Cognitive Rehabilitation after a Stroke

by: cancer - Filed under: Electronic Cigarettes

A stroke occurs within a small amount of time only. However, the after effects of the stroke attack can be felt for the rest of one’s life. The result of a few minutes of blood interruption in some portions of the brain can result not only in motor impairments but also in cognitive impairments. The solution to this dilemma is to have the stroke patient undergo cognitive rehabilitation immediately.

When a patient decides to enroll in a cognitive rehabilitation after a stroke, he or she will go through two essential processes. The first is to restore functions which can be restored and to learn how to do things differently when functioning cannot be restored to pre-stroke level. Cognitive rehabilitation of the stroke patient will be based on the type and degree of neuropsychological symptoms which the stroke victim manifests after the stroke incident. These symptoms will be identified through a series of tests which are designed to measure brain functioning after the stroke attack.

Cognitive rehabilitation after stroke may include solving arithmetic problems, answering logical puzzles, testing concentration skills and/or reading. However, these activities are not enough. Neuro-functional strengths and weaknesses of the stroke patient are factors that should be an important factor when planning cognitive rehabilitation. A thorough neuropsychological analysis on the possible effects of the stroke is the foundation of a good cognitive rehabilitation.

Recovery of the brain follows a systematic pattern of brain development. Just like in infants, a stroke damaged brain must first learn or re-learn gross or large-scale systems before fine and complex systems. The gross cognitive systems include attention, focus and perceptual skills. And when these are redeveloped, complex intellectual activity will follow through.

Cognitive problems after a stroke

The cognitive problems that may arise immediately after a stroke attack may differ from person to person. These may depend on several factors such as the stroke victim’s personality, his or her capabilities prior to the stroke attack and the amount of brain damage caused by the stroke.

Cognitive impairments that may be experienced right after a stroke incident are difficulty with concentration for an amount of time, having problems with organizing thoughts, forgetfulness and becoming easily confused.

When to start cognitive therapy

When a stroke attacks, time is always of the essence. A patient should start cognitive therapy after a stroke while still in the hospital. Early cognitive therapy will focus on increasing alertness and attention. It will also focus on improving the stroke victim’s orientation to person, place, time and situation. It will also help the stroke victim to comprehend speech, another problem associated after a stroke attack.

After discharge, the stroke victim may enroll in long term cognitive rehabilitation. Depending on his or her needs, the stroke survivor may choose an individual or group therapy.

Cognitive rehabilitation aims to help the stroke survivor to achieve the most independent level of functioning as possible. The objectives of cognitive rehab also vary from person to person. Some stroke victims would want to have the ability to express needs verbally in simple terms while others would be happy with just pointing to pictures. But majority of stroke survivors want to improve their capability of defining words and to identify cause and affect relationships.

Tags: , ,

Music Therapy and Stroke Rehabilitation

by: cancer - Filed under: Electronic Cigarettes

What is Music Therapy?

According to Wikipedia, music therapy is a field of scientific research and an allied health disciple which studies the relationship between the process of clinical therapy and biomusicology, music theory, musical acoustics, psychoacoustics and comparative musicology.

How Can Music Therapy Help Stroke Victims?

According to the American Stroke Association, music therapy has been scientifically and medically proven to be a valuable tool in rehabilitation after a stroke in areas of movement and muscle control, speech and communication, cognition, mood and motivation.

  • Movement and muscle control improvement can be achieved by a steady beat, musical timing, and rhythmic patterns. Suggested activities include playing a drum to boost range of motion in the upper extremities, exercising to an upbeat music, and timing music to complement the usual walking pattern.
  • To improve speech and communication in a stroke survivor, a music therapist uses rhythm, melody, and singing. Suggested activities include exercising mouth muscle, rhyming, chanting and rapping and singing the words and transferring them to speech.
  • Cognition (memory, organization, attention and problem solving) can be enhanced by music and music structure. Suggested activities in this aspect include making a song with important information in its lyrics, performing in a band and rhythm repetition games.
  • Lastly, to enhance mood and motivation and help in pain management a music therapist uses the emotional and aesthetic qualities of music. Suggested activities in this area include listening to music, recording and song writing, improvisation and musical performance. (e.g. playing a musical instrument).

The Impact of Music Therapy on Stroke Survivors

Music has been proven to have an effect on sections of the brain and it has a great impact on social interactions and emotions. More recent findings on music therapy suggest a decrease in depression, reduction of anxiety and improvement of mood. Researchers also suggest that music helps in motivating and creating a positive outlook among patients. Music therapy in combination with adjunct therapies significantly increases the rate of rehabilitation success among stroke survivors.

A promising study on Music Therapy and Stroke Patients

According to Teppo Sarkamo, a Finnish researcher at the University of Helsinki and the Helsinki Brain Institute, listening to music for a few hours daily can significantly improve a stroke patient’s early recovery. A study on 54 patients with right or left hemisphere middle cerebral stroke showed valuable improvement in verbal memory and focused attention after 2 months of music therapy. Patients who listened to music daily also had a more positive attitude compared to those who listened to audio books.

Based on these results, Sarkamo suggests that music should be a daily part of rehabilitation, since it is a “targeted, easy-to-conduct and inexpensive means to facilitate cognitive and emotional recovery”. The team also found that 3 months after the stroke, verbal memory improved from the first week post-stroke by 60% in music listeners compared to 18% in audio book listeners and 29% in non-listeners. Similarly, focused attention the ability to control and perform mental operations and resolve conflicts among responses improved by 17% in music listeners, but no improvement was observed in audio book listeners and non-listeners. These differences remained six months after the stroke.

Tags: , , , ,

Hand Exercises for Stroke Patients

by: cancer - Filed under: Electronic Cigarettes

Here is a very practical approach to hand recovery after stroke as it can be done at home. It is composed of a range of motions focused on the hand. Meant to retrain the brain, hand exercises should be done several times a day for mastery and to redevelop coordination.

Here are some hand stretching exercises, arranged sequentially, that you might want to try:

  1. Massage the affected hand with the unaffected hand, beginning with the base of the thumb by the palm, to the tip of the thumb. Repeat for all fingers.
  2. Stretch each finger of the affected hand with the unaffected hand. You could also move each finger of the affected hand in circular motions with the unaffected hand.
  3. Close and open the affected hand, beginning one finger at a time until you form a fist and vice versa. Alternate by closing and opening all fingers at the same time to form a fist and vice versa.
  4. With palms face down on a flat surface, lift thumb and gently return to position. Repeat on all fingers.
  5. With palms face down again, lift hand while bringing each finger tip slowly gliding towards each other to a close. Reverse action. Repeat 5 times.
  6. Stretch fingers as far as you can while palm is faced down on flat surface. Hold in position for 5 seconds. Release. Repeat 5 times.

Once you’re done stretching, here are hand exercises after a stroke to practice your grip and enhance flexibility.

  1. Practice counting with your fingers in sets of 5. From a closed fist, count with the pinky first going to the thumb. Begin the next set of numbers with an open hand. Then close the hand to form a fist beginning with the thumb going to the pinky.
  2. Form the letters of the alphabet using your hand. Also known as finger spelling, here’s a chart you can follow.
  3. Crumple pieces of paper. Throw them all in the air as you would with confetti, such that they fall on the table. Pick each crumpled paper and throw into a trash can as you would in basketball.
  4. Play pickup sticks or pickup objects of various sizes.
  5. Play with a stress ball.

If you had fun with these activities, you may also want to read the book “Hand Recovery After Stroke: Exercises and Results Measurement”, Smits JG, Smits-Boon for more exercises.

Remember, hand exercises after a stroke should be started gradually and reinforced regularly. Take your time in doing each exercise. Take care not to overdo it, though. Most of all, have fun with the hand exercises while listening to your favorite music.

Tags: , ,

Speech disorders and rehabilitation after Stroke

by: cancer - Filed under: Electronic Cigarettes

Stroke and speech impairments

A stroke is the interruption of blood flow to the brain, depriving brain cells from oxygen. These cells die after a few minutes, causing a loss of the neurological functions controlled by those cells. Strokes affecting the parietal lobe, Broca’s center or Wernicke’s center are likely to affect speech.

There are several types of speech difficulties after a stroke:

- Aphasia after a stroke is an acquired language disorder affecting the ability to produce and understand language, as well as reading and writing.
– Dysarthria is a motor disorder affecting the control of speech muscles. Information transmitted to the tongue, throat or lips is disrupted, resulting in poor articulation.
– Apraxia of speech (or verbal apraxia) is the inability to produce information commanding speech muscles.

Treating language disorders after a stroke
The goal of rehabilitation of speech impairments, therefore, is to restore a person’s confidence in communicating with others. This may prove to be a difficult task, but people giving assistance should realize that the ordeal a stroke patient endures because of speech difficulties can be frustrating and should be met with a greater deal of patience and understanding.

1. Aphasia
Since aphasia affects use and comprehension of words, the effective goal for therapy is restoration of language ability. Focus should also be set on improving the patient’s ability to communicate by helping him use his remaining language abilities and compensate for language problems. It must be recalled that the brain damage caused by the stroke may erase some abilities, which must be re-learned during the rehabilitation process.

Patients may also be allowed, at first, to use hand gestures or signals to compensate for lack of appropriate words or just to help in carrying out a train of thought during a conversation. But, this should not let the patient and his therapist deviate from the ultimate goal of reestablishing the language capabilities. The hand gestures should only be used as an initial tool, so as not to contribute to the patient’s frustrations. It is important to keep in mind that together with rehabilitating the language capabilities, the patient’s confidence needs nurturing as well.

2. Verbal apraxia
In verbal apraxia, the patient knows what words to say, but the brain has trouble coordinating the necessary muscles for speaking.

The difference with this impairment is that the speaker is well aware of his mistakes, but still has difficulty in correcting them. Common therapy approaches for apraxia include teaching sound production, rhythm and rate. Again, the exercises entailed in the therapy are aimed at practicing speech patterns, such that the brain sends out the necessary impulses to coordinate facial muscles for generating speech. Tasks may involve repetition of syllables and words to train the lips, mouth and tongue into making these sounds once again. Providing tips on proper placement of the tongue or shape of lips and mouth while producing sounds also helps in this therapy.

3. Dysarthria
Dysarthria, on the other hand, leaves a patient struggling to move the speech muscles because they become too weak or too tight as a result of the stroke. Additional medical help from healthcare personnel should be heeded to identify the specific type of dysarthria, since it is crucial for the treatment. For example, strengthening exercises are appropriate when the muscles are weak, but may be harmful when the muscles have too much tone. A speech language pathologist should be able to aid in the identification and consequently recommend the proper therapy.

Usually, dysarthria rarely requires therapy and often disappears a few months after the stroke. But, in the event that the impairment persists, a more rigid therapy program may be suggested by the speech language pathologist.

Tags: , ,