Stroke is the fourth highest cause of death from natural causes in South Africa, closely following on the top three: TB, diabetes, and heart disease. This is according to the latest information available from Statistics SA, namely for 2016. In 2015, stroke was the third highest cause of death from natural causes. A stroke, also popularly known as a “brain attack”, occurs when blood circulation to the brain fails, either by a blockage of blood flow, or by bleeding from a blood vessel into the brain. Interruption of the blood supply to the brain prevent brain cells from getting oxygen and nutrients, causing brain cells to die in minutes.
Implications of surviving a stroke:
Statistics from the USA show a survival rate of about two-thirds of the people who suffered a stroke. Not all cases of brain damage are permanent, depending on the severity of the damage. Brain cell damage may be temporary in some cases, or the brain can reorganize its functioning, with another area of the brain taking over the functioning of a region that was compromised due to damage by stroke. This ability of the brain to adapt and change is known as neuroplasticity. Most of the stroke survivors end up with some type – and degree – of disability, depending on which area in the brain was damaged. The main types of disability are:
• Paralysis or problems with controlling movement, usually on one side of the body, is one of the most common disabilities after a stroke. It may affect the entire one side of the body, or just the face, or an arm, or a leg.
• Sensory disturbances after a stroke means losing the ability to feel pain, or touch, or temperature, while some patients experience sensations of tingling, pain, or numbness in the affected areas.
• About 25% of stroke survivors experience language problems, either with using, or with understanding language. This type of impairment in the brain’s language control center can include the ability to speak, to write, and to understand language.
• Damage to the parts of the brain involved with thinking and memory can impair learning, awareness, and memory. This condition can manifest in various ways, such as shortened spans of attention, impairment of short-term memory, or the ability to do planning, or to learn new tasks.
• Emotional disturbances can also be experienced, such as fear and anxiety, or anger and frustration with the impairment. The emotional disorder experienced by most stroke survivors is clinical depression.
Rehabilitation usually starts once the patient is stable. The long-term goal of rehabilitation for the stroke survivor is to become as independent as possible. Recovery from a stroke varies from person to person.
According the Mayo Clinic, there are a number of factors which would determine whether recovery from a stroke would be successful:
• Physical factors such as the severity of the stroke, which can affect both cognitive and physical abilities.
• Emotional factors such as your mood, your motivation levels and the ability to persevere with the rehabilitation activities.
• Social factors play an important role, as you would need the continued support of family and friends.
• Therapeutic factors such as an early start to the rehabilitation, usually as soon as the patient is stable, and the skills of the stroke rehabilitation team.
American statistics show that 10% of stroke survivors would recover almost completely, while 10% would require care in a long-term care facility. About 40% of stroke survivors would recover with moderate to severe impairments.
Apart from a therapeutic program, daily exercise activities at home would slowly build endurance and strength, while it is equally important to minimize bed rest and other inactivity. Exercise is a powerful de-stressor which helps to fight depression, and it is free! Regular exercise and being as active as possible not only also improves general health and fitness, it also helps to reduce the risk of having another stroke.
Post-stroke rehabilitation Fact Sheet. Published September 2014. National Institute of Neurological disorders and stroke. National Institutes of Health. USA. (www.ninds.nih.gov)
Stroke rehabilitation: What to expect as you recover. Published 17 April 2019. Mayo Clinic. (www.mayoclinoc.org)
Rehabilitation therapy after a stroke. Reviewed 14 May 2019. American Stroke Association. (www.stroke.org.)
Exercise recommendations for stroke survivors. Published online. American Stroke Association. (www.stroke.org.)
Mortality and causes of death in South Africa: Findings from death notifications, 2016. Published February 2019. Department: Statistics, Republic of South Africa. (www.statssa.gov.za)