Stroke

Stroke

A stroke happens when the blood supply to part of the brain is interrupted or reduced. This prevents brain cells from receiving enough oxygen and nutrients, which can cause damage to the brain.

A stroke can affect movement, strength, balance, sensation, communication, vision, thinking and many other aspects of everyday life. The effects vary depending on which part of the brain has been affected and the size and location of the area involved.

A stroke is a medical emergency. If you think you or someone else is having a stroke, call 999 immediately.

What are the different types of stroke?

There are two main types of stroke:

• Ischaemic stroke: Caused by a blood clot or other blockage stopping blood from reaching part of the brain. This is the most common type of stroke.

• Haemorrhagic stroke: Caused when a blood vessel in or around the brain bursts, resulting in bleeding.

What is a TIA?

A transient ischaemic attack (TIA) happens when the blood supply to part of the brain is temporarily interrupted, causing stroke-like symptoms.

TIA symptoms can last for minutes or hours before disappearing. However, a TIA is a medical emergency and can be a warning sign that someone is at increased risk of having a stroke. It is important to seek urgent medical attention even if the symptoms have completely resolved.

What causes a stroke?

A stroke can happen to anyone, including younger people. There are several factors that can increase the risk of having a stroke.

These include:

• High blood pressure

• High cholesterol

• Diabetes

• Smoking

• Obesity or being overweight

• Certain heart conditions, including atrial fibrillation

• Family history of stroke

• Increasing age

• Previous TIA or stroke

An individual's risk depends on a combination of factors, and some risk factors cannot be changed.

How common is stroke in the UK?

Stroke is one of the UK's leading causes of disability.

The Stroke Association reports that around 100,000 people have a stroke each year in the UK, equivalent to approximately one stroke every five minutes. Around 1.3 million stroke survivors live in the UK.

These figures may change over time, so statistics should be reviewed periodically to ensure they remain accurate.

What are the symptoms of a stroke?

Stroke symptoms often happen suddenly. The main signs can be remembered using FAST:

• Face: Has one side of the face drooped? Can the person smile normally?

• Arms: Can they raise both arms and keep them there? Is there weakness in one arm?

• Speech: Is their speech slurred, unclear or difficult to understand?

• Time: If you notice any of these symptoms, call 999 immediately.

Other possible symptoms include:

• Sudden weakness or numbness, particularly on one side of the body

• Difficulty walking or sudden loss of balance

• Problems with coordination

• Changes in vision or sudden loss of sight

• Difficulty speaking or finding words

• Confusion or difficulty understanding speech

• Memory or concentration difficulties

• Dizziness or falling

• A sudden severe headache

• Nausea or vomiting

Stroke symptoms can sometimes improve or disappear after a short time. You should still seek emergency medical attention by calling 999, even if the symptoms have stopped.

How is a stroke diagnosed?

If a healthcare professional suspects a stroke, they will assess the person's symptoms and medical history and carry out a physical and neurological examination.

Tests may include:

• CT or MRI scans: To examine the brain and help identify the type of stroke.

• Blood tests: To check for factors that may affect treatment.

• ECG: To assess the heart's rhythm.

• Additional investigations: Such as scans of the blood vessels, where appropriate.

Accurate diagnosis is important because the type of stroke and its cause help determine the most appropriate treatment.

How is a stroke treated?

Treatment depends on the type of stroke, when it occurred and the individual's circumstances.

For an ischaemic stroke, treatment may include medication to dissolve a blood clot or a procedure to remove a clot in suitable patients. Haemorrhagic strokes may require different medical or surgical treatment.

Following initial treatment, rehabilitation becomes an important part of recovery. A multidisciplinary team may include doctors, nurses, physiotherapists, occupational therapists, speech and language therapists, psychologists and other healthcare professionals.

Recovery is different for everyone. Some people may recover within days or weeks, while others may continue to experience difficulties for months or years. Rehabilitation can support recovery and help people adapt to any longer-term changes.

How can physiotherapy help after a stroke?

Physiotherapy can play an important role throughout stroke rehabilitation. Treatment focuses on helping people improve or maintain movement and physical function, work towards meaningful goals and become as independent as possible.

A physiotherapy programme may include the following.

Movement retraining

Practising movements that are important to everyday life, such as rolling, sitting, standing, reaching, transferring and getting in and out of a chair.

Walking and gait rehabilitation

Assessing walking ability and working on gait, balance, strength and confidence to help people move more safely and efficiently.

Strength and fitness

Developing strength, cardiovascular fitness and endurance according to the individual's current ability, medical considerations and functional goals.

Balance and coordination

Using activities that challenge balance and postural control in different positions and during functional activities. Exercises may be adapted to the person's abilities and progress as their confidence and control improve.

Muscle tone management

Where appropriate, physiotherapy may include positioning, active movement, stretching and functional activities to help manage changes in muscle tone and maintain comfortable movement.

Upper limb rehabilitation

Encouraging use of the affected arm and hand through reaching, grasping and meaningful functional activities, where appropriate. Treatment can help people practise using their arm in everyday tasks.

Functional rehabilitation

Working towards activities that are meaningful to the individual, such as moving around the home, getting up from the floor, transferring between surfaces or returning to hobbies and other activities.

Fatigue management

Stroke-related fatigue can have a significant impact on everyday life. Physiotherapy may include education around pacing, activity management and gradually building physical capacity.

Pain and comfortable movement

Supporting comfortable movement through appropriate positioning, movement strategies and exercise where pain is affecting function.

Education and support

Providing individuals and their families or carers with information about movement, exercise, mobility and ways to support rehabilitation safely between sessions.

Specialist equipment at Positive Steps

At Positive Steps, we have a range of specialist rehabilitation equipment that can be incorporated into an individual's physiotherapy programme where appropriate. Equipment is selected according to the person's abilities, needs and goals and forms part of a wider programme of rehabilitation.

EzyGain Treadmill

The EzyGain treadmill can be used for supported walking practice and gait rehabilitation. It provides opportunities to work on walking speed, balance, coordination and confidence, as well as feedback on aspects of walking such as left-to-right symmetry.

MOTOmed

The MOTOmed can provide repetitive, assisted or active movement of the arms and/or legs. It can be incorporated into rehabilitation to encourage repetitive movement and active participation, support movement practice and provide opportunities to practise cycling movements when conventional exercise may be difficult.

Hypervibe

The Hypervibe uses whole-body vibration and may be incorporated into a rehabilitation programme where appropriate. Depending on the individual's needs and clinical suitability, it may be used alongside other exercises as part of a programme targeting muscle activation, strength, balance or weight-bearing activities.

BlazePods

BlazePods can be used to create interactive activities that challenge reaction time, coordination, balance, reaching and movement. These activities can make rehabilitation more engaging while working towards functional movement goals.

Hydrotherapy

Hydrotherapy can provide a supportive environment for some people following a stroke. The buoyancy of the water can reduce the amount of weight placed through the body, allowing individuals to practise movement, balance, strength and walking in a different environment. The resistance of the water can also be used to support strengthening and movement control.

Not every piece of equipment will be suitable or necessary for every individual. Our physiotherapists consider the person's needs, abilities, medical history and goals when choosing the most appropriate approaches to rehabilitation.

Can physiotherapy help with the long-term effects of stroke?

Yes. Physiotherapy can support people at different stages following a stroke, including those living with longer-term effects.

Rehabilitation may focus on improving or maintaining:

• Strength and physical fitness

• Balance and coordination

• Walking and mobility

• Upper and lower limb movement

• Functional skills

• Confidence with everyday activities

• Independence and participation

Goals can change over time. For some people, rehabilitation may focus on recovering a particular movement or skill. For others, the focus may be maintaining current abilities, preventing complications, improving physical fitness or finding new ways to complete meaningful activities.

How can Positive Steps help?

Every stroke is different, and the impact on everyday life can vary considerably from one person to another.

At Positive Steps, we work with each individual to understand how their stroke has affected them, what they would like to achieve and what is important to them.

We can develop an individualised physiotherapy programme focused on meaningful goals, whether that involves improving walking, developing strength and balance, using an affected arm, becoming more independent at home or returning to activities that are important to you.

Our approach is centred around what can be done and finding new ways to help people move, participate and thrive.

If you would like to find out more about how physiotherapy could support you or someone you care for following a stroke, please get in touch with the Positive Steps team.

Contact us

If you think you or someone else is having a stroke, do not wait to contact a physiotherapist or GP. Call 999 immediately.