Role of Rehabilitation in Stroke
Author: DR. N K VENKATARAMANA, Senior Consultant
Stroke is a condition that stops or reduces blood supply suddenly to a part or total area brain resulting in a sudden loss of body function. The extent of loss of function depends directly on the area of the brain affected. Though the brain has the ability to repair the entire body very precisely, it fails to do the same when it comes to its own repair. On the other hand, several reactions in response to brain damage like swelling and inflammation can damage the brain further and hamper the repair process. Therefore, regardless of the treatment method in the severe brain damage recovery process, it can start only after all these acute reactions have settled. Even after that, the recovery and repair speed is so dismally slow, doubting all the existing faiths. Nevertheless, phenomenal recovery can take place when the right things come together at the right time. The remaining will be compensated through plasticity.
While we put every possible effort to enhance the repair qualitatively and quantitatively, the connectivity between body and brain takes a long time to resume the full function with quality. Meanwhile, it is essential that the body is maintained in the interval time fit enough to receive the neural signals. Essentially, the nerves’ function is to move the muscles across the joints, using the ligaments as control. By the time the nerve regains its capacity to propagate the right signals from the brain, it takes sufficient time.
Meanwhile, if the muscle and joint are not maintained properly, the nerve will not have any utility despite its successful reactivation. Normally unused muscles will disintegrate (atrophy), and the joints will become stiff (frozen joints), making the nerve function recovery totally futile. Therefore, rehabilitation has an important role to play in overall functional recovery in any long-standing illness of the nervous system, particularly the stroke. By this process, all the muscles and joints are kept in the right shape to take on as soon as the brain signals get rewired.
In addition, constant Physiotherapy also sends signals from the body to the brain encouraging its growth and regeneration. There is ample evidence now that the rehabilitation process should start as soon as possible and continue till a reasonable level of independence is achieved. This will also prevent several other complications like pain, stiffness, shortening of the limb, deformity of limb, eventually contributing to the overall quality of recovery. It is also important that this should be adopted as many times in a day as possible to sustain the benefit. Generally, people do Physiotherapy for one hour a day and the rest for 23 hours in an idle mode. This will not lead them anywhere unless the actions are repeated as often as possible.
Later on, it should be combined and integrated with the day-to-day activities of life. Though the actions look very rough and crude with perseverance, it gets refined quickly. Persistent effort should continue till one achieves perfection in every movement. Then only they can regain their body functions fully with total recovery. This needs determination, effort, perseverance, patience and constant motivation. Emotional balance ultimately plays a significant role in the overall recovery and regaining the original abilities. Allowed addresses all these components systematically through a well-defined process, path and professionalism.