After experiencing a stroke, many people are unsure of how their day-to-day life will look. On top of financial burdens, doctor visits, and therapy sessions, patients often face emotional, physical, and cognitive changes. 

Post-Stroke Challenges


After experiencing a stroke, many people are unsure of how their day-to-day life
will look. On top of financial burdens, doctor visits, and therapy sessions,
patients often face emotional, physical, and cognitive changes. Learning how to
address these sudden life changes is pivotal to gaining both physical and mental
independence.

What to Expect
While each scenario differs, it is common to see physical, cognitive, and
behavioral differences post-stroke. Some common physical changes involve
weakness, stiffness, and numbness. Emotional challenges also arise due to
physical changes to the brain. Cognitive thinking and memory difficulties are
common due to brain damage as well.

Physical Conditions
> 


Having a stroke can result in varying levels of physical disabilities. It is
possible to regain mobility and independence through therapy and other treatment
options.
Some of the most prevalent physical effects of stroke include:

 * Fatigue
   
   
 * Foot Drop
   
    * What is Foot Drop: The inability to lift the front of the foot is a
      condition known as Foot Drop. Following a stroke, it is common for some
      patients to experience changes in the muscle tone in their legs or feet.
      This can cause a decrease in coordination or strength which results in the
      inability to flex the ankle or lift the forefoot.
      
      
    * This causes the person to drag their toes when walking or to lift the knee
      higher to compensate for the foot. This condition can occur in one or both
      feet. Through rehabilitation, patients can often make partial or full
      recoveries.
      
      
    * Treatment Options: If a stroke survivor is experiencing foot drop, they
      should begin rehabilitation immediately. If the condition remains
      untreated, it can lead to permanent gait abnormalities, postural
      deformities, increased fall risk, and further injury to the foot or leg.
      
      If a patient has foot drop, it is critical for them to wear a foot drop
      brace at all times. Without a brace, the risk of falling is much greater.
      A foot brace will help to maintain foot dorsiflexion and prevent the foot
      from inverting while walking. Physical therapy can help to strengthen the
      weakened muscles over time. Electrical stimulation is also an option for
      treating foot drop. Consulting with your medical professional can help you
      explore different treatment options to learn which combinations will work
      best for you.
      
      
    * You can read more about the benefits of a foot drop brace here - What
      does
      a Foot Drop Brace do?
      [https://home.neofect.com/blog/what-does-a-drop-foot-brace-do]
      
      
    * You can read more about foot drop here: What is Foot Drop?
      [https://home.neofect.com/blog/what-is-foot-drop]
      
      
   
   
 * Hemiparesis
   
   
    * What is Hemiparesis: One of the most common physical conditions, impacting
      8 out of 10 stroke survivors, is hemiparesis. Hemiparesis is one-sided,
      “hemi” muscle weakness, “paresis”. The condition varies greatly in
      severity and location. Hemiparesis frequently limits patients’ ability to
      complete everyday tasks like dressing themselves, eating, and using the
      bathroom since the one-sided weakness greatly impacts an individual’s
      ability to balance, walk, and grasp objects. It also reduces your
      coordination capabilities and fine motor skills and leads to frequent
      muscle fatigue.
      
      
    * The location of the stroke in the brain will indicate which side of the
      body is affected. Because of the contralateral relationship between the
      brain and the body, if a patient has a stroke in the right side of their
      brain, they will often experience hemiparesis on the left side of the body
      and vice versa.
      
      
   
   
 * A condition known as hemiplegia also occurs as a result of spinal cord
   injuries or traumatic brain injuries. Hemiplegia, however, results in
   complete paralysis on one side of the body. Overtime, patients may regain
   sensation. Stroke is the leading cause of both hemiplegia and hemiparesis. 
   Learn more about hemiplegia and hemiparesis.
   [https://home.neofect.com/blog/hemiplegia-vs-hemiparesis]
   
    * Hemiparesis Rehabilitation Options: With hemiparesis, there is the
      potential to regain strength, mobility, and independence through
      rehabilitation. Through therapy sessions with an occupational therapist or
      physical therapist, many patients have made significant recoveries
      following their stroke. Your therapist may implement several different
      types of therapy to aid in your recovery.
      Some of the most common treatment options include:
      
       * Modified constraint-induced therapy (mCIT) - mCIT restrengthens the
         weaker side of the body by constraining, and therefore reducing, the
         use of the unaffected side of the body. This forces the patient to use
         their weaker side instead of constantly allowing the other side to take
         over.
       * Cortical stimulation - During cortical stimulation, a small electrode
         is placed on the membrane covering the brain, and electrical
         stimulation is applied during rehabilitation exercises.
       * Imagery - When a patient imagines the affected body part moving while
         completing exercises, it triggers the brain and muscles to think the
         affected body part is moving, even if it isn’t. Mirror Therapy
         [https://home.neofect.com/blog/stroke-exercises-using-mirror-therapy-and-mirror-neurons] 
         is a commonly practiced application of imagery.
       * Electrical stimulation - Electrical stimulation can be used directly on
         the affected body part to improve range of motion and help target the
         muscle to improve strength.
       * Assistive Devices - Your physician or therapist may also recommend a
         device such as a brace, walker, cane, or wheelchair to assist with safe
         mobility. The devices can also help promote strength and movement. The
         fit and maintenance of these devices should be monitored by your
         medical professional in order to ensure safe use.
       * Home rehab - Home rehabilitation is commonly requested by therapists in
         the case of children with hemiparesis. To learn more about devices,
         exercises, and useful tips for home rehab for children with
         hemiparesis, read these helpful posts from our occupational therapists. * 
            Stroke Rehab Toys for Children with Hemiparesis
            [https://home.neofect.com/blog/toys-also-stroke-rehab-toys-for-children-with-hemiparesis]
          * 
            Hemiparesis in Children: Pitfalls and Rehabilitation Solutions from
            an Occupational Therapist.
            [https://home.neofect.com/blog/hemiparesi-in-children-pitfalls-rehabilitation-solutions-from-occupational-therapist]
            Back to School: Keeping up with your Child’s Hemiparesis Exercises
            [https://home.neofect.com/blog/back-to-school-keeping-up-with-your-childs-hemiparesis-exercises]
         
         
      
      
   
   
 * Paralysis
   
    * 9 out of 10 stroke survivors will experience some form of paralysis
      immediately following the event. Through therapy, patients often regain
      varying degrees of movement. After the brain is damaged from the stroke,
      the signals sent to your muscles are often not received. Paralysis can
      occur anywhere in the body. Hemiplegia
      [https://home.neofect.com/blog/hemiplegia-vs-hemiparesis] is paralysis
      occurring on one side of the body. On rare occasions, a stroke results in
      “locked-in” paralysis for the survivor. In this case, the survivor's body
      is completely paralyzed with the exception of their eyes.
   
   
 * Spasticity
   
   



 * Spasticity results from post-stroke brain damage preventing proper signal
   translation from the brain to your muscles. This results in muscle cramps and
   spasms. This leads to difficulties in everyday activities.
   
    * Treatment Options: There are a variety of options available for treating
      spasticity. As always, check with your healthcare professional before
      initiating any treatments.
      
       * Movement - Any form of movement often helps with spasticity. The degree
         and strenuousness often depends on an individual’s case.
         
         
       * Exercises - Certain exercises are often prescribed as a form of
         treatment for spasticity. Spasticity usually decreases a person’s range
         of motion, and exercising is a great way to combat that.
         
         
       * Stretching - Stretching, much like exercising, helps with mobility in
         the affected muscles.
         Equipment like the NEOFECT Hand Extender assists with stretching and
         minimizing spasticity.
         
         
       * Braces - To control spasms in the affected limb, a brace may sometimes
         be used.
         
         
       * Surgery - Performing surgery on the afflicted muscles or tendons and
         joints can help people regain mobility and decrease pain.
         
         
       * Medications - Ask your doctor about available medications to treat
         spasticity.
         
         
       * Injections - Injections like botulinum toxin (Botox) work by blocking
         the chemicals that cause tight muscles.
         Learn more about Spasticity.
         [https://home.neofect.com/blog/how-to-improve-spasticity-spinal-cord-injury]
         
         
      
      
   
   

Emotional Changes


Not all changes after a stroke or TBI are visible. Some hidden effects come in
the form of emotional changes. Some people may experience varying emotions such
as frustration, sadness, anger, sense of loss, anxiety, and fear. Many people
even experience post-stroke depression. All of these changes are normal to
experience after such a traumatic, unexpected event. These changes occur not
only as a result of how the patient feels about the stroke itself but also due
to damage to the brain. If anything feels abnormal, always be sure to address
your concerns with your healthcare professional.

Depression in varying degrees is common post-stroke with more than 1/3 of
survivors experiencing some form of depression. Depression post-stroke is also
underdiagnosed, meaning its highly likely that this percentage is even greater.

Common symptoms of depression include anger, anxiety, frustration, sadness,
hopelessness, and fear. Depression can also lead to suicidal thoughts.

 * Symptoms: Symptoms of depression vary in intensity and prominence. * 
      Persistent sad, hopeless, anxious feelings
    * 
      Disrupted sleep
    * Change
      in eating patterns
    * Social
      withdrawal
    * Fatigue
    * 
      Irritability
    * Feelings
      of hopelessness or worthlessness
    * 
      Difficulty concentrating
    * Suicidal
      thoughts
   
   

Depression can occur any time and some survivors experience it weeks, months, or
even years post-stroke. Not only can depression impact your quality of life, it
can slow down or even halt your recovery progress. Depression can also worsen
other post-stroke conditions if not treated.

 * Treatment Options: Always consult your healthcare provider to discuss your
   options. * Medication - Antidepressants are a common treatment option for people with
      depression. Antidepressants react with the chemicals in your brain to help
      improve mood.
    * Mental health therapy - Therapy provided by a psychiatrist is often
      coupled with antidepressants to help improve mental health.
   
   

Pseudobulbar affect (PBA) is an extremely common emotional change following a
stroke. It is reported that up to half of all stroke survivors experience PBA at
some point following the event. PBA is characterized by an outburst of
uncontrollable laughter or crying. These outbursts are sudden and occur
unexpectedly, even in inappropriate social situations, making the event very
embarrassing for the survivor.

 * Only your medical professional can diagnose PBA. Due to similar symptoms, PBA
   is often misdiagnosed as depression. Without proper diagnosis, it is hard to
   get help. Consult your physician about diagnosis and treatment.

It is important to know these that emotional and behavioral changes following a
stroke are not permanent, as this can often be difficult for both the stroke
survivor and their loved ones to remember. Learn more about Emotional and
Behavioral Challenges needing Stroke Victim Support.
[https://home.neofect.com/blog/emotional-behavioral-challenges-needing-stroke-victim-support]

Cognitive Challenges
> 


In some patients, there is an affect on cognitive capabilities. Memory,
retention, and recognition can all be impacted. Adjusting to these changes can
be hard, but there are strategies, tips, and treatments that can help improve
and restore cognitive capabilities.

Aphasia: A common symptom as a result of a stroke is communication difficulties.
While aphasia appears in varying degrees, it is characterized by a difficulty
understanding others, reading and writing, and finding proper words to express
yourself. Aphasia is a result of the damage to the brain caused by the stroke
and is more common in adults than younger survivors.

There are several different varieties of aphasia. While every individual has
their own unique case, the different types of aphasia are typically divided into 
four categories: expressive aphasia, receptive aphasia, global aphasia, and
anomic/amnesia aphasia. Each form can appear in mild or severe cases.

Expressive aphasia is when a person knows what they want to say but are having
trouble finding the words to say it.

Receptive aphasia is when a person has difficulty understanding and
comprehending speech or written text.

Global aphasia impacts all areas of speech and comprehension. The damage to the
brain and communication centers is severe, leaving the survivor unable to speak,
comprehend speech, read, or write. Global aphasia is the most severe form of
aphasia.

Anomic/amnesia aphasia is when people have difficulties remembering the correct
term for people, places, or items. This is the least severe form of aphasia.

 * How to treat aphasia: Fortunately, it is possible for patients to make a full
   recovery from aphasia. The most popular treatment option for aphasia is
   speech therapy. Different techniques and exercises can be implemented
   depending on each person’s case. Other treatment options like, art therapy,
   melodic intonation therapy, visual speech perception therapy,
   constraint-induced language therapy, group therapy, and support groups have
   also been successful forms of aphasia treatment. Prescription medication is
   occasionally used alongside other therapies as well.
 * Continuing to use therapy methods and incorporating your practices into your
   daily life can help reinforce progress from professional speech therapy. Some
   activities include: playing word games, solving crossword puzzles, reading or
   singing aloud, practicing writing for grocery lists or on cards to family
   members and friends.
 * Supporting survivors with aphasia: Finding creative ways to ease
   communication with survivors with aphasia is very important. Using props such
   as photos or maps can help facilitate conversation. Speaking clearly and
   slowly or drawing pictures or using written words can help as well. When
   communicating with someone with aphasia it is always important to remember to
   be patient. Aphasia usually does not affect thinking, only communicative
   skills. Therefore, it is important to always treat the person with aphasia as
   an intelligent person. Be creative and patient! Aphasia can greatly impact
   social interactions and can be frustrating, especially for the survivor.

Memory Loss: Around 1/3 of stroke patients will experience some degree of memory
problems. In older patients, memory loss commonly appears in the form of
dementia, which can be debilitating.


 * Types of Memory Loss: There are four main types of memory loss: verbal,
   visual, informational, and vascular dementia. For people who experience 
   verbal memory loss, they have trouble recalling names and stories. With 
   visual memory loss, people experience difficulties remembering routes, things
   they’ve seen, shapes, and faces. Informational memory loss leads to
   difficulties recalling old and learning new skills or information. Vascular
   dementia impacts an individual’s thinking and cognitive abilities.
   
   
 * How to Manage Memory Loss: These simple tips can help make memory loss
   manageable.
   
    * Create a routine. Creating a specific sequence or timeline for your daily
      activities can be beneficial to memory loss. Post activities and special
      days on a calendar to keep track of upcoming events.
    * Keep it simple. Breaking down your to-do list into a step-by-step process
      can make big things more manageable.
    * Write things down. Use a notebook to keep yourself organized.
    * Leave yourself instructions around the house. Leaving instructions for
      common tasks such as cooking can be very helpful.
    * Have a home for everything. Designate a spot for all of your items and
      make sure to put them away when you finish using them.
   
   

Find more tools and resources for stroke management.
[http://home.neofect.com/blog/stroke-management]