Know the warning signs of a stroke - think "FAST"
Face: Ask the person to smile. Does one side of the face droop?
Arm: Ask the person to raise both arms. Does one arm drift downward?
Speech: Ask the person to repeat a simple sentence. Does the speech sound slurred or
strange?
Time: If you observe any of these signs, it's time to call 9-1-1 or get to the nearest
stroke center or hospital.
FACTS ABOUT STROKE
Stroke is the third leading cause of death in the United States and in Nebraska. It is also one of the leading causes of adult disability.
A stroke occurs when a blood vessel to the brain is either blocked by a clot or bursts. As a result, part of the brain does not get the blood it needs and begins to die. The longer the blood flow is cut off to the brain, the greater the damage.
ACT FAST
Stroke is a medical emergency. Every minute counts when someone is having a stroke. Go to the emergency room immediately when any of the signs of stroke are noticed or suspected. Immediate treatment can save someone’s life and prevent or reduce disability.
Reducing Stroke Risk
Everyone has some stroke risk. A few stroke risk factors are beyond your control, such as being over age 55, being a male, being an African-American, having diabetes, and having a family history of stroke. If you have one of these risk factors, it is even more important that you learn about the lifestyle and medical changes you can make to prevent a stroke.
Medical stroke risk factors include:
Previous stroke, previous episode of transient ischemic attack (TIA) or mini stroke, high cholesterol, high blood pressure, heart disease, atrial fibrillation and carotid artery disease. These medical risk factors can be controlled. Talk with your doctor about what will work best for you.
Lifestyle stroke risk factors include:
Smoking, being overweight and drinking too much alcohol. You can control these lifestyle risk factors by quitting smoking, exercising regularly, watching what and how much you eat and limiting alcohol consumption.
National Stroke Association's Stroke Prevention Guidelines
1. Know your blood pressure. If it is elevated, work with your doctor to keep it under control. High blood pressure is a leading cause of stroke. Have your blood pressure checked at least once each year – more often if you have a history of high blood pressure.
2. Find out if you have atrial fibrillation (AF). If you have AF, work with your doctor to manage it. Atrial fibrillation can cause blood to collect in the chambers of your heart. This blood can form clots and cause a stroke. Your doctor can detect AF by carefully checking your pulse.
3. If you smoke, stop. Smoking doubles the risk for stroke. If you stop smoking today, your risk for stroke will begin to decrease.
4. If you drink alcohol, do so in moderation. Having one drink each day may lower your risk for stroke (provided that there is no other medical reason you should avoid alcohol). Remember that alcohol is a drug - it can interact with other drugs you are taking, and alcohol is harmful if taken in large doses. If you don't drink, don't start.
5. Know your cholesterol number. If it is high, work with your doctor to control it. Lowering your cholesterol may reduce your risk for stroke. High cholesterol can also indirectly increase stroke risk by putting you at greater risk of heart disease - an important stroke risk factor. Often times, high cholesterol can be controlled with diet and exercise; some individuals may require medication.
6. Control your diabetes. If you are diabetic, follow your doctor's recommendations carefully. Having diabetes puts you at an increased risk for stroke. Your doctor can prescribe a nutrition program, lifestyle changes and medicine that can help control your diabetes.
7. Include exercise in the activities you enjoy in your daily routine. A brisk walk, swim or other exercise activity for as little as 30 minutes a day can improve your health in many ways, and may reduce your risk for stroke.
8. Enjoy a lower sodium (salt), lower fat diet. By cutting down on sodium and fat in your diet, you may be able to lower your blood pressure and, most importantly, lower your risk for stroke.
9. Ask your doctor if you have circulation problems. If so, work with your doctor to control them. Fatty deposits can block the arteries which carry blood from your heart to your brain. Sickle cell disease, severe anemia, or other diseases can cause stroke if left untreated.
10. If you have any stroke symptoms, seek immediate medical attention. For more information on stroke please visit:
www.stroke.org
http://nihseniorhealth.gov/stroke/toc.html
www.ninds.nih.gov
www.americanstroke.org
www.stroke.org
www.nebraskastroke.org
www.strikeoutstroke.org
www.strokeassociation.org
Resources for Patients and Families
National Resources:
- National Stroke Association www.stroke.org 1-800-STROKES (1-800-787-6537)
- American Stroke Association www.strokeassociation.org 1-888-4STROKE (1-888-478-7653)
- American Heart Association www.americanheart.org 1-800-242-8721
- Medicare www.medicare.gov
Nebraska:
- Nebraska State Stroke Association www.nebraskastroke.org 1-888-808-5678
- League of Human Dignity www.leagueofhumandignity.com (402) 441-7871 (Lincoln)
- Central NE Independent Living www.cilne.org
- Nebraska Medicaid www.hhs.state.ne.us/med/medindex.htm
- Vocational Rehab www.vocrehab.state.ne.us/
- Answers for Families www.answers4families.org
Support Groups:
Madonna Stroke Support Group
4th Thursday of every month (1:00-2:00 p.m.)
Madonna Rehabilitation Hospital-Flanagan Room
Contact person: Carol Olson (486-8467)
Stroke Support Group at Brentwood Estates-Lincoln
3rd Tuesday of every month at 7:00 p.m.
Contact for more info: Kathy Schildt at Nebraska State Stroke Association
(1-888-808-5678)
Caregiver Support Group
2nd Thursday of every month at 7:00 p.m.
Madonna Rehabilitation Hospital
Contact person: Jody Luzum (580-0994)
Terminology related to diagnosis/treatment of stroke:
- Ankle Foot Orthosis (AFO)- brace used to prevent/control foot drop during swing phase of gait in patients with hemiparesis following stroke, spinal cord injury or brain injury
- Aphasia- a language disorder that results in impairment in the comprehension and/or formulation of language and can affect both the spoken and written modalities. Aphasia is usually acquired as a result of stroke, brain injury or brain tumor. It can be classified into several types commonly referred to as expressive, receptive, and global aphasia.
- Receptive aphasia- primary deficits relate to comprehension of language
- Expressive aphasia- primary deficits relate to formulation of language
- Global aphasia- both comprehension and formulation of language are impaired
- Apraxia- the inability to plan or execute a movement to function or participate in an activity
- Apraxia of speech- a motor speech disorder caused by disturbance in motor planning or programming of sequential movement for volitional speech production
- Aspiration- penetration of food or liquids into the airway below the level of the vocal folds before, during or after swallowing
- Cognition- the thought process combining sensory function, learning, and the ability to choose an effective response; knowing, thinking, learning and judging
- Contraversive pushing (pusher syndrome)- characterized by active pushing of the non-affected limb towards the affected limb, resulting in loss of postural control/balance and inability to maintain midline or upright posture.
- Dysarthria- weakness or altered neuronal control of the muscles responsible for speech production or defective sensory feedback regarding their movement
- Dysphagia- impairment in the ability to swallow
- Fiberoptic Endoscopic Evaluation of Swallow (FEES)- a functional, diagnostic test of deglutition in which a contrast dye, a flexible endoscopic catheter (inserted nasogastrically), a light source, and an air source (which is used to test sensation of the cricopharyngeal region) connected to a video camera to test and document the oropharyngeal phase of swallow reflex.
- Functional Electrical Stimulation (FES)- involves the use of electrical stimulation to elicit a muscle contraction that translates into a functional activity (eg. walking or performing upper extremity task)
- Hemianopsia (visual field cut) - vision loss (blindness) in one half of the visual field; may involve a portion of the visual field of each eye
- Hemiparesis- weakness on one half of the body
- Hypertonia- abnormally increased muscle tone
- Hypotonia- abnormally decreased muscle tone
- Insight- the ability to foresee and comprehend implications of actions on circumstances; the extent to which an individual accurately judges his/her strengths and weaknesses
- Kinesio Taping- The Kinesio Taping Method is used for patients with neurologic conditions (CVA, SCI, TBI) to improve muscle contraction of weakened muscles, reduce muscle spasm and hypertonicity, increase ROM, and provide proprioeptive feedback and muscle re-education to involved muscle groups.
- Motor control- control of movement and posture
- Neuro-Developmental Treatment- A "problem solving" approach which involves the treatment of movement dysfunction in patients with CNS disorders such as stroke. Therapists identify each patient’s impairments causing ineffective movement patterns and use direct handling and facilitation to improve movement strategies used during functional tasks. Active participation by the patient is key to this approach.
- NPO- "nothing by mouth"
- Orthotic device- an external appliance that supports a paralyzed muscle, promotes a certain motion, or corrects a deformity
- Postural control- the ability to control the body's position in space for stability and orientation
- Proprioception- refers to the unconscious awareness of one's position of joints or limbs in space
- Sensation- the ability to identify the sensory stimuli, where it is located, and how intense the stimuli is
- Spasticity- a type of hypertonicity that is velocity dependent; attributed to hyperactive stretch reflexes mediated through muscles spindle stretch receptors
- Unilateral spatial neglect- unawareness of an entire area of space (usually the hemiparetic side) due to deficits in visual awareness and perception
- Visual attention- the ability to attend visually to elements in the environment including the ability to select objects that demand attention and to focus on them appropriately
- Visual perception- the ability to extract and organize visual information from the environment and integrate it with the information from other sensory modalities and higher cognitive functions
NESS H200 (by Bioness Inc.)- a neuroprosthetic device used to improve hand function and voluntary movement in patients with upper extremity hemiparesis or paralysis due to stroke, spinal cord injury or brain injury. It consists of 5 surface electrodes within the device used to stimulate and activate the muscles of the hand. The device is used to assist patients with grasping and releasing objects and for activities of daily living (ADLs).
NESS L300 (by Bioness Inc.)- a neuroprosthetic device used to prevent foot drop during gait for patients with hemiparesis due to stroke, incomplete spinal cord injury or brain injury. It consists of a small wireless gait sensor, a leg cuff and a hand-held control unit. The leg cuff sits just below the knee and contains a stimulation unit and electrodes. When the heel comes off the ground, wireless signals from the gait sensor are sent to the stimulation unit in the leg cuff which stimulates the muscles to contract and lift the patient's foot while walking.
Body Weight Support Treadmill Training (BWSTT)-
Body weight supported treadmill training (BWSTT) involves fitting a patient in a harness, which is attached to an overhead suspension system positioned over the treadmill. This suspension system is used to support a percentage of the patient's body weight in order to unload the lower extremities as the patient walks on the treadmill at various speeds. Manual assistance is provided by trained therapists to assist in improving the patient's walking pattern. The percentage of body weight supported ranges from 10% to 40%. As the patient's walking ability improves, the percentage of body weight supported is reduced, speed is increased and/or the amount of manual assistance provided is decreased.
