Physiotherapist's Guide to Peroneal Tendinopathy (2023)

Bis 22.06.20 22. June 2020

Stroke (when a blood vessel in the brain becomes blocked or ruptured) is the third leading cause of death in the United States and a leading cause of serious long-term disability in adults. Stroke can strike anyone at any time, regardless of race, gender, or even age, but more women than men suffer a stroke each year, and African Americans are almost twice as likely to have a first stroke as Caucasians. About two-thirds of people who suffer a stroke are over 65 years old. Nearly 800,000 people in the United States suffer a stroke each year. Physical therapists treat people who have had a stroke to restore their ability to move and walk, reduce their disability, and improve their quality of life. If you have one or more of the following symptoms, call 911 or emergency medical services (EMS) immediately to send an ambulance: Sudden numbness or weakness in your face, arm, or leg, especially on one side of your body. Sudden confusion or difficulty speaking or understanding Sudden blurred vision in one or both eyes Sudden difficulty walking, dizziness, loss of balance or coordination Sudden severe headache with no known cause If you think someone may be having a stroke Act FAST! Emergency treatment with a blood-thinning drug called t-PA can help reduce or even eliminate stroke problems, but it must be administered within 3 hours of the onset of symptoms. Recognizing the symptoms can be easy if you remember to follow F.A.S.T. F=face. Ask the person to smile. Do you have sagging on one side of your face? A=arms. Ask the person to raise both arms. Do you have a downtrend arm? S=talk. Ask the person to repeat a simple phrase. Does the speech sound slurred or strange? T=time. If you see any of these signs, call 911 and write down the time you think the stroke started. Research shows that people with stroke who come to the hospital by ambulance receive treatment faster than those who arrive alone. What is a stroke? Stroke is a term used when a blood vessel in the brain becomes blocked (65% of all strokes) or ruptures. It is also known as a cerebrovascular accident (CVA). When blood flow stops or is disrupted, part of the brain doesn't get enough oxygen. Millions of brain cells die every minute during a stroke, increasing the risk of permanent brain damage, disability or death. An ischemic stroke, the most common type, occurs when a blood vessel becomes blocked. A common cause of a blockage is a blood clot, or a build-up of fatty deposits (atherosclerosis) in the blood vessels that supply the brain. A hemorrhagic stroke occurs when a blood vessel leaks or ruptures due to a weakened region of a vessel or in an area of ​​the brain with a group of abnormally shaped vessels. Signs and Symptoms If you have a stroke you may: feel sudden numbness or weakness in your face, arm or leg, especially on one side of your body. Being confused about where you are or what you are doing. have trouble speaking. or understand what others say. You have difficulty seeing with one or both eyes. You have difficulty walking, you get dizzy or lose your balance. You suddenly have a severe headache that seems to come out of nowhere. Some people experience a transient ischemic attack (TIA). , a "mini-stroke" that causes symptoms similar to those of a stroke, but with no lasting damage because blood flow is disrupted for only a short time. Recognizing and treating TIAs can reduce the risk of a major stroke. A stroke can cause a variety of long-term problems, such as Body Intermittent deafness Loss or lack of sensation Sensitivity to cold temperatures Memory loss Speech slowly or slurred Difficulty remembering words How is it diagnosed? Doctors or emergency medical personnel assess a stroke based on signs and symptoms. A stroke is often confirmed by examining the patient, clinical tests, and imaging of the brain, usually with a CT or MRI scan. Because research has shown that early treatment can lessen the effects of stroke and save lives, efforts are being made to move people suspected of having a stroke to the hospital stroke unit instead of the stroke unit. Doctors can use a classification system called TOAST to determine the type of stroke so treatment can begin quickly. How can a physical therapist help? Physiotherapists are part of the stroke rehabilitation team. Rehabilitation begins very soon after a stroke; Your physical therapist's primary goal is to help you resume activity at home, at work, and in your community. After examining and assessing your condition, your physical therapist will develop a customized plan to help you achieve the best possible quality of life. The plan focuses on your ability to move, any pain you may have, and ways to prevent problems that may arise after a stroke. One of the first things your physical therapist will teach you is how to safely move from your bed to a chair and perform bed exercises. As you become more mobile, your physical therapist will teach you strengthening exercises and functional activities. Later, your physical therapist will: Help you improve your balance and walk. Equip him with a wheelchair if necessary. Offer training to your family and caregivers. Train on devices that can help you stay mobile if a stroke has affected your ability to move, walk, or balance: orthotics, prosthetics, canes, walkers, wheelchairs, and maybe even robots. The treatment of a stroke is different. Your specific treatment will depend on the results of your physical therapist's evaluation and how long it has been since your stroke. Stroke recovery depends on the size and location of the stroke, how quickly you were treated, and your other medical conditions. Your physical therapist will help you regain your functional ability so you can participate in the specific activities of your life. Relearn how to use your upper body, how to walk, and how to perform daily activities. Your physiotherapist will create an exercise and strengthening program based on the tasks you need to complete each day and choose from a variety of treatments. Physical therapist researchers are at the forefront of innovating many of these techniques: Constraint Induced Movement Therapy (CIMT). CIMT is used to strengthen an arm affected by a stroke. Your physical therapist will place a mitt or sling on your strong arm to prevent full use of it. This limitation "forces" you to use your stroke-affected arm or hand to complete daily tasks, which helps build your strength and control. CIMT requires the constraint to be used multiple hours a day, multiple days a week to be successful. Functional electrical stimulation (FES). This treatment helps move muscles when they are very weak. For example, your physical therapist might use FES to treat a painful or stiff shoulder. Motor imagination and mental training. These tools are used to strengthen the arms, hands, feet and legs. Working with your physical therapist, you "rehearse" a movement without actually performing it, which stimulates the part of your brain that controls the movement. Positioning. Proper position helps reduce muscle pain, spasms, slowness, or stiffness that can result from a stroke. Your physical therapist will teach you how to safely move ("transfer") from a seated to a standing position and how to use foam wedges, slings, and other supports to support yourself while sitting or lying down. Virtual reality and interactive video games can be used to provide reality-like experiences. With a keyboard and mouse, a special wired glove, or sensors attached to your body, you can practice daily tasks while your therapist helps you rewire your brain and nerve connections. Your therapist can teach you how to continue these activities at home. Partial Bodyweight Support (BWS). BWS is used to help you walk, usually on a treadmill. Your physical therapist will gradually decrease the support as your posture, strength, balance, and coordination improve. biofeedback. This treatment will help you become more aware of how your muscles work and how you can better control them. Your therapist places electrodes on your skin to provide measurements of muscle activity, which are displayed on a monitor. Your physical therapist will work with you to help you understand and change these readings. Your needs will change over time, and your physical therapist may consider using water therapy, robotics, or assistive devices to aid in your recovery. Even after completing rehabilitation at a center, your physiotherapist will continue to see you as needed to assess your progress, update your exercise program, prevent further problems, and encourage as many healthy lifestyles as possible. ., the official consumer website of the American Physical Therapy Association, © 2017


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