Restoring motor coordination after a stroke. Ataxia after stroke - symptoms, diagnostic tests, treatment. How long do they live after a stroke and possible consequences?

Ataxia after stroke - symptoms, diagnostic tests, treatment

Ataxia is a type of movement disorder that occurs in patients after a stroke. This is a collective concept that includes several types of movement coordination disorders. In clinical practice, cerebellar ataxia most often occurs, the cause of which is impaired blood circulation in the cerebellum. According to statistics, cerebellar stroke is not so common - in about 10% of cases.

However, more than half of the episodes of this type of stroke are fatal, and a very high percentage of disability is recorded among survivors.

Ataxia is a disorder of movement coordination and motor skills.

Classification of ataxias

Normally, coordination of movements is regulated by the following parts of the brain:

medulla oblongata and midbrain;
cerebellum;
vestibular apparatus;
frontotemporal cortex of the cerebral hemispheres.

The Gaulle and Burdach bundles pass through the posterior part of the brain stem. They are responsible for deep muscle sensitivity. The main task of the cerebellum is to supplement and coordinate the work of motor centers. Thanks to him, movements become smooth, clear and proportionate. The cerebellar vermis maintains normal muscle tone and balance. Thanks to the coordinated activity of the vestibular nuclei, balance is maintained during movements. The frontal lobe cortex is responsible for voluntary movements.

It is difficult to say which of these departments is the most important in the coordination of movements. All of them are connected by numerous synaptic connections, which ensures normal motor activity. Depending on where the stroke occurred, clinicians distinguish between the following types of motor coordination disorders, or ataxias:

Sensitive ataxia

This type of ataxia develops after a stroke in the posterior columns spinal cord, thalamus. It can occur in both limbs, one arm, or one leg. This type of movement disorder is characterized by loss of proprioceptive sensation. The patient cannot assess the position of his own body parts. A so-called stamping gait is observed - the patient bends his legs excessively and steps very hard on the floor. Often complains of the feeling of walking on a soft carpet. The victim constantly looks at his feet, thus trying to alleviate the pathological symptoms. When closing the eyes, the manifestations of ataxia intensify.

Cerebellar ataxia

Develops after a cerebellar stroke. There is unsteadiness when walking. The patient deviates towards the lesion, in severe cases falls. If the cerebellar vermis is affected, a fall is possible in any direction and backwards. Walking is unsteady, with legs spread wide apart. Walking with an extended step is impossible or severely impaired. Hand movements are disproportionate and slow. The arm and leg on the affected side are more affected. Speech slows down, becomes drawn out and chanted. Unlike aphasia, where speech disorders are based on the death of neurons in cortical centers, coordination of movements is impaired in patients after a cerebellar stroke. The handwriting changes - the letters become sweeping and large.

Distinctive features of the gait of a patient with ataxia

Vestibular ataxia

Vestibular ataxia occurs when moving, sitting or standing. Symptoms intensify when turning the head, torso, and eyes. The person refuses to perform these movements, replaces them with others, or performs them in at a slow pace. Thanks to visual control, it is possible to significantly compensate for coordination disorders. With unilateral lesions of the vestibular nuclei, unsteadiness and deviations of the body occur in the direction of the lesion. Movement disorders are especially noticeable when walking with eyes closed. Vestibular ataxia is accompanied by severe autonomic disorders - nausea, dizziness, nystagmus.

Cortical ataxia

A specific impairment of motor coordination that develops in patients after a stroke in the frontal lobe of the cerebral hemispheres. Mostly in such situations the legs suffer. Hands are not involved. The patient's gait is uncertain, shaky, in one line. The body leans back. The patient cannot stand or walk, although he has no signs of paresis or paralysis.

Clinical manifestations of cortical ataxia

Diagnostic tests

Diagnosis of motor coordination disorders in patients after a stroke is based on the following points:

patient complaints;
inspection data;
diagnostic test results;
data from the results of additional research methods.

Coordination tests allow you to determine the type of ataxia and determine the location of the stroke.

Static ataxia is determined first. The patient is placed in the Romberg position - legs together, arms forward, eyes closed. The patient's stability is assessed. After the usual Romberg test, a complicated one is performed - you are asked to stretch your arms in front of you at shoulder level, spread your fingers to the sides, place your legs so that the toe of one touches the heel of the second limb.

Cerebellar function test

The gait is then assessed. The patient is asked to walk with a normal, straight, heel-to-toe gait and a flanking gait.

After this, dynamic ataxia is diagnosed. The patient is asked to stretch his arms in front of him and reach the tip of the nose or hammer with his index finger. The test is carried out with eyes open and closed.

The symmetry and synchrony of movements can be assessed using an asynergy test - the patient is asked to stretch his arms in front of him and make movements similar to screwing in light bulbs. Another diagnostic test is for dysmetria. The patient needs to raise both arms to shoulder level and extend them in front of him. After this, you need to raise one hand vertically up and lower it to the level of the second. The test is repeated on the opposite side.

Heel-knee test - in a lying position, the patient should touch the heel of one leg to the opposite knee.

Babinski's asinegria - the patient is asked to sit with his arms crossed over his chest. If the cause of impaired coordination of movements is in the cerebellum, it is not the body that rises, but the legs.

Treatment

In patients after a stroke, in the first hours after the disease, the restoration of blood circulation in the area of necrosis comes to the fore. Then nootropic and vascular drugs are prescribed. Their main task is to reduce the size of the lesion and help surviving neurons integrate into the general activity of the central nervous system.

As soon as possible, the patient begins motor exercises.

To improve coordination, it is necessary to perform complex targeted actions - lift small objects from the floor, open locks, “catch up” with moving objects with your hands, press buttons located at some distance from the patient. If it is necessary to coordinate the movements of two joints, then one of them is fixed and movements are carried out without it.

For vestibular ataxia, exercises are performed with increasing and decreasing the area of support, eliminating visual control - in the dark, blindfolded, with headphones. It is recommended to walk on uneven terrain, backwards, in a pattern. It is very useful to combine such exercises with eye exercises.

Massage, passive gymnastics, and physiotherapeutic procedures play an important role.

What are the consequences of ischemic stroke?

Today, a disease such as ischemic stroke is quite common, the consequences of which can be the most unpredictable. After suffering an illness, people may remain disabled, but may later have minor complications that they learn to live with. It should be understood that it is possible to influence the consequences within the first year after the development of the disease. After a year, further measures aimed at recovery and rehabilitation become meaningless and ineffective.

The disease may lead to:

cerebral edema;
disorders of speech, coordination of movement, perception;
dementia;
bedsores;
pneumonia;
thrombosis.

It should be noted that in no case should the primary symptoms of ischemic stroke of the brain be ignored. With timely treatment, many people live normal lives after rehabilitation, without any complications.

To care for a patient during the rehabilitation period, it is better to turn to specialists, because this requires certain skills and knowledge.

Consequences of ischemic stroke - cerebral edema

This condition is one of the most terrible. But you can never avoid it. That is, in any case, a person who has suffered a stroke will experience cerebral edema, in which fluid accumulates in the nerve cells.

The result is an increase in volume inside the skull, increased pressure and the occurrence of unbearable headaches. In some cases, swelling appears on the face, arm or leg. This means that hematopoietic and regenerative processes were disrupted. Brain swelling appears immediately after an attack. A distinctive feature is the rapid growth of swelling. It is untimely assistance that leads to necrosis and death.

Consequences of ischemic stroke - impaired coordination of movement, speech, perception

The consequences of an ischemic stroke can be irreversible. One of the consequences of the disease is impaired coordination of movement. Muscle strength in the arms and legs is not always fully restored. Weakness in the lower limbs forces a person to resort to using a cane when walking. Weakness in upper limbs makes it difficult for a person to perform everyday movements, for example, it is difficult for a person to dress independently or hold a fork.

After an ischemic stroke, sensitivity is impaired. The process of restoration of the nerve fibers responsible for this process takes much longer.

The disease can lead to impaired swallowing reflex - people can choke even on liquid, not to mention solid food. It is these pathologies that sometimes become the cause of aspiration pneumonia and death.

Loss of coordination manifests itself in an unsteady gait, dizziness, and falls. 12% of people subsequently suffer from epileptic seizures. 15% experience changes in the functioning of the pelvic organs - disruptions in the functioning of the genitourinary system and intestines are observed. Such patients require careful care.

Speech disorders do not always occur. Difficulty in communication is due to the fact that a person utters incoherent words; it is simply difficult for him to speak. A right-sided stroke rarely carries such consequences.

For some people, the result of a stroke is cognitive impairment - forgetfulness, the inability to assess the situation soberly. For example, people may not remember their home phone number or address, or they may confuse the time of day or place where they are. Their behavior is very similar to that of small children. The disease can lead to post-stroke depression due to the fear of remaining disabled or being “ballast” for relatives.

The consequence of an ischemic stroke is often a change in the patient’s behavior - aggression, fearfulness, and mood swings.

Complications after a stroke - dementia, pneumonia, bedsores

After a severe stroke, a person may gradually develop dementia. This occurs because connective tissue cells gradually replace destroyed brain cells.

Dementia manifests itself in:

gradual loss of the ability to understand the surrounding world;
decreased adaptive abilities;
inability to self-service;
fading interest in life;
decreased speed of thought processes.

The initial stages of dementia do not always manifest themselves clearly. Therefore, relatives of a person who has suffered an ischemic stroke of the brain should carefully monitor his behavioral reactions in order to prevent the development of dementia. Relatives should be wary of slowness, forgetfulness of words, and isolation. Treatment of this condition is carried out by a neurologist or psychiatrist. Neuroprotectors, antidepressants, and sedatives are prescribed as the main therapy.

Pneumonia after a stroke appears against the background of deteriorating ventilation of the lungs and stagnation of blood accumulating in the lower regions of the lungs due to gravity. If a person has difficulty moving and is unable to roll over or change his body position on his own, he definitely needs help with this.

The patient must be turned at least 12-13 times a day, that is, every 1.5-2 hours. It is very important to avoid sudden movements when turning over, especially in the head area. During the day, a person is seated in bed, with pillows placed under his back. Thus, a change in localization occurs lowest point, blood does not stagnate, blood flow is restored.

If the patient is in a conscious state, then doctors recommend starting from the third day to perform breathing exercises, vibration massage to prevent the development of pneumonia. To do this, it is quite enough to combine massage procedures and inflation. hot air balloon. This helps improve sputum discharge and restore blood supply to the lungs.

If a person is connected to a ventilator, the possibility of developing pneumonia increases significantly. Therefore, doctors prescribe, in addition to the main treatment, antibacterial therapy.

Bedsores appear as a result of restriction of movements of a person who has suffered an ischemic stroke of the brain and constant pressure applied own weight to some areas.

Poor circulation of the skin, thinning of the skin, frequent urination and defecation provoke the development of bedsores. Therefore, patient care and hygiene are very important at this stage of treatment. Today it is possible to prevent the development of such pathology. For this purpose, diapers, anti-decubitus mattresses, medications and cosmetical tools for caring for problem areas of the skin. The mattresses are designed in such a way that you can constantly change the point of contact with skin due to air redistribution.

After an ischemic stroke of the brain, thrombosis may develop

The causes of thrombosis are restriction of movement, impaired blood clotting, and severe dehydration. As mentioned above, after an illness, people often lack the ability to independently care for themselves. But the body needs a lot of fluid to replenish lost reserves. Therefore, it is very important not only during the rehabilitation period, but also in later life to provide a person with the opportunity to consume at least 2.5 liters of fluid per day. He will regularly need to take medications that thin the blood and prevent the development of thrombosis.

A blood clot can form in the vessels of a paralyzed leg, but sometimes in a healthy limb. During initial active actions after rehabilitation, the blood clot may come off. The consequences of this are the development of thromboembolism, which causes death in 89% of cases. To prevent such consequences, when a person begins to move actively, his limbs are bandaged with elastic bandages or compression stockings are used. To prevent the development of thrombosis, doctors prescribe a course therapeutic exercises and medicines.

Impaired coordination of movements

Human body - very complex system, which contains many functions. With the coordinated action of the entire structure, a person can move, think and perform tasks. If one task does not work correctly, other processes change. Thus, a violation of movement coordination occurs as a result of a malfunction of the central nervous system. In order to start treatment on time and eliminate the pathology, it is necessary to understand the symptoms of the disease.

Characteristics of the disease

Impaired coordination of movement is called “ataxia” by the medical term. This condition is a sign of an inflammatory process that was triggered by problems in the functioning and distribution of nerve impulses sent from the brain.

To carry out effective treatment, it is necessary to conduct a comprehensive diagnosis and eliminate the factors that initially influenced the process of human brain activity. Self-medication in such a situation is impossible and unacceptable. This is because serious consequences such as disability or death are possible.

The musculoskeletal system is subject to control by the nervous system. Neurons located in the spinal cord and brain are interconnected. Thanks to their coordinated work, a signal is transmitted to the main human organ. From there comes a response impulse that provokes action.

With high-quality communication between neurons from different areas, the signal is clear and lightning fast. If there are problems in any part, the impulse is supplied slowly or is absent altogether. The disturbance is called loss of motor coordination.

Most often, the disease occurs in older people who have crossed the 60-year threshold, regardless of whether they are men or women. The reason for the occurrence, first of all, is the aging of the body and the inability to clearly and fully carry out assigned tasks. The disease can develop not only in adults, but also in children.

Species and types

There are static and dynamic violations. In the first case, problems with coordination arise only when the person is vertical, when the patient is standing. In the second situation, incoordination appears with any movement.

The following types of ataxia are diagnosed:

Posterior columnar (sensitive) – develops with damage to the spinal and peripheral nerves, as well as the thalamus and posterior columns of the spinal cord. Movement is difficult; when walking, the patient does not feel a hard surface underneath him or his own actions. The cause is changes in the sensitivity of the muscular-articular system.
Cerebellar - manifests itself due to damage to the cerebellar system. It is divided into 2 types: dynamic or static-locomotor. In the first type, the functioning of the cerebellar hemispheres is disrupted. The person makes frequent chaotic movements, there is uncoordination, trembling of the arms and legs, and a speech disorder is detected. The second type is characterized by damage to the cerebellar vermis. The patient has an unsteady gait, he staggers and spreads his legs when walking. In severe cases, the support of the head is disrupted and keeping it in one position becomes impossible.
Vestibular – disorders occur in the vestibular apparatus. The head is constantly dizzy, the condition is accompanied by nausea and vomiting. When changing position or sudden movement symptoms worsen.
Cortical - the problem occurs in the cortex in the frontal lobe in the anterior regions. Impulses from this part are directed to the cerebellum. There is a change in gait, unsteadiness and uncertainty when walking. The human body deviates in different directions, the feet are aligned in one straight line, and legs become entangled.

To correctly diagnose the type of disease, the factors of its occurrence are first identified. Based on these data, the patient is prescribed therapy. To eliminate the problem, you need to know exactly the causes of poor coordination when walking.

Causes of the disease

The movement problem is dangerous and serious for a patient with disabilities. Being in this state, a person is unable to coordinate his own actions.

The development of the disease is influenced by many factors. The following reasons are identified:

Traumatic brain injury;
Formation of tumors in the brain or cerebellum;
Parkinson's disease;
Changes in blood circulation in the brain;
Cervical osteochondrosis;
Muscular dystrophy;
Stroke;
Cerebral palsy;
Intoxication due to improper use of medications;
Gas poisoning;
Autoimmune diseases (diabetes mellitus);
Sclerotic changes in old age;
Infectious diseases: meningitis, encephalitis;
Taking narcotic drugs;
Catalepsy is muscle relaxation due to a surge of emotions.

It is not difficult to identify the disease; the symptoms are visible to the naked eye. But to know exactly what they are, you need to familiarize yourself with the clinical picture.

Symptoms of manifestation

People with a developing disease move poorly, are unsure, lack balance, appear distracted, and have impaired articulation. When trying to draw a figure, for example, a circle, in the air, the patient ends up with a zigzag or broken line.

One method of testing coordination is a test where the patient is asked to touch his nose. If the disease develops, a person cannot normally complete the task. The patient gets it either in the mouth or in the eye. Negative changes are also visible in the handwriting: the letters are written unevenly, creep on top of each other, and jump along the line. These signs indicate neurological problems.

When coordination is impaired, the following symptoms appear:

The pupil perceives the present as an illusion, objects are constantly in motion or rotation;
The gait changes, there are frequent falls;
High blood pressure is recorded, hypertension is detected;
The patient becomes lethargic, drowsiness appears or sleep is disturbed;
There is a malfunction in the functioning of the hearing organs: sometimes noises are heard, sometimes sudden silence;
There is tremor of the limbs;
There is a loss of clarity and coherence of movements;
There are headaches for no apparent reason and severe dizziness;
Irregular breathing, shortness of breath, increased sweating;
Psychoneurological disorders occur - delusions, hallucinations.

Regardless of what symptom is present, you should immediately consult a doctor. The doctor assesses the patient’s condition and accurately establishes a diagnosis, on the basis of which a therapeutic intervention is prescribed. Early detection of disturbances in motor coordination leads to a reduction in symptoms and short-term therapy.

Treatment of ataxia

To accurately identify the disease that the patient suffers from, the doctor records complaints, conducts an external examination and tests. To make an accurate diagnosis, it is necessary to undergo a certain examination:

Biochemical blood test in expanded form;
Magnetic resonance and computed tomography;
General urine and blood tests;
Ultrasound examination of internal organs.

Depending on the patient’s complaints, the diagnosis is adjusted, and the range of necessary tests is expanded. Based on the results obtained, the doctor tells you how and why you need treatment.

To treat motor coordination disorders, a comprehensive approach is used, which includes drug therapy, the need to do exercises and folk remedies.

In accordance with the test results and the severity of the disease, the doctor prescribes medications that help restore and normalize blood circulation in the brain. It is definitely worth supporting the body with fortified complexes. The following medications are used for therapy:

Nootropics and angioprotectors;
Hormone-based drugs;
Vitamins B, A, C, B12;
Antibiotics to treat existing infection in the brain or middle ear;
Medicines that activate cellular metabolism.

All medications are prescribed by the doctor for the patient on an individual basis. They are designed to connect all the negative factors of the disease and comprehensively influence them.

In addition to pills, you need to do daily exercises and apply therapeutic massage. For this purpose, a number of exercises have been specially developed to restore balance and improve coordination of movements:

When traveling to public transport It’s better not to sit down, but to remain standing. The legs are spread shoulder-width apart, you need to refrain from supporting. Try to coordinate your movements while balancing on weight;
Place your feet together, spread your arms in different directions, close your eyes. You need to hold this position for 20 seconds. Then lower your hands and repeat the procedure again;
It is required to take long walks every day, taking walks. You need to walk along a narrow curb without the help of others. This exercise can be done at home. To do this, you need to draw a line or lay out a board and try to walk smoothly along the marked surface;
Exercise with stairs. You have to climb up and down the rungs several times throughout the day.
Both feet are placed on the same line, so that the toe rests on the heel of the other. Hands spread in different directions. You need to stand like this for 15-20 seconds, then change position.

Thanks to daily exercises, all systems are gradually brought back to normal. Drug therapy has an additional effect on internal organs and normalizes blood circulation. This allows you to quickly treat the acquired disease.

Thus, impaired coordination of movement is a pathological process that occurs due to malfunctions of the nervous system. The symptoms of the disease are obvious, so you should not delay treatment. Correctly and daily exercises, as well as taking recommended medications, can quickly restore the patient’s condition.

Consequences of a stroke

Hello, dear readers and guests of the site dedicated to neurorehabilitation. Let's talk today and take a closer look consequences of a stroke- ischemic and hemorrhagic, as well as everything connected with it.

Consequences of a stroke.

Disturbances in any functions after a stroke are directly dependent on its severity, and the severity, in turn, on the size of the lesion and its location in the brain.

Of course, it is fair to note that the size of the lesion and its localization are not all the factors that determine the persistence and depth of neurological disorders that resulted from a stroke, the consequences of which (the nature and their severity) can vary significantly, depending on the specific case. What does this depend on?

The degree of dysfunction after a stroke is not always permanent. With a minor stroke, the consequences may be minimal or even absent, but this does not happen so often. We will discuss cases when these consequences exist and they are persistent. Let’s take a closer look at what exactly the consequences of a stroke are and how they are expressed. Listed below are the most significant dysfunctions of the body that occur after a stroke.

Right-sided and left-sided hemiparesis after stroke.

One of the most common permanent consequences of a stroke is a decrease in strength in half of the body - hemiparesis. As a rule, after a stroke there is a decrease muscle strength in one of the sides of the body, which is opposite to the damaged hemisphere of the brain: if the persistent consequence is hemiparesis of the left side of the body, the stroke occurs in the right hemisphere. The same principle applies to hemiparesis. right side body, in which a stroke is observed in the left hemisphere. That is, the focus of the infarction in the brain is in the hemisphere opposite to the affected half of the body.

It also happens that a stroke leads to a complete lack of muscle strength in half of the body, which is called hemiplegia. With hemiparesis, a person experiences difficulty moving; with hemiplegia, the difficulties are even more significant. Simply put, hemiplegia is paralysis in half of the body (complete lack of movement).

Normal movements in the body are disrupted, and many people have to learn to perform normal daily activities again in order to be able to take care of themselves, be able to eat, change clothes and walk. In general, do everything that before the illness was considered extremely simple and ordinary to do. It is the decrease in muscle strength in half of the body that is the main cause of disability in a person after suffering a cerebrovascular accident. It is because of this that patients lose the ability to move independently - either they lose this ability completely or it is significantly impaired.

As you have already described, gait after a stroke can often be disrupted, and the person begins to move with great difficulty. In some cases, you may need auxiliary devices - a special walker, a support cane or a crutch. The characteristic Wernicke-Mann posture develops when walking. Individual parts of the body may be affected without affecting the entire half of the body. Depending on the affected half of the body, left-sided and right-sided hemiparesis are distinguished.

Central prosoparesis.

The next, one of the most common consequences is the so-called central prosoparesis, in which the facial muscles suffer, resulting in facial asymmetry, as in Figure 1. In this case, a decrease in strength is observed not in the entire half of the face, but only in its lower part, involving the mouth, cheek, and lips.

With this paralysis of the facial muscles, the eyelids and eyes remain unaffected, despite this the distortion is quite noticeable and causes discomfort not only when eating or drinking. Central prosoparesis regresses with recovery from stroke.

With central prosoparesis, eating and drinking fluids is difficult. A person experiences obvious discomfort when performing some actions with facial muscles. Habitual emotions are more difficult to express due to decreased strength in facial muscles Sound production is disrupted and speech begins to suffer.

The defect itself brings noticeable inconvenience, purely from a cosmetic point of view. Facial distortion causes great emotional discomfort, especially when communicating with other people. This can cause withdrawal and withdrawal from communication with others and cause deep depression.

Speech impairment after stroke.

Speech disturbances after a stroke are also quite common, and at the same time they are one of the very first signs of an impending cerebrovascular accident. Speech impairment is the result of damage to the speech centers of the brain, which is a partial or complete loss of the ability to speak and perceive other people's speech, called aphasia.

According to statistics, such disorders are observed in a quarter of all people who have suffered a stroke, and their consequences can be quite persistent. Sometimes, it is difficult for a person to speak due to a violation of the speech apparatus, and the speech of such people is unclear, as if “porridge in the mouth,” and this disorder is called dysarthria . Dysarthria more often occurs with a brainstem stroke or localization of this focus in the cerebral cortex. The next speech disorder is aphasia.

Aphasia- this is a complete absence of speech. Aphasia can be of several types, let's name some of them: when the speech center responsible for pronunciation of speech is damaged, motor aphasia develops. When the focus of the stroke is located in the speech center responsible for its perception, so-called sensory aphasia develops. With sensory aphasia, a person does not understand what is said to him and does not understand what he needs to answer. If both centers are affected, mixed or sensorimotor aphasia occurs. The “pure” form of aphasia is extremely rare, and with a stroke, it is the mixed form that most often occurs.

There are other types of speech disorders after a stroke, which we will discuss in detail in the following articles on speech disorders. Now let’s move on... In addition to the listed violations, the following also occur: consequences of a stroke.

Impaired coordination of movements after a stroke.

Poor circulation in the parts of the central nervous system responsible for coordinating movements and as a result of a stroke can lead to coordination of movements, which is called ataxia. Impaired coordination of movements more often occurs with a brainstem stroke and this is due to the fact that the centers of coordination of movements in our body are located in the stem part of the brain.

It comes in varying degrees of severity. In the most favorable case, these vestibular disorders disappear within the first day from the moment of acute cerebrovascular accident. In other more severe cases, unsteadiness when walking and dizziness persist for a longer period and can last for months.

Visual impairment after stroke.

There may be visual impairments of a wide variety of nature. Visual impairment depends on the location of the stroke and the size of the lesion. Most often, visual impairment manifests itself in the form of loss of visual fields (hemianopsia). In this case, as you may have guessed, half or a quarter of the visual picture is missing. If a quarter of the picture falls out, it is called quadrant hemianopsia.

Other consequences of stroke.

Impaired hearing (hypoacusia), sense of smell (hypo-, anosmia), loss of movement skills with preserved strength (apraxia) and other disorders that can and should be treated; rehabilitation in this case is very important and should be carried out in a timely manner.
Sensory impairment after stroke. Sensory impairment after a stroke can be of a different nature, but most often it is a loss of the ability to feel pain, recognize heat, cold, and a part of the body as such. It is also possible that pain syndrome, having the most diverse character and localization. Most often, there is a decrease in sensitivity in some parts of the body, this phenomenon is called hypoesthesia.

Depression after stroke.

Depression- another consequence of a stroke that can negate any efforts of the doctor and loved ones to restore lost functions. According to some reports, up to 80% of stroke survivors suffer from depression to varying degrees. This is a rather serious consequence that can and should be treated.

In addition to the mood for recovery, an additional no less important “bonus” of eliminating depression will be the analgesic effect. It has long been proven that depression can increase pain in a person, and with a stroke, pain is not a rare occurrence. Prescribing antidepressants can help solve this problem.

It is extremely important to prescribe the “correct” antidepressant, since some of them can cause an “inhibitory effect”, which in some cases can also reduce a person’s desire to follow the doctor’s recommendations and become more active for better rehabilitation.

Stroke, the consequences of which remain after a course of treatment in the hospital, is a common occurrence. Such people need a course of full rehabilitation, which often begins in the hospital. The rehabilitation course itself is prescribed individually, depending on the severity and persistence of the consequences, as well as on the time that has passed since the stroke and the general condition of the patient.

Read about an example of such a rehabilitation center in the article rehabilitation center after a stroke.

Why is coordination of movements when walking impaired and dizziness occurs?

Latin term "coordination" translated as “coordination of actions or processes”. The concept itself "coordination of movements" means the process of interaction between the muscles of the body, which leads to the performance of certain actions.

Loss of coordination and dizziness when walking

Musculoskeletal system controlled by the central nervous system. It controls the coordination of movements of the human body, thanks to it you do not need to make special mental efforts to perform this or that movement.

Neurons in the brain and spinal cord have complex relationships; it is with their help that the signal about any movement is transmitted to the brain. A response signal comes out of it, which provokes movement. If neural connections work Fine, then such a signal is lightning fast, and when there are communication failures, the signal may be distorted or not transmitted at all. As a result - violation of movement coordination. which part of the brain is responsible for coordinating movements. Find out more about

Impaired coordination of movements can most often be observed in people older, because due to aging, human body cannot fully perform its functions, as a result, the activity of the nervous system slows down. But, there are a number of reasons that lead to poor coordination when walking.

You can also find information about the causes of dizziness when standing and when lying down on our website.

Causes and symptoms

Dizziness and imbalance walking problems are the most common problems encountered by doctors. Vestibular disorders of motor coordination can be caused by many diseases: viral, neurological, cardiovascular. Determining the cause can be quite difficult.

The causes of impaired coordination of movement when walking and dizziness can be:

Drug and alcohol use
Traumatic brain injuries
Parkinson's disease
Stroke
Brain disease
Poor circulation in the brain
Tumors of the cerebellum or brain
Arnold-Chiari malformation (part of the cerebellum is drooping)
Hydrocephalus (accumulation of cerebrospinal fluid in the brain system)
Diseases in which myelin breaks down
Cervical osteochondrosis
Diseases of the vestibular cranial nerves
Neuronit
Inner ear inflammation
Poisoning with any potent devices
Neuronyma
Vitamin B12 deficiency

Signs of a violation are:

Feeling the illusion of movement of the body or objects, rotation;
Disorientation in space;
Nausea, partial hearing loss and severe dizziness;
Unsteadiness when standing;
Gait disturbance, frequent falls;
High pressure;
Loss of consciousness;
Weakness;
Impaired body perception;
Trembling of body parts;
Frequent headaches.

Treatment

As mentioned above, problems with coordination and dizziness are consequences of the disease. In order to correct the situation, first of all, it is necessary to remove the cause. To do this you need to contact neurologist specialist, who will listen to the symptoms, identify the problem and prescribe appropriate treatment.

Drugs

Doctors prescribe medications to patients that help restore blood circulation in the brain and various vitamin complexes.

Drugs such as:

Angioprotectors and nootropics designed to normalize blood pressure and metabolism in the brain.
Various hormonal drugs.
Vitamins A, B, C.
Antibiotic therapy, which kills all infections in the inner ear and brain.
Vitamin B12.

Exercises

In order to restore proper coordination of movements, you first need to cure disease which led to it. After this, doctors usually prescribe a number of drugs that help the body normalize its work, various vitamins. Also included in the mandatory treatment program for coordination problems is physiotherapy.

Under the supervision of a specialist, the patient performs a series of simple actions that are designed to help better control their movements and body. All exercises are aimed at training balance when walking and standing, and they also help develop accuracy and precision. With their help, joints and muscles are strengthened.

One way effective treatment is massage, which helps eliminate the problem in a specific area of the body.

Some simple exercises for training coordination, which you can easily do on your own at any convenient time:

If you are traveling by public transport, then instead of sitting down in an empty seat, it’s better to stand. With your feet shoulder-width apart, try not to hold on, balance, trying to stand straight and not fall.
Place your feet together and extend your arms to the sides. Close your eyes and stand still for a minute, then lower your arms and stand for another 20 seconds.
Stretch your arms to the sides, place your feet together. Rise on your toes, freeze in place for 10-15 seconds as you rise, and lower yourself. Do this exercise with your eyes closed every day.
Place your feet together, hands on your waist, rise on your toes and at the same time tilt your head forward and back.
The body is in the same position Only when lifting on your toes, do several bends forward. Try to do the exercise with your eyes closed.
Stretch your arms to the sides lift your leg bent at the knee and stand for 30 seconds, change leg. Try to do it with your eyes closed; if it’s difficult, then reduce the time to 10 seconds.
Very effective exercise using a ladder. Hold onto the ladder with your hands and go up and down slowly. If there are no problems with this, then try to do the same thing only without using your hands. First, place one leg, lean your body forward, and then carefully place the other. Very slowly, try to rise as high as possible.
Imagine that there is a thin long board on the floor, try to walk along it smoothly, without swaying or stumbling. Close your eyes and repeat, trying to walk in a straight line, ask someone from your household to control your movements.
This exercise can be done at home, won't be needed for it special simulators, or technology. Take an apple or orange in each hand. Try tossing them up one by one and catching them. If it works, then complicate the task - throw at the same time, or with a small interval. Try to juggle them, try not to let them in.
Place your feet one after the other like this so that the heel of one foot touches the toe of the other. Place your arms to the sides, stand in this position for 15-20 seconds. Switch legs and try to do it with your eyes closed.
Feet shoulder-width apart, hands on waist, bend forward, backward, left and right. Repeat the exercise 10-15 times with your eyes closed.
Walking home from the store, you can see narrow curbs. Try to walk through them without assistance. This is a great balance exercise.

Which doctors should I contact?

Impaired coordination of movement when walking and dizziness are very serious signs that signal to a person that not everything is in order with his body. They may also indicate the presence of a more serious disease. Therefore, at the first signs, you need to contact a neurologist who will help cure this disease.

Patient's well-being after a stroke

The consequences of a stroke are individual for each patient. The condition following a stroke may be stable and virtually unchanged for some people, while others experience a more severe condition with long-term problems.

The consequences of a stroke depend on the following factors:

which side of the brain was affected;
extent of damage;
general health before the stroke.

Muscles and movement

1. Weakness on one side of the body. This leads to problems walking or performing other tasks.
2. Joint pain and difficulty moving. A person with a very weak arm may have shoulder pain that is caused by an inelastic joint. During rehabilitation, the muscles become elastic again, and stiffness in movements disappears.
3. Painful spasms interfere with rehabilitation; doctors use certain drugs that block nervous reactions and spasms.
4. Problems arise with the sense of touch or the ability to sense hot and cold. In addition, problems may arise in assessing the position of body parts.
5. Pain, numbness, or tingling in the extremities.
6. Loss of motor coordination (apraxia).
7. Trouble swallowing food (dysphagia).

Bowel and bladder

Urinary incontinence or problems emptying the bladder (urinary retention) may occur. You may also have constipation or problems controlling bowel movements after a stroke. Although these consequences make patients feel awkward and spoil their mood, however, bowel and bladder function is restored over time.

Memory

Aphasia usually results from damage to the left side of the brain, which is responsible for the language area. Some people who have aphasia may be unable to understand written or colloquial, read or write, or express your own thoughts.

The patient may have damage to the part of the brain that controls awareness, learning and memory. This leads to problems focusing or remembering. After a stroke, it is difficult to make plans, learn new activities, or perform other complex tasks. The patient may have trouble judging distance, size, position, speed of movement, shape, and how parts relate to the whole. Some people have trouble recognizing the body part on the affected side. This is especially true for people who cannot feel their injured arm or leg.

Vision problems: visual distortions, tunnel vision.

Fear, anxiety, anger, sadness, disappointment are common problems for most patients. About one third of people over 65 who have had a stroke have symptoms of depression.

Pain syndrome after a stroke is a psychologically and physically severe chronic disease caused by damage to the central nervous system. The patient does not feel any touch in the limb, but feels constant pain. Other consequences are decreased sensitivity, inability to respond to stimuli, and a feeling of heat.

Chronic headaches are a serious complication that is difficult to treat. They become a serious threat to the normal course of rehabilitation. The patient is not able to fully undergo all stages of therapy. Chronic pain reduces the quality of life and impairs the recovery rate of patients.

Fine motor skills require the proper functioning of the muscular, skeletal and neurological systems together. Physical therapists help patients improve their fine motor function. Patients perform some exercises at home in order to steadily continue working on restoring the body after a stroke.

Power training

Exercise is essential for stroke victims. Patients consistently achieve amazing results with consistent training. Exercises are aimed at engaging the affected side while inhibiting movements from the side healthy hand and legs.

Alternative therapy

Patients find an alternative in water training, hippotherapy, and also in healing with music. Musician John Hopkins wrote the story “Healing Through Music,” and for John and other sick people, music became a cure. Patients were able to find strength and joy in moments of despair.

Drawing has a positive effect, since in addition to joyful emotions and communication in a creative team, it improves fine motor skills. At first, the patients' drawings are very similar to children's, but over time, the function of the hand is restored and the paintings become not only part of the therapy, but also a good creative development. One of the alternative methods of treating the consequences of stroke is acupuncture.

Horseback riding

After a stroke, people rarely think of horseback riding as a form of therapy, but researchers have found that it is a useful addition to therapy for many sufferers. Horses provide a unique combination of pleasure and therapy for the rider's mind and body. Walking on a horse stimulates the patient's pelvis and torso in a way that is very similar to human walking. This movement stimulates the rider's body to respond in a three-dimensional, constantly changing pattern, resulting in stronger muscle tone, increased endurance and improved coordination.

Restoring coordination

About 40 percent of stroke survivors have a serious fall within a year of the attack. In a study published in the Journal of the American Heart Association, women have difficulty maintaining balance after a stroke. While getting dressed, they are seven times more likely to fall than before the attack. Poor balance of patients is also affected by frequent dizziness.

The body uses a combination of three systems to stay balanced: vision, vestibular and somatosensory. Strokes most often affect the central nervous system, after which the vestibular system is damaged.

In therapy after a stroke, simulators are used that train the vestibular apparatus. The simulator consists of moving platforms connected to a computer. The trainer identifies which body balance systems are not working properly. The test can pinpoint which muscles need to be strengthened to restore coordination, and also identifies exercises that can help combat dizziness.

Most patients have balance problems because one side is stronger than the other. Doctors recommend using not only healthy limbs, but also affected ones in everyday life.

An effective exercise for patients is to stand up from a lying position on the floor. During this exercise it is difficult to use only healthy limbs; one way or another, the affected muscles will also be involved.

To reduce the symptoms of dizziness, it is recommended to look at the object, while turning your head without taking your eyes off the observed object.

Hello, dear readers and guests of the site dedicated to neurorehabilitation. Let's talk today and take a closer look consequences of a stroke– ischemic and hemorrhagic, as well as everything connected with it.

Consequences of a stroke.

Disturbances in any functions after a stroke are directly dependent on its severity, and the severity, in turn, on the size of the lesion and its location in the brain.

The nature and persistence of the consequences of a stroke depend on the size of the lesion in the brain and its location.

The persistence of the consequences is strongly related to the time and volume of treatment and rehabilitation performed, but we’ll talk about this a little later, read on.

Right-sided and left-sided hemiparesis

One of the most common lasting consequences of a stroke is decreased strength in half the body. As a rule, after a stroke, there is a decrease in muscle strength in one of the sides of the body, which is opposite to the damaged hemisphere of the brain: if the persistent consequence is hemiparesis of the left side of the body, the stroke occurs in the right hemisphere. The same principle applies to hemiparesis on the right side of the body, in which a stroke is observed in the left hemisphere. That is, the focus of the infarction in the brain is in the hemisphere opposite to the affected half of the body.

Central prosoparesis

Fig.1. Central paresis of the facial muscles (central prosoparesis)

With central prosoparesis, eating and drinking fluids is difficult. A person experiences obvious discomfort when performing some actions with facial muscles. It is more difficult to express habitual emotions; due to a decrease in strength in the facial muscles, sound production is disrupted and speech begins to suffer.

Speech Impairment

According to statistics, such disorders are observed in a quarter of all people who have suffered a stroke, and their consequences can be quite persistent. Sometimes, it is difficult for a person to speak due to a violation of the speech apparatus, and the speech of such people is unclear, as if “porridge in the mouth,” but this disorder is called . Dysarthria more often occurs with a brainstem stroke or localization of this focus in the cerebral cortex. The next speech disorder is aphasia.

Aphasia is a complete absence of speech. Aphasia can be of several types, let's name some of them: when the speech center responsible for pronunciation of speech is damaged, motor aphasia develops. When the focus of the stroke is located in the speech center responsible for its perception, so-called sensory aphasia develops. With sensory aphasia, a person does not understand what is said to him and does not understand what he needs to answer. If both centers are affected, mixed or sensorimotor aphasia occurs. The “pure” form of aphasia is extremely rare, and with a stroke, the mixed form is most often found.

Impaired motor coordination

Visual impairment

There may be visual impairments of a wide variety of nature. Visual impairment depends on the location of the stroke and the size of the lesion. Most often, visual impairment manifests itself in the form of loss of visual fields(hemianopsia). In this case, as you may have guessed, half or a quarter of the visual picture is missing. If a quarter of the picture falls out, it is called quadrant hemianopsia.

Other consequences

Impaired hearing (hypoacusia), sense of smell (hypo-, anosmia), loss of movement skills with preserved strength (apraxia) and other disorders that can and should be treated; rehabilitation in this case is very important and should be carried out in a timely manner.
Sensory impairment after stroke. Sensory impairment after a stroke can be of a different nature, but most often it is a loss of the ability to feel pain, recognize heat, cold, and a part of the body as such. It is also possible for a pain syndrome to appear, of a very diverse nature and localization. Most often, there is a decrease in sensitivity in some parts of the body, this phenomenon is called hypoesthesia.

These dysfunctions may well manifest themselves as the first signs of a stroke at the very onset of the disease and persist for an indefinitely long time in the absence of active restoration of impaired neurological functions.Please note that the severity of all these changes and their persistence directly depend on the size of the lesion and the nature of the stroke. Read more about the factors that play the main roles in the development of ischemic stroke and the formation of its consequences.

Depression

Depression– another consequence of a stroke that can negate any efforts of the doctor and loved ones to restore lost functions. According to some reports, up to 80% of stroke survivors suffer from depression to varying degrees. This is a rather serious consequence that can and should be treated.

It is extremely important to prescribe the “correct” antidepressant, since some of them can cause an “inhibitory effect,” which in some cases can also reduce a person’s desire to follow the doctor’s recommendations and become more active for better rehabilitation.

If the hospital failed to fully restore a person after a stroke, then it is advisable to carry out further treatment in a specialized rehabilitation center.

Read about an example of such a rehabilitation center in the article.

Ataxia after stroke - symptoms, diagnostic tests, treatment

However, more than half of the episodes of this type of stroke are fatal, and a very high percentage of disability is recorded among survivors.

Ataxia is a disorder of movement coordination and motor skills.

Classification of ataxias

Normally, coordination of movements is regulated by the following parts of the brain:

medulla oblongata and midbrain;
cerebellum;
vestibular apparatus;
frontotemporal cortex of the cerebral hemispheres.

Sensitive ataxia

This type of ataxia develops after a stroke in the posterior columns of the spinal cord, the thalamus. It can occur in both limbs, one arm, or one leg. This type of movement disorder is characterized by loss of proprioceptive sensation. The patient cannot assess the position of his own body parts. A so-called stamping gait is observed - the patient bends his legs excessively and steps very hard on the floor. Often complains of the feeling of walking on a soft carpet. The victim constantly looks at his feet, thus trying to alleviate the pathological symptoms. When closing the eyes, the manifestations of ataxia intensify.

Cerebellar ataxia

Develops after a cerebellar stroke. There is unsteadiness when walking. The patient deviates towards the lesion, and in severe cases falls. If the cerebellar vermis is affected, a fall is possible in any direction and backwards. Walking is unsteady, with legs spread wide apart. Walking with an extended step is impossible or severely impaired. Hand movements are disproportionate and slow. The arm and leg on the affected side are more affected. Speech slows down, becomes drawn out and chanted. Unlike aphasia, where speech disorders are based on the death of neurons in cortical centers, coordination of movements is impaired in patients after a cerebellar stroke. The handwriting changes - the letters become sweeping and large.

Distinctive features of the gait of a patient with ataxia

Vestibular ataxia

Vestibular ataxia occurs when moving, sitting or standing. Symptoms intensify when turning the head, torso, and eyes. The person refuses to perform these movements, replaces them with others, or performs them at a slow pace. Thanks to visual control, it is possible to significantly compensate for coordination disorders. With unilateral lesions of the vestibular nuclei, unsteadiness and deviations of the body occur in the direction of the lesion. Movement disorders are especially noticeable when walking with eyes closed. Vestibular ataxia is accompanied by severe autonomic disorders - nausea, dizziness, nystagmus.

Cortical ataxia

Clinical manifestations of cortical ataxia

Diagnostic tests

Diagnosis of motor coordination disorders in patients after a stroke is based on the following points:

patient complaints;
inspection data;
diagnostic test results;
data from the results of additional research methods.

Coordination tests allow you to determine the type of ataxia and determine the location of the stroke.

Cerebellar function test

The gait is then assessed. The patient is asked to walk with a normal, straight, heel-to-toe gait and a flanking gait.

Heel-knee test - in a lying position, the patient should touch the heel of one leg to the opposite knee.

Treatment

As soon as possible, the patient begins motor exercises.

Massage, passive gymnastics, and physiotherapeutic procedures play an important role.

How to restore coordination of movements

Article from our subscriber

One of the main damage caused by a stroke is severe loss of coordination of movements. I couldn't complete the simplest test. Stretch your arms forward, close your eyes and touch the tip of your nose with your left and right hands. I missed. Right hand not much. Instead of the tip of the nose, it hit the bridge of the nose. With his left hand he missed badly, hit the forehead area, or even completely missed the head.

Recovery after a stroke is not possible without restoring coordination. To perform any movement, more than just muscle strength is required. It is necessary to coordinate their work.

At first I couldn't put a teaspoon into a cup. Didn't hit.

Coordination is more severely impaired on the left side. But we don't more exercise to the left side. Everything becomes equal gradually during the lessons.

Entry level exercises

To restore coordination, we do special gymnastics. We selected exercises to practice exactly those movements with coordination problems. As we recover, we make the gymnastics more difficult. Therefore, several gymnastics came out. Here's the gymnastics we started with. We started doing some of the exercises in bed.

1. Touching the nose

I do it while sitting in bed.
I stretch both arms out in front of me.
I close my eyes.
I alternately touch the tip of my nose with the fingers of my right and left hands.
10 reps.

2. Chess with the right hand

I do it while sitting in bed.
I place the pieces on the chessboard with my right hand.
5 reps.

3. Chess with the left hand

I do it while sitting in bed.
I place the pieces on the chessboard with my left hand.
10 reps.

4. Right hand square

I do it while sitting in bed.
I “draw” a square with my right hand. In front of you, at a distance arm's length. At the level of the face.
10 reps.

5. Square with your left hand

I do it while sitting in bed.
I “draw” a square with my left hand. In front of you, at arm's length. At the level of the face.
10 reps.

6. Right hand circle

I do it while sitting in bed.
I “draw” a circle with my right hand. In front of you, at arm's length. At the level of the face.
10 reps.

7. Left hand circle

I do it while sitting in bed.
I “draw” a circle with my left hand. In front of you, at arm's length. At the level of the face.
10 reps.

8. Two squares

I do it while sitting in bed.
I “draw” two squares with both hands at the same time and synchronously. In front of you, at arm's length. At the level of the face.
10 reps.

9. Two circles

I do it while sitting in bed.
I “draw” two circles with both hands at the same time and synchronously.
10 reps.
In front of you, at arm's length. At the level of the face.

10. Circle with your left foot

I perform while sitting on the edge of the bed.
With the toe of my left foot I “draw” a square on the floor.
10 reps.

11. Circle with your right foot

I perform while sitting on the edge of the bed.
With the toe of my right foot I “draw” a circle on the floor.
10 reps.

12. Square feet

I perform while sitting on the edge of the bed.
I “draw” a square on the floor with both feet and toes synchronously.
10 reps.

13. Circle with legs

I perform while sitting on the edge of the bed.
I “draw” a circle on the floor with both legs and toes synchronously.
10 reps.

Upgrade Rules

When drawing figures, I try to make the figures even and neat. I perform the exercises slowly, smoothly and calmly.

The exercises are very simple. We started doing them three weeks after the stroke. The results from them are noticeable and obvious. We did gymnastics five times a week. After a month, the coordination of movements of both arms and legs improved greatly.. More complex exercises began to happen.

Any movement you make is a micro training for coordination. It is important to think before doing something. Even to simply reach out to a cup and take it, you need to think about what you are doing and how. Every movement, especially one repeated many times, is registered and remembered in the brain. This is a skill.

We realized that if movements are made slowly and smoothly, then they are easier to coordinate and do correctly. As a result, it is fixed in the brain correct movement, not an error. Plus, with smooth and slow movements, I did less damage and did not catch objects around me. So the most effective way to restore coordination is to control every movement and make it smooth.

Advanced exercises

But that doesn't change special exercises. Proper gymnastics consists of movements more complex than in life. Therefore, having learned to do the complex, then it is easy to do the simple. We see the point sports training during recovery after a stroke. When skiing, biking or taking long walks, we make millions of movements.

Strength and endurance training takes place. Coordination of movements is practiced and strengthened. In ordinary life there are no such loads and complex movements as in sports. Therefore, after training, simple and ordinary skills are actively restored.

Having moved from “lying down”, bed rest to “walking” and having slightly restored the initial coordination skills, we moved on to more complex gymnastics:

14. Figures with the right foot

hands on the belt.
I shift my weight to my left leg. The right leg is completely unloaded
toe ( thumb) right leg, straight in front of me, I draw shapes on the floor in order (circle, square, triangle).
I draw medium-sized figures so that they are comfortable and don’t have to stretch.
3 reps x 3 shapes.

15. Figures with the left foot

I do it while standing. If it is needed. I do it with support.
hands on the belt.
I shift my weight to my right leg. Left leg completely unloaded.
With the toe (big toe) of my left foot, straight in front of me, I draw shapes on the floor in order (circle, square, triangle).
3 reps x 3 shapes.

16.Right foot numbers

I do it while standing. If it is needed. I do it with support.
hands on the belt.
I shift my weight to my left leg. The right leg is completely unloaded.
With the toe (big toe) of my right foot, straight in front of me, I draw numbers on the floor, in order from 1 to 10.
I draw the numbers in medium size, so that it is convenient and does not have to stretch.
2 repetitions x 10 numbers.

17. Numbers with your left foot

I do it while standing. If it is needed. I do it with support.
hands on the belt.
I shift my weight to my right leg. The left leg is completely unloaded
With the toe (big toe) of my left foot, straight in front of me, I draw numbers on the floor, in order from 1 to 10.
2 repetitions x 10 numbers.

We perform these exercises smoothly. When “drawing” figures or numbers on the floor, I make movements smoothly and slowly. The main quality of the “drawing”. With such exercises we train coordination, this is the main thing. That's why in the beginning I made them with support.

So as not to think about balance. Standing on my left leg makes it more difficult for me to maintain balance. Standing on my right leg, I maintain my balance confidently, but at the same time, “drawing” with my left leg is not very good. Just when doing similar exercises shoals with coordination come out. That's what we catch.

Is there a risk of stroke?

1. Increased (over 140) blood pressure:

often
Sometimes
rarely

2. Vascular atherosclerosis

3. Smoking and alcohol:

often
Sometimes
rarely

4. Heart disease:

birth defect
valve disorders
heart attack

5. Undergoing medical examination and MRI diagnostics:

Every year
once in a lifetime
never

Total: 0%

Stroke is a rather dangerous disease that affects people not only of old age, but also of middle age and even very young people.

A stroke is a dangerous emergency that requires immediate help. It often ends in disability, in many cases even death. In addition to blockage of a blood vessel in the ischemic type, the cause of an attack can also be a cerebral hemorrhage due to high blood pressure, in other words, hemorrhagic stroke.

A number of factors increase the likelihood of having a stroke. For example, genes or age are not always to blame, although after 60 years the threat increases significantly. However, everyone can do something to prevent it.

1. Avoid hypertension

High blood pressure is a major risk factor for stroke. Insidious hypertension does not manifest symptoms on initial stage. Therefore, patients notice it late. It is important to measure your blood pressure regularly and take medications if levels are elevated.

2. Quit smoking

Nicotine constricts blood vessels and increases blood pressure. The risk of stroke for a smoker is twice as high as for a non-smoker. However, there is good news: those who quit smoking noticeably reduce this danger.

3. If you are overweight: lose weight

Obesity is an important factor in the development of cerebral infarction. Obese people should think about a weight loss program: eat less and eat better, add physical activity. Older adults should discuss with their doctor how much weight loss they would benefit from.

4. Keep your cholesterol levels normal

Elevated levels of “bad” LDL cholesterol lead to deposits of plaques and emboli in blood vessels. What should the values be? Everyone should find out individually with their doctor. Since the limits depend, for example, on the presence of concomitant diseases. Additionally, high values of “good” HDL cholesterol are considered positive. Healthy image life, especially a balanced diet and plenty physical exercise, may have a positive effect on cholesterol levels.

5. Eat healthy food

A diet that is generally known as “Mediterranean” is beneficial for blood vessels. That is: lots of fruits and vegetables, nuts, olive oil instead of frying oil, less sausage and meat and lots of fish. Good news for gourmets: you can afford to deviate from the rules for one day. It is important to eat healthily in general.

6. Moderate alcohol consumption

Excessive alcohol consumption increases the death of stroke-affected brain cells, which is not acceptable. It is not necessary to abstain completely. A glass of red wine a day is even beneficial.

7. Move actively

Movement is sometimes the best thing you can do for your health to lose weight, normalize blood pressure and maintain the elasticity of blood vessels. Endurance exercises such as swimming or fast walk. Duration and intensity depend on personal physical training. Important note: Untrained individuals over 35 years of age should be initially examined by a physician before starting to exercise.

8. Listen to the rhythm of your heart

A number of heart diseases contribute to the likelihood of a stroke. These include atrial fibrillation, birth defects, and other rhythm disorders. Possible early signs of heart problems should not be ignored under any circumstances.

9. Control your blood sugar

People with diabetes are twice as likely to suffer a cerebral infarction than the rest of the population. The reason is that elevated levels glucose can damage blood vessels and promote plaque deposits. In addition, people with diabetes often have other risk factors for stroke, such as hypertension or too high blood lipids. Therefore, diabetic patients should take care to regulate their sugar levels.

10. Avoid stress

Sometimes stress has nothing wrong with it and can even motivate you. However, prolonged stress can increase blood pressure and susceptibility to disease. It can indirectly cause the development of a stroke. There is no panacea for chronic stress. Think about what is best for your psyche: sports, an interesting hobby, or perhaps relaxation exercises.

Impaired coordination of movements

The human body is a complex system that contains many functions. With the coordinated action of the entire structure, a person can move, think and perform tasks. If one task does not work correctly, other processes change. Thus, impaired coordination of movement occurs as a result of a malfunction of the central nervous system. In order to start treatment on time and eliminate the pathology, it is necessary to understand the symptoms of the disease.

Characteristics of the disease

Species and types

The following types of ataxia are diagnosed:

Posterior columnar (sensitive) - develops with damage to the spinal and peripheral nerves, as well as the thalamus and posterior columns of the spinal cord. Movement is difficult; when walking, the patient does not feel a hard surface underneath him or his own actions. The cause is changes in the sensitivity of the muscular-articular system.
Cerebellar - manifests itself due to damage to the cerebellar system. It is divided into 2 types: dynamic or static-locomotor. In the first type, the functioning of the cerebellar hemispheres is disrupted. The person makes frequent chaotic movements, there is uncoordination, trembling of the arms and legs, and a speech disorder is detected. The second type is characterized by damage to the cerebellar vermis. The patient has an unsteady gait, he staggers and spreads his legs when walking. In severe cases, the support of the head is disrupted and keeping it in one position becomes impossible.
Vestibular – disorders occur in the vestibular apparatus. The head is constantly dizzy, the condition is accompanied by nausea and vomiting. When changing position or sudden movement, the symptoms worsen.
Cortical - the problem occurs in the cortex in the frontal lobe in the anterior regions. Impulses from this part are directed to the cerebellum. There is a change in gait, unsteadiness and uncertainty when walking. The human body deviates in different directions, the feet are aligned in one straight line, and legs become entangled.

Causes of the disease

The movement problem is dangerous and serious for a patient with disabilities. Being in this state, a person is unable to coordinate his own actions.

The development of the disease is influenced by many factors. The following reasons are identified:

Traumatic brain injury;
Formation of tumors in the brain or cerebellum;
Parkinson's disease;
Changes in blood circulation in the brain;
Cervical osteochondrosis;
Muscular dystrophy;
Stroke;
Cerebral palsy;
Intoxication due to improper use of medications;
Gas poisoning;
Autoimmune diseases (diabetes mellitus);
Sclerotic changes in old age;
Infectious diseases: meningitis, encephalitis;
Taking narcotic drugs;
Catalepsy is muscle relaxation due to a surge of emotions.

It is not difficult to identify the disease; the symptoms are visible to the naked eye. But to know exactly what they are, you need to familiarize yourself with the clinical picture.

Symptoms of manifestation

When coordination is impaired, the following symptoms appear:

The pupil perceives the present as an illusion, objects are constantly in motion or rotation;
The gait changes, there are frequent falls;
High blood pressure is recorded, hypertension is detected;
The patient becomes lethargic, drowsiness appears or sleep is disturbed;
There is a malfunction in the functioning of the hearing organs: sometimes noises are heard, sometimes sudden silence;
There is tremor of the limbs;
There is a loss of clarity and coherence of movements;
There are headaches for no apparent reason and severe dizziness;
Irregular breathing, shortness of breath, increased sweating;
Psychoneurological disorders occur - delusions, hallucinations.

Treatment of ataxia

Biochemical blood test in expanded form;
Magnetic resonance and computed tomography;
General urine and blood tests;
Ultrasound examination of internal organs.

Depending on the patient’s complaints, the diagnosis is adjusted, and the range of necessary tests is expanded. Based on the results obtained, the doctor tells you how and why you need treatment.

To treat impaired motor coordination, a comprehensive approach is used, which includes drug therapy, the need to do exercises and folk remedies.

Nootropics and angioprotectors;
Hormone-based drugs;
Vitamins B, A, C, B12;
Antibiotics to treat existing infection in the brain or middle ear;
Medicines that activate cellular metabolism.

All medications are prescribed by the doctor for the patient on an individual basis. They are designed to connect all the negative factors of the disease and comprehensively influence them.

When traveling on public transport, it is better not to sit down, but to remain standing. The legs are spread shoulder-width apart, you need to refrain from supporting. Try to coordinate your movements while balancing on weight;
Place your feet together, spread your arms in different directions, close your eyes. You need to hold this position for 20 seconds. Then lower your hands and repeat the procedure again;
It is required to take long walks every day, taking walks. You need to walk along a narrow curb without the help of others. This exercise can be done at home. To do this, you need to draw a line or lay out a board and try to walk smoothly along the marked surface;
Exercise with stairs. You have to climb up and down the rungs several times throughout the day.
Both feet are placed on the same line, so that the toe rests on the heel of the other. Hands spread in different directions. You need to stand like this for 15-20 seconds, then change position.

Thanks to daily exercises, all systems are gradually brought back to normal. Drug therapy additionally affects internal organs and normalizes blood circulation. This allows you to quickly treat the acquired disease.

Consequences of a stroke

Consequences of a stroke.

Disturbances in any functions after a stroke are directly dependent on its severity, and the severity, in turn, on the size of the lesion and its location in the brain.

Right-sided and left-sided hemiparesis after stroke.

One of the most common permanent consequences of a stroke is a decrease in strength in half of the body - hemiparesis. As a rule, after a stroke, there is a decrease in muscle strength in one of the sides of the body, which is opposite to the damaged hemisphere of the brain: if the persistent consequence is hemiparesis of the left side of the body, the stroke occurs in the right hemisphere. The same principle applies to hemiparesis on the right side of the body, in which a stroke is observed in the left hemisphere. That is, the focus of the infarction in the brain is in the hemisphere opposite to the affected half of the body.

Central prosoparesis.

Speech impairment after stroke.

Impaired coordination of movements after a stroke.

Visual impairment after stroke.

Other consequences of stroke.

Impaired hearing (hypoacusia), sense of smell (hypo-, anosmia), loss of movement skills with preserved strength (apraxia) and other disorders that can and should be treated; rehabilitation in this case is very important and should be carried out in a timely manner.
Sensory impairment after stroke. Sensory impairment after a stroke can be of a different nature, but most often it is a loss of the ability to feel pain, recognize heat, cold, and a part of the body as such. It is also possible for a pain syndrome to appear, of a very diverse nature and localization. Most often, there is a decrease in sensitivity in some parts of the body, this phenomenon is called hypoesthesia.

Depression after stroke.

Read about an example of such a rehabilitation center in the article rehabilitation center after a stroke.

Why is coordination of movements when walking impaired and dizziness occurs?

Loss of coordination and dizziness when walking

Impaired coordination of movements can most often be observed in people older, because due to aging, the human body cannot fully perform its functions, as a result, the activity of the nervous system slows down. But, there are a number of reasons that lead to poor coordination when walking.

You can also find information about the causes of dizziness when standing and when lying down on our website.

Causes and symptoms

The causes of impaired coordination of movement when walking and dizziness can be:

Drug and alcohol use
Traumatic brain injuries
Parkinson's disease
Stroke
Brain disease
Poor circulation in the brain
Tumors of the cerebellum or brain
Arnold-Chiari malformation (part of the cerebellum is drooping)
Hydrocephalus (accumulation of cerebrospinal fluid in the brain system)
Diseases in which myelin breaks down
Cervical osteochondrosis
Diseases of the vestibular cranial nerves
Neuronit
Inner ear inflammation
Poisoning with any potent devices
Neuronyma
Vitamin B12 deficiency

Signs of a violation are:

Feeling the illusion of movement of the body or objects, rotation;
Disorientation in space;
Nausea, partial hearing loss and severe dizziness;
Unsteadiness when standing;
Gait disturbance, frequent falls;
High pressure;
Loss of consciousness;
Weakness;
Impaired body perception;
Trembling of body parts;
Frequent headaches.

Treatment

Drugs

Doctors prescribe medications to patients that help restore blood circulation in the brain and various vitamin complexes.

Drugs such as:

Angioprotectors and nootropics designed to normalize blood pressure and metabolism in the brain.
Various hormonal drugs.
Vitamins A, B, C.
Antibiotic therapy, which kills all infections in the inner ear and brain.
Vitamin B12.

Exercises

One of the effective treatment methods is massage, which helps eliminate the problem in a specific area of the body.

We have developed some simple exercises for training coordination that you can easily perform on your own at any convenient time:

If you are traveling by public transport, then instead of sitting down in an empty seat, it’s better to stand. With your feet shoulder-width apart, try not to hold on, balance, trying to stand straight and not fall.
Place your feet together and extend your arms to the sides. Close your eyes and stand still for a minute, then lower your arms and stand for another 20 seconds.
Stretch your arms to the sides, place your feet together. Rise on your toes, freeze in place for 10-15 seconds as you rise, and lower yourself. Do this exercise with your eyes closed every day.
Place your feet together, hands on your waist, rise on your toes and at the same time tilt your head forward and back.
The body is in the same position Only when lifting on your toes, do several bends forward. Try to do the exercise with your eyes closed.
Stretch your arms to the sides lift your leg bent at the knee and stand for 30 seconds, change leg. Try to do it with your eyes closed; if it’s difficult, then reduce the time to 10 seconds.
A very effective exercise using stairs. Hold onto the ladder with your hands and go up and down slowly. If there are no problems with this, then try to do the same thing only without using your hands. First, place one leg, lean your body forward, and then carefully place the other. Very slowly, try to rise as high as possible.
Imagine that there is a thin long board on the floor, try to walk along it smoothly, without swaying or stumbling. Close your eyes and repeat, trying to walk in a straight line, ask someone from your household to control your movements.
This exercise can be done at home, it does not require special simulators or equipment. Take an apple or orange in each hand. Try tossing them up one by one and catching them. If it works, then complicate the task - throw at the same time, or with a small interval. Try to juggle them, try not to let them in.
Place your feet one after the other like this so that the heel of one foot touches the toe of the other. Place your arms to the sides, stand in this position for 15-20 seconds. Switch legs and try to do it with your eyes closed.
Feet shoulder-width apart, hands on waist, bend forward, backward, left and right. Repeat the exercise 10-15 times with your eyes closed.
Walking home from the store, you can see narrow curbs. Try to walk through them without assistance. This is a great balance exercise.

Which doctors should I contact?

Patient's well-being after a stroke

The consequences of a stroke depend on the following factors:

which side of the brain was affected;
extent of damage;
general health before the stroke.

Muscles and movement

1. Weakness on one side of the body. This leads to problems walking or performing other tasks.
2. Joint pain and difficulty moving. A person with a very weak arm may have shoulder pain that is caused by an inelastic joint. During rehabilitation, the muscles become elastic again, and stiffness in movements disappears.
3. Painful spasms interfere with rehabilitation; doctors use certain drugs that block nervous reactions and spasms.
4. Problems arise with the sense of touch or the ability to sense hot and cold. In addition, problems may arise in assessing the position of body parts.
5. Pain, numbness, or tingling in the extremities.
6. Loss of motor coordination (apraxia).
7. Trouble swallowing food (dysphagia).

Bowel and bladder

Memory

Aphasia usually results from damage to the left side of the brain, which is responsible for the language area. Some people who have aphasia may be unable to understand written or spoken language, read or write, or express their own thoughts.

Vision problems: visual distortions, tunnel vision.

Fear, anxiety, anger, sadness, disappointment are common problems for most patients. About one third of people over 65 who have had a stroke have symptoms of depression.

Power training

Exercise is essential for stroke victims. Patients consistently achieve amazing results with consistent training. The exercises are aimed at engaging the affected side while inhibiting movement on the unaffected arm and leg.

Alternative therapy

Patients find alternatives in water exercises, hippotherapy, and healing through music. Musician John Hopkins wrote the story “Healing Through Music,” and for John and other sick people, music became a cure. Patients were able to find strength and joy in moments of despair.

Horseback riding

Restoring coordination

Most patients have balance problems because one side is stronger than the other. Doctors recommend using not only healthy limbs, but also affected ones in everyday life.

To reduce the symptoms of dizziness, it is recommended to look at the object, while turning your head without taking your eyes off the observed object.

Impaired motor function is one of the most common consequences of cerebral stroke. It manifests itself in the form of paralysis of one or both legs, and sometimes the arms also lose their functions. Most often this occurs with an ischemic stroke that occurs in the right side of the brain. When the patient is given first aid, blood circulation is normalized and discharged from the hospital, he will need long-term rehabilitation. The most difficult thing to do after a stroke is to restore walking, because... it will be very difficult to achieve results, and it will not be possible to cope at all without outside help.

Motor dysfunction

Paralysis lower limbs with ischemic stroke it is observed in 80% of cases. Also, the legs can be paralyzed due to hemorrhagic hemorrhage, but most often it disrupts the functioning of only one leg. Such consequences are explained by the fact that after a failure of blood circulation, the areas of the brain that respond to movement are left without power. At the same time, all the impulses that the brain sends to the limbs cannot reach the goal. The result is the inability to control individual or all muscles.

How violations may manifest themselves:

The gait becomes very unsteady, the person may sway to the sides;
The leg does not straighten or bend;
When moving, the injured leg describes a semicircle, reminiscent of turning a compass;
The person stands on his toes and finds it difficult to stand on his entire foot.

Restoring contact between the brain and muscles, learning to walk, and regaining the ability to control the legs are the main tasks for the rehabilitation period. This may require a lot of time and patience. In most cases, it takes 3 to 4 months to restore motor function. Sometimes this period can last even longer, because... everything is complicated by the patient’s fear of not achieving results, lack of motivation and decreased cognitive functions.

- Very swipe not only in the body, but also in the psyche. Therefore, the support of loved ones is very important for the patient. Their task will be to provide comfortable conditions for the rehabilitation of the victim. It is important to try to rid him of fear, convince him that there is no need to be afraid, constantly communicate with him and help him in everything.

Impairment of motor function can occur even if the stroke affects the spinal cord and not the brain.

Class safety

It is impossible to restore motor function abruptly. Everything should happen gradually, the patient should be monitored in order to receive timely help if necessary. But even with the right approach to rehabilitation, achieving a positive result can be extremely difficult. It is very important to follow a number of simple rules:

Warming up the muscles. Before any exercise, you should warm up your muscles so that they work better and are not damaged.
Help from loved ones. For any physical activities The patient should have close people nearby who will help if he falls or gets injured.
Safe conditions. You should begin trying to walk only in a room where the patient will not be injured by falling and will not trip over any things.
Go outside. You can only move your walking training outside in good weather. If it is hot, cold or very windy, the patient will become ill.
The right shoes. Feet should be dressed in shoes that are high and close to the skin, but they should be light, comfortable and easy to put on.

It is equally important to dose the load. You should not immediately go for a long walk without good preparation. It is recommended to always start small. At the same time, you need to let your body regain its strength, and not start training immediately after leaving the hospital.

Almost everyone after a stroke sways in different directions while walking. To get rid of this problem, you need to strengthen the muscles of the lower extremities. This can be partially achieved with the help of simple gymnastics, but the main recovery will occur in the process of re-learning to walk. While the person is unstable, a special support should be used. 3 options are suitable:

Cane. A familiar attribute for older people can help anyone who has suffered a stroke. Using a cane can make walking training safer and more effective. The advantage of this option is its low cost and simplicity.
Walkers. A special vehicle will create support on both sides at once. There are several types of walkers, which allows you to choose the most suitable option. The main advantage of this method is increased safety for the patient.
Crutches. This is a very safe option, but it is the least effective. Achieve quick recovery motor function will not be possible with crutches, because their use interferes with walking training.

You can try to train even without support, but then physical support from other people will be very important. If it is not there, the patient will fall, which can not only cause pain, but also set the result back several stages, and a complete loss of motivation will be possible.

Passive gymnastics

Walking restoration should begin with passive gymnastics. It is carried out with the help of a rehabilitation doctor or a loved one who is familiar with this technique. Movements must be performed in all joints of the legs. The classes are very simple: the patient lies down, and the rehabilitator takes him by the limbs and performs certain movements.

Training may include:

Circular rotations in the joints 5 times each. After completion, you should repeat them in the opposite direction.
Stretching all joints. You need to pull out all the joints one by one, and then press them back with a slight movement. Repeats several times.
Flexion and extension of each joint. You need to bend and straighten each of them at least 7 times.

These exercises are repeated for a short period of time - about a week. They can be supplemented with an unusual method. It consists of hanging a special loop over the patient’s bed, into which he must insert his leg, hooking his foot. The rehabilitation therapist will slowly rock the patient's leg. When a person begins to recover motor functions, he can swing the limb independently.

Gradually, the recovery of the leg after a stroke should be transferred from passive to active gymnastics, but some kind of preparation will be required. The patient will need to show willpower and mentally try to achieve mobility of the limbs. This goal can be achieved using 2 methods:

Mental sending of impulses. The patient must imagine the movement with the paralyzed leg, then reproduce it with the healthy one if only one is injured, and then try to mentally transfer the resulting sensation to the first limb. Such impulses must be sent repeatedly.
Motivation from the outside. A rehabilitation therapist or a loved one should constantly talk to the patient, trying to motivate him to active movements. You need to ask him to help move his limbs, convince him that everything will work out soon, and also praise him for any successes achieved.

When he is able to perform the movements, he should immediately move on to active gymnastics, which will lead to a speedy recovery and learning to walk properly.

Active gymnastics

The first active exercises should be performed in supine position. They help restore all basic limb movement skills, and at the same time, gymnastics will improve blood circulation. It is important to monitor the load so as not to overexert a weakened body. If it becomes difficult for the patient, then you need to stop all training and give him a rest.

You can do quite a lot while lying down different exercises. A rehabilitator or a loved one must ensure that all movements are correct and the muscles are fully functional. Gymnastics complex for bedridden patients includes the following exercise options:

The direction of the feet is outward and inner side. This should be done with your legs bent at the knees, and the soles of your feet should be pressed against the surface of the bed.
Knee bends. When bending, the foot should move along the bed. Can be supplemented with similar hand movements. First you should train your right limbs, and only then your left ones.
Heel movement. You need to lie straight, with the foot of one leg running along the front of the shin of the other. Then repeat for the second limb.
Reverse leg curls. The person lies on his stomach and begins to slowly bend his legs at the knee joint, repeating the movement several times.
Lifting and spreading the legs. First you need to raise your legs up, slowly spread them in different directions, and then return them to the starting position.
Raising the pelvis. You need to bend your knees and then slowly lift your pelvis up. This should not be done too hard so as not to injure the joints and spine. Movements should be smooth and careful.
Side leg raise. The patient lies on his side and begins to slowly lift and lower upper leg. After several repetitions, you should do the same on the other side.
Swinging legs. You should bend your knees, resting your feet on the bed. The goal is to throw one leg over the other. The exercise must be performed alternately for both legs. If it seems difficult, then the leg can be thrown only to the knee, fixing it on it and slowly moving it to the side.
Turning over to the other side. Made by bending knee joints, throwing bent legs sideways and independently turning the body in a given direction.
Pedaling. Famous exercise“bicycle” requires lifting your legs bent at the knees and slowly rotating them in such a way as if a person is pedaling a bicycle. It is important not to overdo it, because... Rapid movements can cause damage to weak joints.

When the patient can perform these actions easily enough, you need to move on to the next stage. It involves trying to get back on your feet so you can begin walking exercises after a stroke.

When the patient learns to sit without any help, the rehabilitation process can be considered successful. The main task then becomes the development of this skill and long-term retention of the position. Therefore, it is necessary to teach him to remain sitting for a long time. To do this, you need to help the person sit down by lifting him by the arms. His feet must touch the floor and be slightly apart. The body is slightly tilted forward to maintain the position due to the center of gravity.

If a person can already sit, then it is worth moving on to full-fledged exercises that will strengthen this skill. All of them are performed at home. The most effective of them:

Head rotation. Required circular movements head, capturing together with it several cervical vertebrae (up to 7). Additionally, you should tilt it forward. The exercise is repeated up to 10 times.
Holding a position. You need to sit on the bed and hold on to a hard, reliable surface with your hands, carefully arching your back. The exercise only takes a few seconds, but requires 10-15 repetitions.
Lifting your feet off the floor. The patient should sit on the bed and raise his feet 40 cm so that they do not touch the floor surface. You need to hold this position for about 10 seconds. Repeat the exercise 10-20 times.

Additionally, you can alternately pull your legs towards your chest while lying on your back to prepare your joints for future stress. After completing all therapeutic exercises you should try to learn to stand up. It will be very difficult, but you will be able to achieve results if you try hard and believe in yourself. It is attempts to get up that are the main method of restoring walking after a stroke. There are 2 training options:

Lifting. With the help of a rehabilitation therapist, the patient should rise slightly while remaining on the bed. Gradually the level of lift should be increased.
Movements on the bed. The patient needs to sit on the edge of the bed, and then slowly move from the top to the bottom, moving his legs along the floor.

When you manage to stand up fully, you can move on to walking. The last stage will be the most difficult, so loved ones should show increased attention and care towards the sick person.

During exercises with getting up, there should be no hard objects near the patient that he could hit hard if he falls.

You should start walking very carefully. Almost everyone's first attempts to start walking end in falling to the floor. Therefore, the patient must first be physically supported to avoid accidental injury. It is important to consider that learning to walk will be very difficult and this stage can take a huge amount of time.

The rehabilitation specialist must ensure that the patient walks correctly. If you don’t do this, it will be difficult to relearn, and the effectiveness of all classes will drop significantly. The following points need to be ensured:

The legs rest on the heel. In most cases, people stand on their toes after a stroke, which should be avoided at all costs.
The feet move straight forward. Many patients move their legs, describing a semicircle with their feet, which should not happen during the learning process.
The knee bends before placing the foot on the heel. If the patient leaves his leg straight, then you should pay attention to this and correct his mistake.

You need to think about how to restore your leg only after remembering the listed rules. Once the patient is familiar with them, you can move on to the first exercises to regain the ability to walk fully. Among them:

Trampling. You need to slowly shift your weight from one leg to the other, and then back. You need to repeat such movements many times in a row. At first, the feet should lift off the floor only slightly, but later they should be lifted completely.
Rifles. You should stand up straight, keeping your feet together, and begin to roll your weight from your heels to your toes, and then back. Such rolling should be performed within a few minutes.
Stepping over. Any object should be placed in front of the patient. A pen or pencil is a good place to start, but larger items should be added later. Its task is that the placed object must be stepped over.

If you can perform the exercises without any problems, you should switch to normal walking. First you need to learn to walk around the apartment. All steps should be small and careful, and you should limit your speed.

A little later you can move outside. The patient must be accompanied by another person who can help if necessary. First, you need to take short walks, walk to the store or the nearest park, try to walk along the drawn line and lift up alternately with both feet on the curb. Later, you can move on to training by walking up the stairs, and it is best to walk along them sideways.

Sports equipment

When the anti-paralysis remedies used bring good results, you can move on to more advanced training. This will help light sport, which goes well with rehabilitation after many diseases that impair motor functions.

The first option to help you regain the ability to walk easily is to use a treadmill. You can benefit from it not only for the return of motor functions, but also for health in general. If you are not careful, there is a risk of harm because... too much active activities will lead to increased blood circulation and increased blood pressure, which is strictly contraindicated after a stroke. The following rules must be followed:

Increase your speed gradually, taking into account your capabilities. Start with only slow walking.
Hold on to the handrails while exercising. This will prevent you from falling in case of unexpected disruption of the movement of one of your legs.
Monitor your pulse. For this you can use a special sports bracelet or get readings from the sensor built into the simulator.

Additionally, you can use a special leg trainer. You should not choose too heavy weights, because... this will harm your joints and muscles. It is also not recommended to get carried away and perform too many approaches.

Nordic walking after a stroke is the second option for sports recovery. This is a unique way to achieve desired results without serious risk. Because All training is carried out using poles for support; a patient who has suffered a stroke will find it very easy to practice. This kind of walking is good for the heart, blood vessels, muscles and joints. A number of rules apply to it:

Do not exercise if the weather is very hot outside. Also, do not go to practice in the rain or heavy snow.
Start walking slowly. This is necessary in order to achieve the most correct technique walking.
Choose the right clothes. After a stroke, you should dress only for the weather, avoiding hypothermia or overheating.

After full return of motor function, you can move on to heavier loads on the legs. Even then, care must be taken to avoid injury.

Additionally, you can use the services of a massage therapist. Massage will help restore blood circulation in the legs and increase muscle tone, which will have a positive effect on the effectiveness of training.

Is it difficult to achieve results?

Restoring walking after a stroke at home is a complex process that requires not only a lot of effort, but also a lot of time. Achieve good result Only 20% of victims who try to treat a stroke and all its consequences succeed. However, don't give up. Only hard work will help restore motor function.

Ataxia after stroke - symptoms, diagnostic tests, treatment

However, more than half of the episodes of this type of stroke are fatal, and a very high percentage of disability is recorded among survivors.

Ataxia is a disorder of movement coordination and motor skills.

Classification of ataxias

Normally, coordination of movements is regulated by the following parts of the brain:

medulla oblongata and midbrain;
cerebellum;
vestibular apparatus;
frontotemporal cortex of the cerebral hemispheres.

Sensitive ataxia

Cerebellar ataxia

Distinctive features of the gait of a patient with ataxia

Vestibular ataxia

Vestibular ataxia occurs when moving, sitting or standing. Symptoms intensify when turning the head, torso, and eyes. The person refuses to perform these movements, replaces them with others, or performs them at a slow pace. Thanks to visual control, it is possible to significantly compensate for coordination disorders. With unilateral lesions of the vestibular nuclei, unsteadiness and deviations of the body occur in the direction of the lesion. Movement disorders are especially noticeable when walking with eyes closed. Vestibular ataxia is accompanied by severe autonomic disorders - nausea, dizziness, nystagmus.

Cortical ataxia

Clinical manifestations of cortical ataxia

Diagnostic tests

Diagnosis of motor coordination disorders in patients after a stroke is based on the following points:

patient complaints;
inspection data;
diagnostic test results;
data from the results of additional research methods.

Coordination tests allow you to determine the type of ataxia and determine the location of the stroke.

Cerebellar function test

The gait is then assessed. The patient is asked to walk with a normal, straight, heel-to-toe gait and a flanking gait.

Heel-knee test - in a lying position, the patient should touch the heel of one leg to the opposite knee.

Treatment

As soon as possible, the patient begins motor exercises.

Massage, passive gymnastics, and physiotherapeutic procedures play an important role.

Restoring coordination (sitting) after a stroke

One of the main obstacles to recovery after a stroke was completely lost balance. For the first five months I was extremely dizzy. A real storm in my head. Sitting on the bed, I could not maintain my balance and fell onto my side. My head only stopped spinning when I was lying down. Well, shouldn’t I lie there all my life?

We began restoring balance and fighting dizziness by simply sitting up in bed. Despite the dizziness, every day we spent more and more time in sitting position. Balance was clearly restored, dizziness did not decrease much.

Then they began to sit on the edge of the bed and lower their legs to the floor. To maintain balance, I propped myself up with my arms. I placed them on the side of the bed and did not move them much behind my back. This was how I managed to keep myself from falling to the right, left and back. Falling forward happened less often and my wife or son protected me.

Exercises at first

We started with the simplest exercises:

Exercise 1

Sitting in bed, my back rests against the back of the sofa.

I hold this position for 2-5 seconds. and again I lean on my back.
20 repetitions with daily increasing time. We reached 20 seconds.

Exercise 2

I place my hands with my palms on the bed on either side of me and spread out for stability.
I lean forward a little and stop leaning on the headboard.
I hold this position.

I maintain balance without support from the back of the sofa and without support from my arms. The first time I held on as long as I could. About 3 sec. Then I lost my balance and had to lean on my hands again. Every day we increased the time of maintaining balance by 2-5 seconds. We noticed that maintaining balance depended on many things: well-being, mood, weather, and external stimuli. Every little thing had a noticeable impact. Therefore, they added it differently every day. Sometimes it was not possible to maintain balance even as on the previous day.

As soon as we learned to maintain balance while sitting in bed, with the possibility of support on its back, we moved on. We started doing the exercises while sitting on the edge of the bed and lowering our feet to the floor. It may seem like they are the same thing. That was not the case. The weight distribution of the body changes, the support at the back disappears.

Exercise 3

I rest my feet a little on the floor so as not to fall forward. I was sure to be insured against falling.
I hold this position for 20-30 seconds.
After completing the exercise, I calmly and smoothly lean back on the bed and rest for 20-30 seconds.
15 reps.

Exercise 4

Sitting position on the edge of the bed without back support.

I place my hands with my palms on the bed on either side of me and move them slightly back behind my back to help prevent me from falling backwards. I spread my arms out for stability.
I rest my feet a little on the floor so as not to fall forward.
I fix the position for 1-2 seconds. Making sure I keep my balance.
At the same time, I lift my hands off the bed and raise them up 3-5 cm above the surface of the bed.
I maintain my balance without support.
After completing the exercise, I lean back on the bed and rest for 20-30 seconds.

The first time we held our balance as long as we could. The initial result was taken as a basis. Every day we increased the time of maintaining balance by 2-5 seconds. Eventually we learned to sit on the edge of the bed without support.

We began restoring balance after a stroke with basic exercises. We quickly learned how to do them. Let's move on to the next exercises.

Advanced exercises

After suffering a stroke, poor balance and severe dizziness made it very difficult to recover and do anything at all. It is quite obvious to us that the sense of balance is trained and developed through exercise. As when training any other skill, you need to start simple. In order to achieve small changes, you need to repeat the same thing every day and persistently for a long time.

We were able to quickly master the simple exercises we started with. To further move forward, we have complicated and supplemented them. Here is the second series of exercises that we performed while sitting in bed:

Exercise 1

Sitting in bed, my back rests against the back of the sofa.

I place my hands with my palms on the bed on either side of me and spread out for stability.
I lean forward a little and stop leaning on the headboard.
I turn my head to the right all the way. The head movement is active, but smooth.
I hold my head in the extreme right position for 2 seconds. I move my eyes to the right as far as possible. It's like I'm looking behind me over my right shoulder.
I turn my head to the left all the way. The head movement is active, but smooth.
I hold my head in the extreme left position for 2 seconds. I move my eyes to the left as far as possible. It's like I'm looking behind me over my left shoulder.
15 reps.

At first I couldn’t turn my head smoothly. It came out sharply and quickly without holding it in the extreme position. To prevent the head from coming off)), I had to stop the exercise, pause, then calmly and smoothly continue. As soon as I started shaking my head wildly again, they stopped again. The wife supervised the exercise. As soon as I was peddling, she slowed me down.

In addition to balance, I trained the skill of coordinating movement and maintaining the required rhythm.

Exercise 2

Sitting in bed, my back rests against the back of the sofa.

I place my hands with my palms on the bed on either side of me and spread out for stability.
I lean forward a little and stop leaning on the headboard.
I tilt my head to the right until my ear touches my shoulder. I make the movement smoothly and without haste.
I hold the tilt of my head to the right for 2 seconds.
I tilt my head to the left until my ear touches my shoulder. I make the movement emphatically smooth and calm.
I hold the head tilt to the left for 2 seconds.
15 reps.

I had to make sure that I didn’t tuck my shoulders towards the movements of my head. This movement arose unconsciously. We stopped him immediately.

Exercise 3

Sitting in bed, my back rests against the back of the sofa.

I place my hands with my palms on the bed on either side of me and spread out for stability.
I lean forward a little and stop leaning on the headboard.
I actively but smoothly raise my head up and turn my gaze to the ceiling.
I hold my head up, looking at the ceiling for 2 seconds.
I lower my head until my chin touches my chest. I accompany the movement of my head with my eyes and look down.
Up again and hold for 2 seconds.
15 reps.

As soon as I raised my head up, I couldn’t maintain my balance; I started to fall onto my side. And when I looked at the ceiling, everything began to spin and float. I had to hold myself up with my hands.

Exercise 4

Sitting in bed, my back rests against the back of the sofa.

I place my hands with my palms on the bed on either side of me and spread out for stability.
I lean forward a little and stop leaning on the headboard.
Rotate your head clockwise two turns.
Pause 2 seconds.
Rotate your head counterclockwise two turns.
Pause 2 seconds.
5 repetitions in each direction.

When I moved my head I felt very dizzy. If it was completely intolerable, we stopped. No feat is needed here.

Later we made a more complicated version. Sitting on the edge of the bed with your feet on the floor, but with your hands resting on the bed. Then without support with your hands. We did these exercises for about two months. The result was positive and obvious. I learned to sit confidently. If I turned my head to the sides, it did not cause problems.

The stroke bombed my sense of balance to pieces. Any sudden turn of the head and I fell over. Therefore, we complicated the balance training exercises slowly and gradually. We repeated them many times, doing them daily. They do not require much physical effort. They require regularity, a huge number of repetitions over a long time.

Balance is a fundamental thing. The entire recovery after a stroke greatly depends on its restoration.

How to restore coordination of movements

Article from our subscriber

One of the main damage caused by a stroke is severe loss of coordination of movements. I couldn't complete the simplest test. Stretch your arms forward, close your eyes and touch the tip of your nose with your left and right hands. I missed. Not much with the right hand. Instead of the tip of the nose, it hit the bridge of the nose. With his left hand he missed badly, hit the forehead area, or even completely missed the head.

Recovery after a stroke is not possible without restoring coordination. To perform any movement, more than just muscle strength is required. It is necessary to coordinate their work.

At first I couldn't put a teaspoon into a cup. Didn't hit.

Coordination is more severely impaired on the left side. But we don't do any more exercises on the left side. Everything becomes equal gradually during the lessons.

Entry level exercises

1. Touching the nose

I do it while sitting in bed.
I stretch both arms out in front of me.
I close my eyes.
I alternately touch the tip of my nose with the fingers of my right and left hands.
10 reps.

2. Chess with the right hand

I do it while sitting in bed.
I place the pieces on the chessboard with my right hand.
5 reps.

3. Chess with the left hand

I do it while sitting in bed.
I place the pieces on the chessboard with my left hand.
10 reps.

4. Right hand square

I do it while sitting in bed.
I “draw” a square with my right hand. In front of you, at arm's length. At the level of the face.
10 reps.

5. Square with your left hand

I do it while sitting in bed.
I “draw” a square with my left hand. In front of you, at arm's length. At the level of the face.
10 reps.

6. Right hand circle

I do it while sitting in bed.
I “draw” a circle with my right hand. In front of you, at arm's length. At the level of the face.
10 reps.

7. Left hand circle

I do it while sitting in bed.
I “draw” a circle with my left hand. In front of you, at arm's length. At the level of the face.
10 reps.

8. Two squares

I do it while sitting in bed.
I “draw” two squares with both hands at the same time and synchronously. In front of you, at arm's length. At the level of the face.
10 reps.

9. Two circles

I do it while sitting in bed.
I “draw” two circles with both hands at the same time and synchronously.
10 reps.
In front of you, at arm's length. At the level of the face.

10. Circle with your left foot

I perform while sitting on the edge of the bed.
With the toe of my left foot I “draw” a square on the floor.
10 reps.

11. Circle with your right foot

I perform while sitting on the edge of the bed.
With the toe of my right foot I “draw” a circle on the floor.
10 reps.

12. Square feet

I perform while sitting on the edge of the bed.
I “draw” a square on the floor with both feet and toes synchronously.
10 reps.

13. Circle with legs

I perform while sitting on the edge of the bed.
I “draw” a circle on the floor with both legs and toes synchronously.
10 reps.

Upgrade Rules

When drawing figures, I try to make the figures even and neat. I perform the exercises slowly, smoothly and calmly.

We realized that if movements are made slowly and smoothly, then they are easier to coordinate and do correctly. As a result, the correct movement is recorded in the brain, not an error. Plus, with smooth and slow movements, I did less damage and did not catch objects around me. So the most effective way to restore coordination is to control every movement and make it smooth.

Advanced exercises

But this does not cancel special exercises. Proper gymnastics consists of movements more complex than in life. Therefore, having learned to do the complex, then it is easy to do the simple. We see this as the essence of sports training during stroke recovery. When skiing, biking or taking long walks, we make millions of movements.

Having moved from “lying down”, bed rest to “walking” and having slightly restored the initial coordination skills, we moved on to more complex gymnastics:

14. Figures with the right foot

hands on the belt.
I shift my weight to my left leg. The right leg is completely unloaded
With the toe (thumb) of my right foot, straight in front of me, I draw shapes on the floor in order (circle, square, triangle).
I draw medium-sized figures so that they are comfortable and don’t have to stretch.
3 reps x 3 shapes.

15. Figures with the left foot

I do it while standing. If it is needed. I do it with support.
hands on the belt.
I shift my weight to my right leg. The left leg is completely unloaded.
With the toe (big toe) of my left foot, straight in front of me, I draw shapes on the floor in order (circle, square, triangle).
3 reps x 3 shapes.

16.Right foot numbers

I do it while standing. If it is needed. I do it with support.
hands on the belt.
I shift my weight to my left leg. The right leg is completely unloaded.
With the toe (big toe) of my right foot, straight in front of me, I draw numbers on the floor, in order from 1 to 10.
I draw the numbers in medium size, so that it is convenient and does not have to stretch.
2 repetitions x 10 numbers.

17. Numbers with your left foot

I do it while standing. If it is needed. I do it with support.
hands on the belt.
I shift my weight to my right leg. The left leg is completely unloaded
With the toe (big toe) of my left foot, straight in front of me, I draw numbers on the floor, in order from 1 to 10.
2 repetitions x 10 numbers.

So as not to think about balance. Standing on my left leg makes it more difficult for me to maintain balance. Standing on my right leg, I maintain my balance confidently, but at the same time, “drawing” with my left leg is not very good. It is when performing such exercises that problems with coordination come out. That's what we catch.

Is there a risk of stroke?

1. Increased (over 140) blood pressure:

often
Sometimes
rarely

2. Vascular atherosclerosis

3. Smoking and alcohol:

often
Sometimes
rarely

4. Heart disease:

birth defect
valve disorders
heart attack

5. Undergoing medical examination and MRI diagnostics:

Every year
once in a lifetime
never

Total: 0%

Stroke is a rather dangerous disease that affects people not only of old age, but also of middle age and even very young people.

A stroke is a dangerous emergency that requires immediate help. It often ends in disability, in many cases even death. In addition to blockage of a blood vessel in the ischemic type, the cause of an attack can also be a hemorrhage in the brain against the background of high blood pressure, in other words, a hemorrhagic stroke.

1. Avoid hypertension

High blood pressure is a major risk factor for stroke. Insidious hypertension does not show symptoms at the initial stage. Therefore, patients notice it late. It is important to measure your blood pressure regularly and take medications if levels are elevated.

2. Quit smoking

3. If you are overweight: lose weight

Obesity is an important factor in the development of cerebral infarction. Obese people should think about a weight loss program: eat less and better, add physical activity. Older adults should discuss with their doctor how much weight loss they would benefit from.

4. Keep your cholesterol levels normal

Elevated levels of “bad” LDL cholesterol lead to deposits of plaques and emboli in blood vessels. What should the values be? Everyone should find out individually with their doctor. Since the limits depend, for example, on the presence of concomitant diseases. Additionally, high values of “good” HDL cholesterol are considered positive. A healthy lifestyle, especially a balanced diet and plenty of exercise, can have a positive effect on your cholesterol levels.

5. Eat healthy food

6. Moderate alcohol consumption

Excessive alcohol consumption increases the death of stroke-affected brain cells, which is not acceptable. It is not necessary to abstain completely. A glass of red wine a day is even beneficial.

7. Move actively

Movement is sometimes the best thing you can do for your health to lose weight, normalize blood pressure and maintain the elasticity of blood vessels. Endurance exercises such as swimming or brisk walking are ideal for this. Duration and intensity depend on personal fitness. Important note: Untrained individuals over 35 years of age should be initially examined by a physician before starting to exercise.

8. Listen to the rhythm of your heart

9. Control your blood sugar

People with diabetes are twice as likely to suffer a cerebral infarction than the rest of the population. The reason is that elevated glucose levels can damage blood vessels and promote plaque deposits. In addition, people with diabetes often have other risk factors for stroke, such as hypertension or too high blood lipids. Therefore, diabetic patients should take care to regulate their sugar levels.

10. Avoid stress

Consequences of a stroke

Consequences of a stroke.

Disturbances in any functions after a stroke are directly dependent on its severity, and the severity, in turn, on the size of the lesion and its location in the brain.

Right-sided and left-sided hemiparesis after stroke.

Central prosoparesis.

Speech impairment after stroke.

Impaired coordination of movements after a stroke.

Visual impairment after stroke.

Other consequences of stroke.

Impaired hearing (hypoacusia), sense of smell (hypo-, anosmia), loss of movement skills with preserved strength (apraxia) and other disorders that can and should be treated; rehabilitation in this case is very important and should be carried out in a timely manner.
Sensory impairment after stroke. Sensory impairment after a stroke can be of a different nature, but most often it is a loss of the ability to feel pain, recognize heat, cold, and a part of the body as such. It is also possible for a pain syndrome to appear, of a very diverse nature and localization. Most often, there is a decrease in sensitivity in some parts of the body, this phenomenon is called hypoesthesia.

Depression after stroke.

Read about an example of such a rehabilitation center in the article rehabilitation center after a stroke.

Restoring motor coordination after a stroke. Ataxia after stroke - symptoms, diagnostic tests, treatment. How long do they live after a stroke and possible consequences?

Ataxia after stroke - symptoms, diagnostic tests, treatment

Classification of ataxias

Sensitive ataxia

Cerebellar ataxia

Vestibular ataxia

Cortical ataxia

Diagnostic tests

Treatment

What are the consequences of ischemic stroke?

Consequences of ischemic stroke - cerebral edema

Consequences of ischemic stroke - impaired coordination of movement, speech, perception

Complications after a stroke - dementia, pneumonia, bedsores

After an ischemic stroke of the brain, thrombosis may develop

Impaired coordination of movements

Characteristics of the disease

Species and types

Causes of the disease

Symptoms of manifestation

Treatment of ataxia

Consequences of a stroke

Right-sided and left-sided hemiparesis after stroke.

Central prosoparesis.

Speech impairment after stroke.

Impaired coordination of movements after a stroke.

Visual impairment after stroke.

Other consequences of stroke.

Depression after stroke.

Why is coordination of movements when walking impaired and dizziness occurs?

Loss of coordination and dizziness when walking

Causes and symptoms

Treatment

Drugs

Exercises

Which doctors should I contact?

Patient's well-being after a stroke

Muscles and movement

Bowel and bladder

Memory

Power training

Alternative therapy

Horseback riding

Restoring coordination

Right-sided and left-sided hemiparesis

Central prosoparesis

Speech Impairment

Impaired motor coordination

Visual impairment

Other consequences

Depression

Ataxia after stroke - symptoms, diagnostic tests, treatment

Classification of ataxias

Sensitive ataxia

Cerebellar ataxia

Vestibular ataxia

Cortical ataxia

Diagnostic tests

Treatment

How to restore coordination of movements

Entry level exercises

1. Touching the nose

2. Chess with the right hand

3. Chess with the left hand

4. Right hand square

5. Square with your left hand

6. Right hand circle

7. Left hand circle

8. Two squares

9. Two circles

10. Circle with your left foot

11. Circle with your right foot

12. Square feet

13. Circle with legs

Upgrade Rules

Advanced exercises

14. Figures with the right foot

15. Figures with the left foot

16.Right foot numbers

17. Numbers with your left foot

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