Opinion: A Stroke Can Cause Paralysis Or Other Physical Disabilities, But Recovery Possible With Right & Early Interventions

Stroke can lead to debilitating physical disabilities, but early and intensive rehabilitation can help survivors regain lost function and improve quality of life.

In India, new cases of stroke have almost doubled in the last 30 years, as per a Lancet study.

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By Dr Vijay Battina

World Stroke Day: We often tend to think of people with disabilities as the “others” — their struggles, wins, and lived experiences may seem alien to those who are non-disabled. However, everyone is just one incident away from living this supposedly unrecognisable life. Stroke is a leading reason globally for someone who may be in perfect physical health one day to have a disability the next. 

In India, new cases of stroke have almost doubled in the last 30 years, as per a Lancet study. This means there is an urgent need for all of us to be aware and alert about the symptoms of a stroke, the need to act urgently when we spot them, and how to care for loved ones in the aftermath of a stroke.  

As one may imagine, stroke-related disabilities take a huge toll on the physical and mental well-being of survivors. However, the tremendous caregiving burden on families and loved ones is often ignored. The good news is that with the right interventions, many stroke survivors can recover significant function.

A stroke occurs when the blood supply to a part of the brain is interrupted, either due to a clot (ischemic stroke) or bleeding in the brain (haemorrhagic stroke). The lack of oxygen and nutrients causes brain cells to get damaged or die. As a consequence, depending on which area of the brain is affected, a stroke can lead to a range of physical disabilities.

Physical Disabilities A Stroke Can Cause 

Hemiparesis or Hemiplegia: Many of us may know patients of stroke who have weakness or complete paralysis on one or both sides of the body. This is one of the most common consequences of a stroke. In medical terms, these symptoms may be called Hemiparesis (weakness in one leg, arm, or side of the face) or Hemiplegia (severe or complete unilateral loss of strength or paralysis). That’s where the specialised field of neuro physiotherapy comes in. Techniques like constraint-induced movement therapy, which involves repetitive use of the affected limb, can stimulate brain plasticity and help regain lost functions. Additionally, neuro physiotherapists use a variety of techniques to help patients regain their ability to walk, including body-weight-supported treadmill training, robotic-assisted gait therapy, functional electrical stimulation, and even virtual-reality-based games. These interventions help recondition muscles and improve coordination for a more natural gait pattern.

Coordination and Dexterity: Imagine being unable to perform daily activities like buttoning your shirt or washing your plate. A stroke can impact such fine motor skills, leading to a much greater sense of dependence among stroke patients. It’s imperative to work with skilled neuro physiotherapists, who use specific exercises to retrain the brain and body to work together. For example, exercises targeting muscle strength, joint flexibility, and motor control can help stroke survivors improve their ability to stand still, maintain their balance, and grasp objects. Another professional who may be invaluable at this juncture is an occupational therapist. They can help modify a patient's environment, provide assistive devices, and develop strategies to compensate for physical limitations. By breaking tasks down into manageable steps or providing adaptive tools, occupational therapy can help stroke survivors regain a sense of independence and control over their lives.

Spasticity and Muscle Stiffness: Many stroke survivors experience spasticity or muscle tightness, where muscles contract involuntarily. This can make movements rigid and painful, further limiting mobility and independence. Stretching exercises, muscle relaxation techniques, and using splints or braces can significantly aid in flexibility and preventing joint issues. In many cases, physiotherapy is supplemented by Botulinum toxin (Botox) injections, which play a strong role in managing severe spasticity.

Aphasia or Speech Difficulties: In cases where the stroke affects areas of the brain responsible for speech, patients may experience aphasia (difficulty understanding or producing speech). This can range from mild difficulty in finding words to a complete inability to speak. For stroke survivors with aphasia or other speech difficulties, speech and language therapy is essential. Speech therapists use exercises and techniques to help patients improve their communication skills in a plethora of ways, through speech, writing, or alternative communication methods. In addition, they may assist with swallowing difficulties (dysphagia), which can be a common complication after a stroke.

Not Always Easy, But Recovery Is Within Reach

The physical disabilities caused by stroke can be life-altering, but they are not insurmountable. The success of stroke rehabilitation hinges on its early initiation and continuous practice. Starting rehabilitation as soon as possible after a stroke can help prevent secondary complications such as muscle atrophy, joint stiffness, and pressure sores. Early intervention also maximises the potential for neuroplasticity — the brain’s ability to rewire itself and compensate for lost functions.

Initial rehabilitation measures may go a long way, but they are not enough. Stroke survivors and their caregivers must be diligent in their tryst with recovery. This may include regular physiotherapy sessions, home-based exercises, or follow-up assessments to track progress. It's also important to constantly have one's ear to the ground (metaphorically, of course) and adjust the rehabilitation plan as needed. It is not always easy, but recovery is within reach!

Dr Vijay Battina, Center Head, Atharv Ability, Hyderabad.

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]