary to undergo regular preventive examinations and, if necessary, go to the hospital for treatment. In the first months after a stroke, recovery is faster than later.

Factors affecting life expectancy after a stroke

The subsequent life after a stroke will depend on the type of disease, the degree of damage and the presence of additional background diseases. There are a number of circumstances that can both facilitate and complicate the course of the underlying disease and the process of restoring brain cells. So, here are the key factors that have a direct impact on the recovery process:

Damage area. It affects the future life of the patient. In the case of extensive damage, the cells are damaged so badly that they can no longer be restored. Because of this, the functioning of the brain is disrupted, which leads to malfunctions in other systems and organs, and even to the death of the patient.
Consequences of a stroke. Patients suffering from paralysis, impaired speech function, sensitivity, mental disorders are unlikely to be able to lead a normal and fulfilling life. If they manage to recover, then only partially. Forecasts are unfavorable because these conditions lead to bedsores, intoxication, and other complications. All these phenomena significantly reduce life expectancy.
Age features. In the process of recovery after a stroke, the elderly have the least chance. The fact is that their cells do not have the ability to quickly renew themselves, they often develop inflammatory processes, vascular pathologies, repeated hemorrhages, heart attacks occur. Even if patients manage to survive the attack itself, in case of nervous overstrain, an attack of hypertension, there is a risk of a second stroke. In addition, women have much more chances to recover than men, which is associated with their physiological characteristics. Therefore, the general condition of the patient also depends on age and sex.
Prolonged immobility. When a patient recovers from a stroke, he is often unable to move due to paralysis, paresis. If you neglect the implementation of the rehabilitation program, the muscles gradually lose their tone, the blood supply to the internal organs worsens. This leads to thrombosis, tissue necrosis, intoxication. Therefore, the condition worsens even more, inflammation, infectious processes, and cardiovascular diseases develop. Such a patient has much less time to live than a person who regularly moves, does exercises and has a positive attitude.
Localization of the disease. Of course, the prognosis directly depends on the localization of the affected areas. Ischemia can affect the tissues that supply blood to the carotid artery, basilar and vertebral, as well as their branches. In addition, ischemic cerebral stroke is the most dangerous condition that reduces the chances of survival. Hemorrhagic stroke most often affects the shell (in 55% of cases), thalamus, cerebellum, brain stem.

No one can give an unequivocal answer to the question related to life expectancy after a stroke. This is due to the individual characteristics of each organism. However, according to statistics, about 35% of deaths occur in the first month after the disease, and 50% of patients die during the first year. In any case, one recommendation should be followed: lead a healthy lifestyle. It is he who will avoid complications, prolong life and make it more complete.

Lifestyle after a stroke

In order for life after a stroke to be not only long, but also happy, it is necessary to contact a specialist in a timely manner. This step is relevant for those who are only at risk, and for those who have already suffered a brain disease. The doctor will conduct a comprehensive examination and offer an individual course of therapy and prevention. It may include:

taking medication,
cure of chronic pathologies that aggravate the general condition;
diet food,
massage,
physiotherapy,
surgical intervention.

After taking adequate and timely measures, we should talk about full recovery and preventing the appearance of foci of inflammation. After all, the disease often ends in disability or death for the reason that in 70% of cases, patients postpone a visit to the doctor indefinitely.

Recovery period

Recovery after a pathology involves the use of certain medications. These are tablets, drops, injections, solutions. Most often, doctors prescribe neurostimulants, coagulants, nootropics, etc. Traditionally, the duration of the course is at least 5 months, and it is important that the use continues even when the disease subsides and the symptoms subside. Drug therapy, carried out under the supervision of a physician, provides:

restoration of damaged cells;
regulation of metabolic processes;
improving the supply of brain cells with oxygen;
activation of blood circulation in the damaged area.

If a person after a stroke stops taking these drugs, the damaged areas of the brain will not fully recover, and the body will not be able to fully function. If you refuse to take drugs that stop seizures, this will lead to a relapse of the disease and, most likely, to death or coma.

In the first month, the rehabilitation of patients involves the following activities:

stay in a specialized department of the hospital for 2-4 weeks, depending on the degree of damage;
restoration of brain cells located near the lesion with the help of special medical measures;
muscle recovery. This requires therapeutic exercises, moderate physical activity;
massage.

If the above measures have given the desired effect, doctors proceed to the stage of discharge and subsequent rehabilitation, which includes:

restoration of speech function through special exercises;
adherence to the principles of proper nutrition;
regular walks in the fresh air.

Compliance with a therapeutic diet is the basis for rehabilitation after a stroke. This is especially true in situations where the patient is overweight or has high blood sugar levels. The menu should include foods with a lot of fiber, as well as follow the principle of fractional nutrition (eating food in small portions, but often). The following products are prohibited:

pork and other fatty meats;
high-fat fish;
smoked products;
sausages;
dairy products with a high percentage of fat content;
pastries, pastries;
grape;
legumes (lentils, peas, beans, chickpeas, beans);
soda;
tea and coffee.

It is best to give preference to a vegetarian diet (soups, stewed vegetables, cereals). You can include dried fruits, herbal decoctions in the diet.

Such a diet will allow not only to get rid of excess weight, but also to normalize blood circulation, and prevent a recurrent stroke.

Prevention of recurrent stroke

The likelihood of a second attack increases if the simplest rules of recovery are not followed. During the first few days after the illness, special attention must be paid to preventing a relapse. Each subsequent defeat is fraught with even more serious deviations in the work of the body, the psyche. The most serious threat at this stage is death.

In order to avoid such consequences, it is necessary to find out the causes of the disease, carry out a number of preventive procedures, and coordinate restorative measures with the doctor. Next, you should take the medicines prescribed by your doctor and have regular check-ups.

An important role is played by the rejection of bad habits (drinking alcohol, smoking), prohibited foods (sweets, smoked meats, fast food) and dieting, since not only the likelihood of a relapse depends on nutrition, but also the general state of health. In addition, there are a number of rules, following which will reduce the risk of relapse:

changing eating habits;
getting rid of extra pounds;
regular walking;
physical education;
treatment of chronic diseases;
constant medical supervision.

The doctor will individually advise each patient on what to do in order to prolong life and improve its quality. It will also set the maximum allowable blood pressure that will need to be maintained.

In addition, the doctor will make a list of medications that you need to take for a speedy recovery. In order to reduce the likelihood of relapse, you should take a blood test and determine the content of glucose in it. This will reduce the chance of another stroke.

Thus, each patient lives after a stroke for a different number of years. It mainly depends on his gender, age, degree of damage as a result of the disease, localization of the lesion and other factors.

A competent approach to rehabilitation and prevention of recurrent stroke guarantees not only an increase in life expectancy, but also an improvement in general condition. The patient will be able to return to his usual rhythm and feel great.

Stroke is an acute vascular accident that ranks first in the structure of disability and mortality. Despite improvements in medical care, a large percentage of stroke survivors remain disabled. In this case, it is very important to readapt such people, adjust them to a new social status and restore self-service.

brain stroke- acute violation of cerebral circulation, accompanied by a persistent deficit of brain functions. There are synonyms for cerebral stroke: acute cerebrovascular accident (ACC), apoplexy, stroke (apoplexy). There are two main types of stroke: ischemic and hemorrhagic. In both types, the death of the part of the brain that was supplied by the affected vessel occurs.

Ischemic stroke occurs due to the cessation of blood supply to a part of the brain. The most common cause of this type of stroke is atherosclerosis of the vessels: with it, a plaque grows in the wall of the vessel, which increases over time until it blocks the lumen. Sometimes part of the plaque comes off and clogs the vessel in the form of a blood clot. Thrombi are also formed during atrial fibrillation (especially in its chronic form). Other rarer causes of ischemic stroke are blood diseases (thrombocytosis, erythremia, leukemia, etc.), vasculitis, some immunological disorders, oral contraceptives, hormone replacement therapy.

Hemorrhagic stroke occurs when a vessel ruptures, with which blood enters the brain tissue. In 60% of cases, this type of stroke is a complication of hypertension against the background of vascular atherosclerosis. Modified vessels are torn (with plaques on the walls). Another cause of hemorrhagic stroke is the rupture of an arteriovenous malformation (saccular aneurysm) - which is a feature of the structure of the vessels of the brain. Other causes: blood diseases, alcoholism, drug use. Hemorrhagic stroke is more severe and the prognosis is more serious.

How to recognize a stroke?

A characteristic symptom of a stroke is a complaint of weakness in the limbs. You need to ask the person to raise both hands up. If he really had a stroke, then one arm rises well, and the other may or may not rise, or the movement will be difficult.

In stroke, there is facial asymmetry. Ask a person to smile, and you will immediately notice an asymmetrical smile: one corner of the mouth will be lower than the other, the smoothness of the nasolabial fold on one side will be noticeable.

Stroke is characterized speech disorder. Sometimes it is obvious enough that there is no doubt about the presence of a stroke. To recognize less obvious speech disorders, ask the person to say: "Three hundred and thirty-third artillery brigade." If he has a stroke, impaired articulation will become noticeable.

Even if all these signs occur in a mild form, do not expect that they will pass by themselves. It is necessary to call an ambulance team at the universal number (both from a landline phone and from a mobile phone) - 103.

Features of female stroke

Women are more susceptible to stroke, take longer to recover, and are more likely to die from its effects.

Increase the risk of stroke in women:

- smoking;

- the use of hormonal contraceptives (especially over the age of 30 years);

- Hormone replacement therapy for menopausal disorders.

Atypical signs of a female stroke:

an attack of severe pain in one of the limbs;
sudden attack of hiccups;
an attack of severe nausea or pain in the abdomen;
sudden fatigue;
short-term loss of consciousness;
sharp pain in the chest;
asthma attack;
sudden rapid heartbeat;
insomnia (insomnia).

Principles of treatment

Future prospects depend on the early start of stroke treatment. In relation to a stroke (however, as in relation to most diseases), there is a so-called "therapeutic window" when the ongoing therapeutic measures are most effective. It lasts 2-4 hours, then the part of the brain dies, unfortunately, completely.

The system of treatment of patients with cerebral stroke includes three stages: pre-hospital, inpatient and rehabilitation.

At the prehospital stage, a stroke is diagnosed and the patient is urgently transported by an ambulance team to a specialized institution for inpatient treatment. At the stage of inpatient treatment, stroke therapy can begin in the intensive care unit, where urgent measures are taken to maintain the vital functions of the body (cardiac and respiratory activity) and to prevent possible complications.

Consideration of the recovery period deserves special attention, because often its provision and implementation falls on the shoulders of the patient's relatives. Since strokes occupy the first place in the structure of disability among neurological patients, and there is a tendency to “rejuvenate” this disease, each person should be familiar with the rehabilitation program after a cerebral stroke in order to help his relative adapt to a new life for him and restore self-care.

Rehabilitation of patients with cerebral stroke

The World Health Organization (WHO) defines medical rehabilitation as follows.

medical rehabilitation - this is an active process, the purpose of which is to achieve a complete restoration of functions impaired due to a disease or injury, or, if this is not possible, the optimal realization of the physical, mental and social potential of a disabled person, the most adequate integration of him in society.

There are some patients who, after a stroke, have a partial (and sometimes complete) self-restoration of damaged functions. The speed and degree of this recovery depend on a number of factors: the period of the disease (prescription of the stroke), the size and location of the lesion. Restoration of impaired functions occurs in the first 3-5 months from the onset of the disease. It is at this time that restoration measures should be carried out to the maximum extent - then they will be of maximum benefit. By the way, it is also very important how actively the patient himself participates in the rehabilitation process, how much he realizes the importance and necessity of restorative measures and makes efforts to achieve the maximum effect.

Conventionally, there are five periods of stroke:

acute (up to 3-5 days);
acute (up to 3 weeks);
early recovery (up to 6 months);
late recovery (up to two years);
period of persistent residual effects.

Basic principles of rehabilitation measures:

earlier start;
regularity and duration;
complexity;
phasing.

Rehabilitation treatment begins already in the acute period of a stroke, during the treatment of a patient in a specialized neurological hospital. After 3-6 weeks, the patient is transferred to the rehabilitation department. If, even after discharge, a person needs further rehabilitation, then it is carried out on an outpatient basis in the conditions of the rehabilitation department of the polyclinic (if any) or in a rehabilitation center. But most often such care is shifted to the shoulders of relatives.

The tasks and means of rehabilitation vary depending on the period of the disease.

Rehabilitation in acute and early recovery periods of stroke

It is carried out in a hospital setting. At this time, all activities are aimed at saving lives. When the threat to life has passed, measures to restore functions begin. Treatment with position, massage, passive exercises and breathing exercises begin from the first days of a stroke, and the time for the start of active recovery measures (active exercises, transition to a vertical position, standing up, static loads) is individual and depends on the nature and degree of circulatory disorders in the brain, from the presence of comorbidities. Exercises are performed only in patients in a clear mind and in their satisfactory condition. With small hemorrhages, small and medium heart attacks - on average from 5-7 days of a stroke, with extensive hemorrhages and heart attacks - for 7-14 days.

In the acute and early recovery periods, the main rehabilitation measures are the appointment of medications, kinesitherapy, and massage.

Medications

In its pure form, the use of drugs cannot be attributed to rehabilitation, because it is rather a treatment. However, drug therapy creates the background that provides the most effective recovery, stimulates the disinhibition of temporarily inactivated brain cells. Medications are prescribed strictly by a doctor.

Kinesiotherapy

In the acute period, it is carried out in the form of therapeutic exercises. The basis of kinesitherapy is positional treatment, passive and active movements, and breathing exercises. On the basis of active movements carried out relatively later, training in walking and self-care is built. When carrying out gymnastics, overworking of the patient should not be allowed, efforts should be strictly dosed and the loads should be gradually increased. Treatment with position and passive gymnastics for uncomplicated ischemic stroke begins on the 2-4th day of illness, for hemorrhagic stroke - on the 6-8th day.

Position treatment. Purpose: to give the paralyzed (paretic) limbs the correct position while the patient lies in bed. Make sure that your arms and legs do not stay in one position for a long time.

Dynamic exercises performed primarily for muscles whose tone usually does not increase: for the abductor muscles of the shoulder, supinators, extensors of the forearm, hand and fingers, abductor muscles of the thigh, flexors of the lower leg and foot. With pronounced paresis, they begin with ideomotor exercises (the patient first mentally imagines a movement, then tries to perform it, while pronouncing the actions performed) and with movements in facilitated conditions. Lightweight conditions involve the elimination of gravity and friction forces in various ways, which make it difficult to perform movements. For this, active movements are performed in a horizontal plane on a smooth slippery surface, systems of blocks and hammocks are used, as well as the help of a methodologist who supports the segments of the limb below and above the working joint.

By the end of the acute period, the nature of active movements becomes more complex, the pace and number of repetitions gradually but noticeably increase, they begin to carry out exercises for the body (light turns, tilts to the sides, flexion and extension).

Starting from 8-10 days (ischemic stroke) and from 3-4 weeks (hemorrhagic stroke), with good health and satisfactory condition of the patient, they begin to teach sitting. At first, he is helped to take a semi-sitting position with a landing angle of about 30 0 1-2 times a day for 3-5 minutes. Within a few days, while controlling the pulse, increase both the angle and the time of sitting. When changing the position of the body, the pulse should not increase by more than 20 beats per minute; if there is a pronounced heartbeat, then reduce the angle of landing and the duration of the exercise. Usually, after 3-6 days, the angle of elevation is adjusted to 90 0, and the procedure time is up to 15 minutes, then learning to sit with legs down begins (in this case, the paretic arm is fixed with a scarf to prevent stretching of the articular bag of the shoulder joint). When sitting, a healthy leg is sometimes laid on the paretic one - this is how the patient is taught the distribution of body weight on the paretic side.

Along with teaching the patient to walk, exercises are carried out to restore household skills: dressing, eating, performing personal hygiene procedures. Self-service recovery exercises are shown in the table below.

Massage

Massage begins with uncomplicated ischemic stroke on the 2nd-4th day of illness, with hemorrhagic stroke - on the 6th-8th day. Massage is carried out when the patient lies on his back and on a healthy side, daily, starting from 10 minutes and gradually increasing the duration of the massage up to 20 minutes. Remember: vigorous tissue stimulation, as well as a fast pace of massage movements, can increase muscle spasticity! With a selective increase in muscle tone, massage should be selective.

On muscles with increased tone, only continuous planar and encircling strokes are used. When massaging the opposite muscles (antagonist muscles), stroking is used (planar deep, forceps-like and encircling intermittent), slight transverse, longitudinal and spiral rubbing, light shallow longitudinal, transverse and forceps-like kneading.

Direction of massage: shoulder-scapular girdle → shoulder → forearm → hand; pelvic girdle → thigh → lower leg → foot. Particular attention is paid to the massage of the pectoralis major muscle, in which the tone is usually increased (slow strokes are used), and the deltoid muscle, in which the tone is usually reduced (stimulating methods in the form of kneading, rubbing and tapping at a faster pace). Massage course 30-40 sessions.

In a hospital, rehabilitation measures are carried out no longer than 1.5-2 months. If it is necessary to continue rehabilitation treatment, the patient is transferred to an outpatient rehabilitation facility.

Outpatient rehabilitation measures in the recovery and residual periods of a stroke

Patients are referred for outpatient rehabilitation treatment no earlier than 1.5 months after ischemic stroke and 2.5 months after hemorrhagic stroke. Patients with motor, speech, sensory, coordinating disorders are subject to outpatient rehabilitation. Outpatient rehabilitation for a stroke patient who has had a stroke for a year or more will be beneficial if there are signs of continued recovery of function.

Basic outpatient rehabilitation measures:

- drug therapy (prescribed strictly by a doctor);

– physiotherapy;

– kinesitherapy;

– psychotherapy (conducted by doctors of relevant specialties);

- restoration of higher cortical functions;

- occupational therapy.

Physiotherapy

It is carried out under the supervision of a physiotherapist. Physiotherapeutic procedures are prescribed not earlier than 1-1.5 months after ischemic stroke and not earlier than 3-6 months after hemorrhagic.

Patients who have had a stroke are contraindicated:

- general darsonvalization;

– general inductometry;

- UHF and MBT on the cervical-collar zone.

Allowed:

- electrophoresis of solutions of vasoactive drugs;

– local sulfide baths for the upper extremities;

- a constant magnetic field on the cervical-collar region in case of violations of the venous outflow;

- general sea, coniferous, pearl, carbonic baths;

– massage of the cervical-collar zone daily, course 12-15 procedures;

- paraffin or ozocerite applications on the paretic limb;

- acupressure;

– acupuncture;

- diadynamic or sinusoidally modulated currents;

- local application of d'Arsonval currents;

- electrical stimulation of paretic muscles.

Kinesiotherapy

Contraindication for kinesitherapy - blood pressure above 165/90 mm Hg, severe cardiac arrhythmias, acute inflammatory diseases.

In the early recovery period, the following types of kinesitherapy are used:

1) treatment by position;

2) active movements in healthy limbs;

3) passive, active-passive and active with the help, or in facilitated conditions of movement in the paretic limbs;

4) relaxation exercises combined with acupressure.

Direction of the exercises: shoulder-scapular girdle → shoulder → forearm → hand; pelvic girdle → thigh → lower leg → foot. All movements must be performed smoothly, slowly in each joint, in all planes, repeating them 10-15 times; all exercises must be combined with proper breathing (it should be slow, smooth, rhythmic, with an extended breath). Make sure that there is no pain during the exercise. Restoring proper walking skills is of particular importance: it is important to pay more attention to training an even distribution of body weight on the diseased and healthy limbs, support on the entire foot, learning to “triple shorten” (flexion at the hip, knee and extension at the ankle joints) of the paretic leg without abducting it to the side.

In the late recovery period, there is often a pronounced increase in muscle tone. To reduce it, you need to perform special exercises. The peculiarity of these exercises: in the treatment of the position, the paretic arm and leg are fixed for a longer time. Removable gypsum splints are applied for 2-3 hours 2-4 times a day, and in case of significant spasticity, they are left overnight.

It occurs due to a violation of blood circulation in the brain. As a result, neurons in a certain area cease to receive nutrients, oxygen and die. Quite often, after an attack, a person dies. But there are people who not only continue to live, but also return to work. In such people, most of the functions are restored. But still, they will never become completely healthy.

Is it possible to live a fulfilling life after a stroke?

The critical age for a stroke is 60 years. But in recent years, the disease has become so younger that even people over 30 suffer from it. How long do people live after a stroke? The body of each person is individual, all people endure the disease in different ways. Some people are able to work, although they become less active than they were before the illness. Others, after all they have suffered, learn to walk again,. It is necessary to support yourself as much as possible, to limit in certain matters. Then the person has a chance to recover faster.

The sufferer is shown:

special exercises;
regular classes;
psychological help;
moral support.

Hemorrhagic and ischemic stroke, which one is more dangerous

Hemorrhagic stroke

A person affected by the disease, at first, must exclude the possibility of relapse. There are two types of disease: and ischemic. The causes of brain damage vary depending on these species. Ischemic occurs due to blockage of blood vessels. The disease has a popular name "brain infarction". Some diseases are the causes that caused it. These are diabetes mellitus, atherosclerosis, heart rhythm disturbance. People suffering from hypertension and having a lot of extra centimeters at the waist are at risk of developing this type of disease.

Hemorrhagic stroke occurs due to beriberi, defects in cerebral vessels, intoxication. Depending on the type of illness and the causes of its cause, the doctor prescribes to the patient a number of specific procedures and rules that must be followed. If a person is disciplined and follows the doctor's advice, then the possibility will be minimized. As for bad habits, they will have to be abandoned immediately. and alcohol is prohibited. The latter and a healthy person should not be consumed in large quantities. And no one is allowed to smoke.

The patient, in order for his life to be long, should take care of himself. He can change his diet.

Age is not a hindrance to moderate physical activity. There are exercises that you can do, walking is very useful. Losing those extra pounds doesn't hurt. The doctor will advise the patient what the maximum blood pressure should be and the set mark should not be exceeded. The person begins to take medication. Often, the action of drugs is aimed at preventing the formation of blood clots and reducing blood clotting. The amount of glucose in the blood should be optimal. In order for a stroke to bring a minimum of trouble, medical experts advise the patient to spend some time in the hospital. It is in honey. institution, the process of treatment and rehabilitation will be optimal. Doctors use therapeutic exercises to restore the patient. Medical preparations are used. The workload is increasing daily. The first time is shown, rubbing, electrical devices are used to stimulate muscle work.

The help and support of relatives is an important factor for recovery

Exercise after a stroke

Having suffered a stroke, people can recover quite well within a month in honey. institution. There are times when it takes a year or more to return to normal life. It is important not to stop doing the exercises prescribed by your doctor. The sufferer can live at home. The neurologist draws up an adaptation card for the patient. Following it, it is necessary to perform the procedures and. How many years they live after a stroke depends largely on loved ones. If the atmosphere in the house is positive. Relatives do their best to cheer up the patient, believe in the success of the treatment and in his full recovery, then the patient will quickly get out of the state of psychological shock and he will feel much better. The first year of rehabilitation is the most important. This is followed by a period of adaptation of the sufferer, he has already learned to put up with the functional disorders of his body. People understand that the world around them is ready to accept them as they have become. It is quite possible to find something to your liking and not sit idle and live many more happy years, if you take care.

Depression after an illness

How long a person can live, whose functions are limited due to the death of brain neurons, largely depends on him. It is necessary to fight bouts of depression, which may well occur in the sufferer. The patient does not want to see anyone, he lives in his own closed world, does not want to move. Maybe antidepressants will help to get rid of a bad mood. Specialists explain to the patient that he can live many good moments, he is needed on earth, it is not easy to survive a severe attack, but it is possible to get out.

What can a person do after everything he has suffered

The physical capabilities of a person are limited. But, oddly enough, for some, the disease helps to begin to appreciate life, even if they were not able to do it before. There are plenty of entertainment options. You can appear in public places, visit restaurants, theaters. All feasible work can be done, or just help the household. If a person was very fond of digging in the dacha, garden, then after the suffering he experienced, he can devote himself to caring for indoor plants. Previously favorite activities can be replaced with similar and feasible ones.

Stroke attack, how long do they live after it

people experience it easier, 75% of them survive. But the hemorrhagic form is more dangerous. As many as 65% of people may not get out. According to statistics, only 35% of people live for more than a year. Why does this happen, especially if the patient received timely medical assistance? The fact is that even in the first month of treatment, about 15-25% of people do not survive. Complications that have arisen are the reason for such statistics. Cerebral edema is one of the reasons. Heart disease, kidney failure, pneumonia are a list of other causes. The sufferer is able to survive after the first stroke and recover well enough, but if such an ailment strikes again, then the mortality rate increases markedly, recovery is even more difficult than in the first case. After a stroke to a person until the end of his days:

shown diet;
you need to monitor the pressure;
follow the recommendations of doctors;
take regular walks
forget about bad habits.

A person who has had a stroke is at risk, he can have a relapse at any time.

He strongly depends on what the doctor has prescribed for him, and if this is neglected, then death will overtake quickly.

Video

Hello, dear readers and guests of the site dedicated to neurorehabilitation. Let's talk today and take a closer look consequences of a stroke- ischemic and hemorrhagic, as well as everything connected with this.

Consequences of a stroke.

Violations of any functions after a stroke are directly dependent on its severity, and severity, in turn, on the size of the focus and its location in the brain.

The nature and persistence of the consequences of a stroke depends on the size of the focus in the brain and its location.

Of course, it would be fair to note that the size of the focus and its localization are far from all factors that determine the persistence of the depth of neurological disorders caused by a stroke, the consequences of which (the nature and severity) can vary greatly, depending on the specific case. What does it depend on?

The persistence of the consequences is in a strong relationship with the time and volume of treatment and rehabilitation, but we will talk about this a little later, read on.

The degree of dysfunction after a stroke is not always persistent. With a small stroke, the consequences may be minimal or even absent, but this does not happen so often. We will discuss cases when these consequences are present and they are persistent. We will analyze in more detail what exactly the consequences of a stroke are and how they are expressed. Below are the most significant violations of body functions that occur after a stroke.

Right-sided and left-sided hemiparesis

One of the most common persistent consequences of a stroke is a decrease in strength in half of the body. As a rule, after a stroke, there is a decrease in muscle strength in one of the sides of the body, which is opposite to the damaged hemisphere of the brain: if hemiparesis of the left side of the body is a persistent consequence, the stroke occurs in the right hemisphere. By the same principle, hemiparesis of the right side of the body, in which a stroke is observed in the left hemisphere. That is, the focus of infarction in the brain is located in the opposite hemisphere of the affected half of the body.

It also happens that a stroke leads to a complete lack of muscle strength in half of the body, which is called hemiplegia. With hemiparesis, a person experiences difficulty in moving, with hemiplegia, the difficulties are even more significant. Simply put, hemiplegia is paralysis in half of the body (complete lack of movement).

Habitual movements in the body are disturbed, many people have to learn to perform normal daily activities again in order to be able to take care of themselves, be able to eat, change clothes and walk. In general, to do everything that before the illness was considered extremely simple and ordinary to perform. It is the decrease in muscle strength in half of the body that is the main reason for the disability of a person after suffering a violation of cerebral circulation. It is because of this that patients lose the ability to move independently - or lose this ability completely or it is significantly impaired.

As you have already described, gait after a stroke can often be disturbed, while a person begins to move with great difficulty. In some cases, assistive devices may be needed - special walkers, a support cane or a crutch. The characteristic Wernicke-Mann posture develops when walking. Individual parts of the body may be affected without involving the entire half of the body. Depending on the affected half of the body, there are left-sided and right-sided hemiparesis.

Central prosoparesis

Fig.1. Central paresis of the facial muscles (central prosoparesis)

The next, one of the most common consequences, is the so-called central prosoparesis, in which the mimic muscles suffer, resulting in facial asymmetry, as in Figure 1. At the same time, a decrease in strength is observed not in the entire half of the face, but only in its lower part, capturing the mouth, cheek, lips.

The eyelids and eyes with this paralysis of the mimic muscles remain unaffected, despite this, the distortion is quite noticeable and causes discomfort not only during meals or liquids. Central prosoparesis regresses with recovery from stroke.

With central prosoparesis, food intake and fluid intake are difficult. A person experiences obvious discomfort when performing some actions with facial muscles. Habitual emotions are more difficult to express, due to a decrease in strength in facial muscles, sound production is disturbed and speech begins to suffer.

The defect itself brings a tangible inconvenience purely from the cosmetic side. Distortion of the face causes great emotional discomfort, especially when communicating with other people. This can cause isolation and renunciation of communication with others and cause deep depression.

Speech disorder

Speech disorders after a stroke are also quite common, at the same time it is one of the very first signs of an onset (upcoming) cerebrovascular accident. Speech impairment is the result of damage to the speech centers of the brain, which is a partial or complete loss of the ability to speak and perceive someone else's speech, called aphasia.

According to statistics, such violations are observed in a quarter of all people who have experienced a stroke, their consequences can be quite persistent. Sometimes it is difficult for a person to speak, due to a violation of the possession of the speech apparatus, and the speech of such people is fuzzy, as if “porridge in the mouth”, but such a violation is called . dysarthria more common in stem stroke or localization of this focus in the cerebral cortex. The next speech disorder is aphasia.

Aphasia is the complete absence of speech. Aphasia can be of several types, to name some of them - with the defeat of the speech center responsible for the pronunciation of speech, motor aphasia develops. When the focus of the stroke is located in the center of speech, which is responsible for its perception, the so-called sensory aphasia develops. With sensory aphasia, a person does not understand what is being said to him and does not understand what he needs to answer. If both centers are affected, mixed or sensory-motor aphasia. The “pure” form of aphasia is extremely rare, and in stroke, it is the mixed form that most often occurs.

There are other types of speech disorders after a stroke, which we will discuss in detail in the following articles on speech disorders. And now let's move on ... In addition to the violations listed above, there are the following consequences of a stroke.

Disorders of coordination of movements

Impairment of blood circulation in the parts of the central nervous system responsible for the coordination of movements and as a result of a stroke can lead to coordination of movements, which is called ataxia. Disturbances in coordination of movements often occur with stem stroke and this is due to the fact that in the stem part of the brain there are centers for coordinating movements in our body.

There are different degrees of expression. In the most favorable case, these vestibular disorders disappear within the first day after the acute cerebrovascular accident. In other, more severe cases, unsteadiness when walking and dizziness persist for a longer period and may last for months.

visual impairment

There may be visual impairments of the most diverse nature. Visual impairment depends on the location of the stroke and the size of the focus. The most common form of visual impairment is visual field loss(hemianopia). In this case, as you may have guessed, half or a quarter of the visual picture falls out. If a quarter of the picture falls out, it is called a quadrant hemianopsia.

Other consequences

Hearing impairments (hypoacusia), smell impairments (hypo-, anosmia), loss of movement skills with the strength stored in them (apraxia) and other disorders that can and should be treated, rehabilitation in this case is very important and should be carried out in a timely manner.
Loss of sensation after a stroke. Violation of sensitivity after a stroke can be of a different nature, but most often it is a loss of the ability to feel pain, recognize heat, cold, and a part of the body as such. It is also possible the appearance of pain syndrome, which is of the most diverse nature and localization. Most often, there is a decrease in sensitivity in any part of the body, this phenomenon is called hypesthesia.

These dysfunctions may well manifest themselves as the first signs of a stroke at the very onset of the disease and persist for an indefinitely long time in the absence of active recovery of impaired neurological functions.Please note that the severity of all these changes and their persistence directly depend on the size of the focus and the nature of the stroke. Read more about the factors that play a major role in the development of ischemic stroke and the formation of its consequences.

Depression

Depression- another consequence of a stroke that can negate any efforts of a doctor and loved ones to restore lost functions. According to some reports, up to 80% of stroke survivors suffer from depression in varying degrees of severity. This is a rather serious consequence that can and should be treated.

In addition to the mood for recovery, an additional no less important “bonus” of eliminating depression will be an analgesic effect. It has long been proven that depression can exacerbate pain in a person, and with a stroke, pain is not uncommon. Prescribing antidepressants can help with this problem.

It is extremely important to prescribe the “correct” antidepressant, since some of them can cause an “inhibitory effect”, which in some cases can also reduce a person’s desire to follow the doctor’s recommendations and activate for better rehabilitation.

A stroke, the consequences of which remained after a course of treatment in a hospital, is a frequent phenomenon. Such people need a full-fledged rehabilitation course, which often begins already in the hospital. The rehabilitation course itself is prescribed individually, depending on the severity and persistence of the consequences, as well as on the time that has passed since the stroke and the general condition of the patient.

If the hospital failed to fully restore a person after a stroke, then further treatment is desirable to be carried out in a specialized rehabilitation center.

Read about an example of such a rehabilitation center in the article.