STROKE,  HEAD INJURY, & NEUROLOGICAL REHABILITATION

STROKE REHABILITATION

A stroke is caused by a clot or a bleed in the brain which causes brain cells to die. A stroke is the third most common cause of death in the UK and remains the most common cause of severe disability with more than 250,000 people living with disability as a result of Stroke. 

Following stroke people may experience:

• Motor impairment, Weakness or paralysis - this can lead to difficulties in walking, movement or coordination. These often affect one side of the body – known as hemiparesis or hemiplegia.

• Lack of feeling - or loss of awareness of objects on one side of the body, known as left- or right-sided neglect, depending on the side affected.

• Swallowing difficulties - these can cause trouble with eating or drinking which, if not managed, can result in chest infections including pneumonia as food or liquid passes into the windpipe and lungs instead of the gullet. Dehydration or constipation may also result .

• Speech or language difficulties - including difficulties in understanding, speaking (dysphasia, aphasia), reading, writing and calculation. Speech and language problems are usually a result of damage to the brain,s left hemisphere.

• Problems of perception - these can include trouble recognising or being able to use everyday objects such as a kettle or teapot, difficulties telling the time, and problems interpreting what the eyes see, even where vision is not affected.

• Cognitive difficulties - these include problems caused by damage to areas of the brain controlling mental processes such as thinking clearly and logically, learning, paying attention, memory, decision-making and forward planning.

• Behaviour changes - these may include being slower to react than before the stroke, excessive caution, disorganisation, finding it difficult to adjust to change and becoming confused or irritated.

• Difficulties with bowel or bladder control (urinary or faecal incontinence) - these may be caused by a variety of different problems following stroke. These can often be considerably improved or overcome with medical help and physiotherapy.

• Fatigue - although a recognised phenomenon, the reason for fatigue is not fully understood. There may be sleep disturbance caused by damage to areas of the brain controlling the body,s sleep-wake cycle and it could also be linked to depression.

• Psychological impairment / mood changes, depression, and changes in cognitive functioning. This can include mood swings, irritability, laughing or crying even when you do not feel particularly happy or sad. Depression is extremely common following a stroke, with symptoms such as loss of appetite, insomnia, crying, low self-esteem and anxiety that can all be signs of depression.

• Post-stroke pain - a small number of people develop a burning, shooting, throbbing pain that does not respond to painkillers following a stroke.

• Epilepsy - 7-20 per cent of people who have strokes develop epilepsy. This can usually be treated with anti-epileptic drugs.

RECOVERY FROM STROKE AND REHABILITATION

Of people who survive a stroke around half will be left with significant disability Having said that, the brain is remarkably adaptable and in the months or years after a stroke many cells that have sustained damage recover some of their function. At the same time other areas of the brain take over the functions performed by the cells that have died. The time it takes to recover is extremely variable. However, commonly people have a surge of recovery in the weeks following a stroke followed by a slower recovery over the next year to 18 months or so.  Rehabilitation following stroke is about the process of achieving the best level of independence as possible by:

• Learning new skills

• Relearning skills and abilities

• Adapting to the physical, emotional and social consequences of the stoke

HOW WE CAN HELP:

Our interdisciplinary team of Consultants, Nursing staff, Physiotherapists, Occupational Therapist, with access to as required to Neuro Psychology and Speech and Language Therapy aim to provide a patient centred, goal orientated approach to Stroke Rehabilitation to enable the individual to reach their optimum level of recovery.  We motivate patients to participate in their rehabilitation programmes and support them to transfer skills obtained into their own homes, including return to work, family or education.

HEAD INJURY REHABILITATION

It is estimated that one million people in Britain attend hospital a year as a result of head injury and is most common amongst males of 15-29 years, but can affect all ages.  Head injury can be described as being trauma to the head resulting in injury to the brain.  Injury to the brain can include complications such as trauma, hypotension, intracranial haemorrhage and raised intracranial pressure.

• Memory problems- both short-term and long-term

• Executive functioning – planning, organization, problem solving

• Information processing – speed, capacity and control of information

• Communication problems

• Changes in mobility

• Sleep disorders

• Mood and personality changes

These are just a few of the range of difficulties people may experience.  These problems are often multiple and overlap in a complex way.

HOW WE CAN HELP:

Our interdisciplinary neurological rehabilitation team of Consultants, Nurses, Neuro Physiotherapy, Occupational Therapy, with access to Neuro Psychology and Speech and Language Therapy are able to provide structured rehabilitation programmes to enable the patient to manage their complex problems.  The rehabilitation programmes are patient centred and goal driven enabling the patient to play an active part in their rehabilitation, empowering them to make informed decision throughout the whole process.  Through the goal process we motivate patients to participate in their rehabilitation and support them to transfer skills into their own homes, including return to work, family or education.

Rehabilitation Services also include Bowel and Bladder Management, Calliper Training, Driving Assessments and Lessons, Fertility Advice, Functional Electrical Stimulation, Hydrotherapy, Mobilisation after Surgery, Occupational Therapy, Physiotherapy, Psychological Counselling, Skills Honing and Top-up Rehabilitation, Speech and Language Therapy, Splinting, Teaching Activities of Daily Living, Treadmill Therapy, Wheelchair and Cushion Assessments, and Wound and Pressure Care.

OTHER NEUROLOGICAL CONDITIONS

 We provide rehabilitation programmes to a wide range of Neurological Conditions, these include:

Multiple Sclerosis

Between 3 and 7 people per 100,000 of the population are diagnosed with MS each year and usually starts in early life, there is no cure and the person lives with the diagnosis for life.  MS is a disease of the central nervous system and where the white matter within the brain or spinal cord becomes inflamed and then destroyed by the person’s  own immune system.  This results in scarring to some areas of the brain or spinal cord.  Many of these episodes do not cause symptoms, but when sudden symptoms occur the person is said to have had a relapse. 

Parkinson Disease

It is estimated that 100-180 per 100,000 of the populations are effected by Parkinson’s Disease.  PD is a progressive neurodegenerative condition leading to the death of dopamine containing cells of the substantia nigra.  People generally present with bradykinesia (slowness of voluntary movement and speech), rigidity and rest tremor.  Though it is predominantly a movement disorder, though people can develop psychiatric problems such as depression and dementia.

Motor Neurone Disease

Motor Neurone Disease (MND) is a progressive neurodegenerative disease that attacks the upper and lower motor neurones.  Degeneration of the motor neurones leads to weakness and wasting of muscles, causing increasing loss of mobility in the limbs, and difficulties with speech, swallowing and breathing.