There are physiotherapists and there are physiotherapists; and as the Bard in his wisdom once said, “a rose by any other name would smell as sweet”. While I agree in principle with the spirit of this declaration I do have differences with it in one regard, namely one cannot generalise. I say this with special reference to physiotherapists. I have by now been treated almost continuously by physiotherapists since early 2007 and can safely claim to be something of an authority on them.

Therefore, I beg to differ with the bard insofar as physiotherapists are concerned. They are not all the same. They may all have the same or similar qualifications but each one differs from the other and not only because they are individuals but also in their approach to treatment, behaviour and consequently results.

I have come across physiotherapists who consider their duty adequately performed if they are regular and punctual without paying any heed to the varying needs of their patients and with no evaluation of the results obtained. I remember one physiotherapist who would ask me to repeat exercises in exactly the same way as I had done previously with no thought whatsoever about the effect these exercises had on me or about any improvements – or lack of – that were achieved.

We must remember that ‘physiotherapy’ is a branch of medical treatment that relies heavily on the effort and commitment of both the patient and the practitioner. I dare say that this is also true of other branches of medicine but probably more so in this case, where the treatment operates jointly on the physical and mental level.

The inadequacies of my earlier physiotherapists became more apparent to me when I started treatment with my latest therapist. For the sake of convenience and anonymity I shall refer to her as “N.S.”

N.S. is a young slim and tall girl whose slender build belies her strength and it is this that separates her from run of the mill physiotherapists. This strength is not just a physical attribute but one that also aplies to her mind. Other features that distinguish her are:

• She extracts feedback from me on a regular basis
• Every day before she starts she asks me to demonstrate the exercises I have done on my own time – this keeps me on my toes
• She maintains a continuous flow of feedback to me on my performance and makes immediate corrections when I make mistakes
• She thinks beyond the day’s exercises and relates these, with my performance, to my daily life so that improvements are achieved. In other words her treatment is not isolated and removed from the everyday
• In addition she is lavish in giving positive and negative points where deserved
• She has a sense of humour which lightens the mood and makes the exercise a fun thing.

Thanks to her in the past several months my ability to walk has improved considerably and I have learnt to walk on different surfaces, including grass.

A compound found in soya beans and chickpeas could help stroke patients, research suggests.

A study into a dietary supplement containing isoflavone found it improved artery function in stroke patients.

Heart disease patients who had suffered a stroke caused by a blood clot were split into two groups, with one given isoflavone and the other a placebo.

Researchers measured the way the main artery in the arm dilated following an increase in blood flow, known as flow-mediated dilation (FMD). The greater the FMD, the better the artery is working.

The results showed the level of poor FMD was similar between the groups at the start, but after 12 weeks the FMD was ‘significantly greater’ in those taking isoflavone.

When reading this article in the health section of the Mail Online – http://www.dailymail.co.uk – I noticed that some commentators suggested that this was due to the ‘oestrogen effect’ in the soya/ chickpeas. Others reminded readers of the side-effects of increased stomach gases. However, I think an occasional – even weekly – dish of chickpeas, especially with chapattis and prepared Indian style may not be a bad idea. Anything to help improve circulation would surely be a good. Of course regularly trying to get up and get moving would be beneficial.

Ten Tips for Caregivers to Stroke Survivors
If your loved one just had a stroke, you (or a relative) will face the scary prospect of starting your on-the-job training as a new caregiver when he or she comes home from the hospital or stroke rehab center. It will be a long road filled with….
http://www.associatedcontent.comarticle/204495/ten_tips_for_caregivers_to_stroke_survivors.html

The biggest or hardest challenge a caregiver faces is—as the Serenity Prayer says—finding the courage to accept the things that cannot be changed, the courage to change the things that can be changed and the wisdom to tell the difference.©

The 23rd Psalm (Old Testament, The Bible)
The Lord is my Shepherd; I shall not want.
He maketh me to lie down in green pastures:
He leadeth me beside the still waters.
He restoreth my soul:
He leadeth me in the paths of righteousness for His name’ sake.

Yea, though I walk through the valley of the shadow of death,
I will fear no evil: For thou art with me;
Thy rod and thy staff, they comfort me.
Thou preparest a table before me in the presence of mine enemies;
Thou annointest my head with oil; My cup runneth over.

Surely goodness and mercy shall follow me all the days of my life,
and I will dwell in the House of the Lord forever.

Caring for the stroke victim’s hands

A stroke can cause a lack of sensation or movement in one or both hands. Fluids may pool in the hand because it is not being used. This can cause swelling, pain and skin problems. 

What can be done

• Support the arm on a lap tray with the hand in front, fingers opened and wrist supported
• Place foam wedges or arm supports to elevate the hand to reduce swelling
• Encourage the stroke victim to use his/her other hand to gently bend and open the fingers But if the hand is extremely contracted tight or spastic, don’t force it open. Gently stroke the back of the hand and wrist until the fingers start to open
• Do not squeeze soft balls. This causes the hand to close and the fingers to tighten

Foot care

A stroke often affects how the stroke victim walks, which can lead to problems with the feet.

 What can be done

• Check feet daily for cracks, blisters, sores, swelling or changes in skin colour. Tell the doctor or chiropodist if you notice any signs of infection such as redness, swelling or discharge.
• Always wear socks made of natural fibres (cotton or wool) to help absorb sweat and keep the feet cool and dry.
• Make sure shoes fit properly. They should be wide and deep enough but fit snugly at the heel. Shop for shoes at the end of the day when feet are naturally swollen and be sure to have both feet measured.
• Ideal shoes for anyone who has had a stroke is low heels, shock absorbing soles, laces or Velcro, deep rounded toe boxes and leather or canvas uppers.

Many people who have had a stroke need special footwear either for support or to fit braces or orthotics (devices that give extra support and help straighten your foot inside your shoe). Footwear advice and specialty items can be obtained from a chiropodist or stroke rehabilitation specialist.

adapted from www.heartandstroke.ca

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Pitfalls on the road to recovery
After the stroke one is totally helpless and dependent on others, as a result of which:
a) one is bathed, one is fed, one’s bottom is cleaned, in other words – oral and rectal needs are taken care of.
b) One is transported from one place to another without moving a finger (no puns intended)
c) No one gives you any responsibility or accountability. In other words large comfort zones are created both at the physical and emotional level. These comfort zones are very easily slipped into by the individual. I’ve carved a phrase for this phenomenon and call it the “infant syndrome”. One must beware of slipping into this enchanted island of sirens. It’s like quick sand and difficult to escape from.
d) Expenses have a tendency for a meteoric rise on all fronts. Hospital bills, surgery, fees, medicines, therapy before, during and after are massive!! With individual medicines costing in the range of IRS*.3000/- to IRS.7000/-. One has to be ready with the funds to meet the exorbitant costs.
e) There are times when one looks down the tunnel and sees no light at the end, one feels like giving up, especially, since the tunnel/road is dotted with instances of humiliation, discomfort and helplessness.

At a time like this even small criticisms are received with a heightened sensitivity. During this time I faced some personal criticism. At the time this is how I felt:
“Some people express the opinion that I am being pampered because my poor sisters came to me in Manipal (in South India) from different parts – one from Bahrain and the other from Kolkata (Calcutta). They also seem to think that I am very lucky – and in most ways I am – insofar that I have a wife who takes such good care of me and caters to my every need. Good family ties are not a matter of luck, they are to be worked upon; they don’t just happen. Also I don’t think that giving help and assistance to a person incapable of doing anything for himself would come under the heading of being pampered. I would gladly give up all this in exchange for even a small degree of normalcy, and pampering be damned. A stroke is not a minor occurrence it alters the course of our lives.”
(*Indian Rupees)

Stroke Warning Signs

If you notice one or more of these signs, don’t wait. Stroke is a medical emergency. Call 9-1-1 or your emergency medical services. Get to a hospital right away! The American Stroke Association wants you to learn the warning signs of stroke:

How physiotherapy works

Having a stroke can have a serious impact on movement, sensation, balance and co-ordination and the aim of physiotherapy is to help regain as many of these abilities as possible. The severity of the stroke will dictate how much recovery is possible, but physiotherapy works to maximise potential recovery.

Normally a stroke affects one side of the body and the affected side will often feel weak and heavy, which makes it more difficult for the person to move.

In order to compensate for the weaker side, the stronger side becomes dominant and overactive to compensate for the weaker side. This means that a person who has had a stroke will tend to rely heavily on the stronger side of their body.

A physiotherapist will assess the alignment and activity of various body parts, and the physiotherapy treatment will focus on getting the side affected by the stroke to move more effectively.

Every person who has had a stroke has different degrees of difficulty in the activities of daily living. Physiotherapy will address the particular problems at the time of treatment. Generally the aim will be to help with mobility and balance.

If the stroke is severe, this could mean helping with getting from bed to chair or on and off the toilet. If the stroke is mild and the person young and previously fit, this could mean help with running and jumping, and returning to sport

The recovery of movement is most marked in the first 3 months following a stroke but it is our experience that progress can still be made many years after a stroke. The degree of recovery depends on many factors, the most important being the severity of damage caused to the brain by the stroke.

Individual assessment and treatment is the best way to plan physiotherapy to help with specific problems.

source:http://www.physiotherapy-for-strokes.co.uk