The Importance of an Early Treatment with an Orthosis after a Stroke
A stroke is also called apoplexy, brain attack or cerebrovascular accident. According to the World Health Organisation (WHO), around 15 million people worldwide suffer a stroke every year. As a stroke usually occurs regionally in one half of the brain, the consequence is often hemiplegia or hemiparesis.
The sooner a stroke is recognised and treated, the better the chance of avoiding long-term damage. If paralysis occurs as a result of a stroke, it is often beneficial to provide the patient with an orthosis at an early stage in order to practice standing and walking as quickly as possible.
Why an Orthosis Helps
If certain neuronal functions have been lost due to a stroke, these can be taken over by unaffected areas of the brain. This process of creating new nerve connections is called neuronal plasticity. The trigger for this process is the repeated training of the impaired functions, which should start as soon as possible after the stroke. In particular, if neuronal functions are impaired that are responsible for balance and muscles for safe standing and walking, both stance and gait training must be started very early. Both require the early use of the right medical devices. Without an orthosis, training can be very laborious for both the therapist and the patient. Therefore, standing and walking are often integrated into the treatment regimen too late or too little. This can already be started in early rehabilitation if a custom-made orthosis is produced for the affected leg immediately after the stroke. Unfortunately, the importance and potential of the right orthosis for the course of therapy, as well as the assistance that an orthosis provides for therapists and attending personnel, is often underestimated or not even recognised. Patients who have suffered a stroke and are now treated with an orthosis share their experiences.
Click here to go to the experience reports.
The Altered Pathological Gait Affects the Whole Body:
- lack of safety when standing and walking
- balance difficulties
- too little exercise for the muscles
- development of deformities
Impairments caused by a stroke can be reduced or eliminated with the help of an orthosis. For instance, an orthosis supports the patient in relearning how to stand and walk physiologically. Moreover, the risk of secondary damages due to a pathological gait is reduced. Combined with physiotherapy/occupational therapy, a gait can be achieved that allows the patient to feel safe on their feet again. Not having to stumble or fall down anymore creates a sense of security and self-confidence. Thus, an orthosis contributes to an early mobilisation of the patient. In most cases, it makes sense to provide the patient with a custom-made ankle-foot orthosis. Such an orthosis is also called AFO. The term AFO (ankle-foot orthosis) refers to the body parts included in the orthotic treatment: ankle and foot.
An orthosis with individual functional elements affects different levels:
- support of the paralysed calf muscles (plantar flexors) for more safety while standing and walking
- support of the paralysed shin muscles (dorsal flexors) to prevent tripping
- balance support thanks to functional elements with precompressed spring units
Through these three functions, the orthosis helps the muscles establish the correct cerebral connections through motor impulses. A cerebral connection is the control programme that the brain stores in order to be able to execute complex movement patterns.
Where Can I Find Out More about Strokes and Orthoses?
Our Stroke Guide offers “a concept for the orthotic treatment of the lower extremity following a cerebral vascular accident”. It contains various orthotic treatment suggestions for the different gait types after a stroke.
The basis for the division of the gait types is the N.A.P. Gait Classification®. It was developed by physiotherapists and experts from the fields of orthopaedic technology and medicine to facilitate interdisciplinary communication and treatment selection. The guide describes recommendations for orthotic treatments as well as their effect and how they differ from previous treatment options.
You can download the Stroke Guide free of charge here. Upon request, we will gladly send you a printed copy. Please contact our In-house Customer Service at info(at)fior-gentz.de or +49 4131 24445-0.
In our User Stories and Videos you get to know patients who are already being treated with an orthosis. You can find the section on patients with strokes here.
General Information on Strokes
What Is a Stroke?
A stroke is the result of a sudden circulatory disorder in the brain. The brain is undersupplied for more than 24 hours, which can lead to cells dying. The affected areas of the brain can no longer fulfil their task properly.
There are two main types of stroke:
Ischaemic Stroke (Most Common Type of Stroke)
reduced blood flow and thus undersupply of an area
acute cerebral bleeding, causing areas to become undersupplied as blood flows into surrounding tissues
What Are the Symptoms of a Stroke?
The FAST test (Face, Arms, Speech, Time) can be used to quickly confirm the suspicion of a stroke.
F (Face) Can the person smile without one side of the face becoming distorted?
A (Arms) Can the person stretch both arms forward and turn their palms upward?
S (Speech) Can the person repeat a simple sentence?
T (Time) If all symptoms occur, do not waste time. Call the emergency services!
What Are the Consequences of a Stroke?
Different impairments can occur depending on which area of the brain is affected. Some of them remain permanently. This includes:
- difficulties when speaking
- impaired vision
- motor function restrictions
- paralysis of arms and/or legs
- difficulties when walking
What is a TIA?
A TIA (Transient Ischaemic Attack) is a so-called mini stroke. A circulatory disorder occurs here as well. However, the symptoms disappear within 24 hours.
A TIA may be a warning sign of an impending stroke. The causes and symptoms are the same. Even if the symptoms disappear, one should urgently consult a physician.