Balance Exercise In Stroke Patients.

 

Balance Exercise In Stroke Patients.

·       The world  health Organization define the stroke is “ Rapidly developing Clinical signs of focal  (or global)  disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin.

·        Stroke was the second-leading global cause of death after ischemic heart disease, representing 11.8% of total death worldwide.

·       India  and other developing countries are facing a double burden communicable and non - Communicable disease. The estimated adjusted prevalence rate of stroke range 84-264/100,000 in rural and 334 – 424/100,000 in urban areas. The incidence rate is

119-145/100,000 based on recent population studies.

·       The incidence of stroke rises rapidly with increasing age: two third of all stroke occur in people older than age of 65 years; and after the age of 55 years, the risk of stroke doubles every 10 years.

 

·       Stroke is mainly classified in 2 main categories:

 

1)   Ischemic stroke :

Ischemic strokes are the most common type, it is affecting about 80% of individuals with stroke, it occurs when the lack of cerebral blood flow deprives the brain of needed oxygen and glucose, disrupts cellular metabolism, and leads to injury and death of tissues.

 

2)   Hemorrhagic stroke :

 Hemorrhagic stroke results from the rupture of some blood vessels with abnormal bleeding in to the extra vascular areas of brain due to increase in the intracranial pressure with injury to brain tissue and restriction of blood flow.

 

 

 

 

 

 

Risk Factors for Stroke Impairment:

·       Hypertension

·       Heart disease

·       Rheumatic  heart disease

·       Endocarditis

·       Cardiac surgery produces embolic stroke

·       Diabetes

·       Elevated total blood cholesterol and low density lipoprotein (LDL).

Modifiable risk factors:

·       Smoking

·       Obesity

·       Lack  of  exercise

·       Diet

·       Alcohol consumption .

 

 

Stroke is subdivided into three phases:

 

Acute phase:  The initial phase starts immediately following cerebro     vascular accident   and continues for next   2 weeks.

Sub-acute phase: This is the next phase after initial phase which continues for few months   upto 6 months following stroke.

Chronic Phase: The last phase that continues from months to year following episode of stroke and patients may sometimes completes his life with this phase.

·        following stroke, patients lose functions of the motor, sensory and higher brain cognitive abilities to various degree which lead to diminished balance.

·       By using various interventions, we can improve balance in stroke patients.         

1)   Sitting on a mat to sitting on a therapy ball;  

2)   Standing  Position :

 

·       Wide base of support to narrow  base  of support to tandem position;

 

      

             

 

·       standing on one Lower extremity  (beginning with less affected, progression to  more affected LE).

 

·       First perform exercise with eye open then  eye  closed.

 

3)   Upper Extremity movements:

·       Single upper extremity  raises to bilateral upper extremity raises (symmetrical, asymmetrical)

·       reaching movements with emphasis to the more affected side

·        picking objects off table, stool, floor.

 

4)   Lower extremity  movements:

·       Single Lower extremity support,

·       Stepping forward, backward and side;

·       Step-up and down.

 

·       Marching in place

            

5)   Trunk movements:

·       Head and trunk rotations

·        Looking up at ceiling or down to floor

 

6)   functional activities:

·       Sit-to-stand

·       Turning

·       Lunges

 

7)   Dual-task training:

·       Standing while catching or kicking a ball,

·        standing while talking,

·       standing while holding a tray with a glass of water

 

8)   Balance Board Activity