Abstract
Cerebrovascular disease, one of the most prevalent and devastating diseases among adults, may arise from various sources, including disorders of the brain vasculature, cardiac and pulmonary disorders, and systemic and genetic diseases. Cerebrovascular disease encompasses a broad spectrum of disorders including stroke and transient ischemic attack. Regardless of the cause, the cerebrovascular accident can be either ischemic or hemorrhagic type. Diagnostic evaluation should include a careful and detailed history; bedside physical and neurological examinations; brain, heart, and vascular imaging; and laboratory investigations. In addition to covering the medical, surgical, and interventional strategies during the acute phase of stroke management, this chapter also provides an overview of the vascular and functional anatomy of the brain; the epidemiology, etiology, and pathophysiology of stroke; clinical features; and complications of stroke. A detailed outline of the physiotherapy management of both supratentorial and brainstem strokes is included.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Further Reading
Aroor S, Singh R, Goldstein LB. BE-FAST (balance, eyes, face, arm, speech, time): reducing the proportion of strokes missed using the FAST Mnemonic. Stroke. 2017;48(2):479–81.
Balaban B, Tok F. Gait disturbances in patients with stroke. PMR. 2014;6(7):635–42.
Bjorklunds A, Fecht A. The effectiveness of constraint-induced therapy as a stroke intervention: a meta-analysis. Occup Ther Health Care. 2006;20(2):31–49.
Bohannon RW. Muscle strength and muscle training after stroke. J Rehabil Med. 2007;39(1):14–20.
Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987 Feb;67(2):206–7.
Bovend'Eerdt TJ, Newman M, Barker K, Dawes H, Minelli C, Wade DT. The effects of stretching in spasticity: a systematic review. Arch Phys Med Rehabil. 2008;89(7):1395–406.
Broetz D, Karnath H. New aspects for the physiotherapy of pushing behavior. Neurorehabil. 2005;20:133–8.
Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C. Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire community stroke project [published correction appears in stroke 1994 Sep;25(9):1887]. Stroke. 1994;25(2):333–7.
Caplan LR. Caplan’s stroke: a clinical approach. fifth Cambridge: Cambridge University Press; 2016.
Chayer C, Freedman M. Frontal lobe functions. Curr Neurol Neurosci Rep. 2001;1:547–52.
Chen MD, Rimmer JH. Effects of exercise on quality of life in stroke survivors: a meta-analysis. Stroke. 2011;42(3):832–37.
Cuoco JA, Hitscherich K, Hoehmann CL. Brainstem vascular syndromes: A practical guide for medical students. Edorium J Neurol. 2016;3:4–16.
Dalal KK, Joshua AM, Nayak A, Mithra P, Misri Z, Unnikrishnan B. Effectiveness of prowling with proprioceptive training on knee hyperextension among stroke subjects using videographic observation- a randomised controlled trial. Gait Posture. 2018;61:232–7.
Davies PM. Right in the middle: selective trunk activity in the treatment of adult hemiplegia. Berlin: Springer-Verlag New York Inc.; 1990.
Deb P, Sharma S, Hassan KM. Pathophysiologic mechanisms of acute ischemic stroke: An overview with emphasis on therapeutic significance beyond thrombolysis. Pathophysiology. 2010;17(3):197–218.
Donaghy M, editor. Brain’s Diseases of the nervous system. 12th New York: Oxford University Press; 2009.
Dromerick AW, Edwards DF, Hahn M. Does the application of constraint-induced movement therapy during acute rehabilitation reduce arm impairment after ischemic stroke?. Stroke. 2000;31(12):2984–8.
Eng JJ, Tang PF. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Expert Rev Neurother. 2007;7(10):1417–36.
Fisher M, Garcia JH. Evolving stroke and the ischemic penumbra. Neurology. 1996;47(4):884–8.
Flansbjer UB, Miller M, Downham D, Lexell J. Progressive resistance training after stroke: effects on muscle strength, muscle tone, gait performance and perceived participation. J Rehabil Med. 2008;40(1):42–8.
Ford A, McGregor KM, Case K, Crosson B, White KD. Structural connectivity of Broca’s area and medial frontal cortex. Neuroimage. 2010;52(4):1230–7.
Gray V, Rice CL, Garland SJ. Factors that influence muscle weakness following stroke and their clinical implications: a critical review. Physiother Can. 2012;64(4):415–26.
Hammer A, Nilsagård Y, Wallquis M: Balance training in stroke patients–a systematic review of randomized, controlled trials. Adv Physiother. 2008;10:163–72.
Han P, Zhang W, Kang L, Ma Y, Fu L, Jia L, et al. Clinical evidence of exercise benefits for stroke. Adv Exp Med Biol. 2017;1000:131–51.
Harrison RA, Field TS. Post stroke pain: identification, assessment, and therapy. Cerebrovasc Dis. 2015;39(3–4):190–201.
Hesse S. Treadmill training with partial body weight support after stroke: a review. Neurorehabilitation. 2008;23(1):55–65.
Jovin TG, Demchuk A, Gupta R. Pathophysiology of acute ischemic stroke. CONTINUUM Lifelong Learning in Neurology. 2008;14:28–45.
Karnath H, Ferber S, Dichgans J. The origin of contraversive pushing: evidence for a second graviceptive system in humans. Neurology. 2000; 55(9):1298–304.
Kruger E, Teasell R, Salter K, Foley N, Hellings C. The rehabilitation of patients recovering from brainstem strokes: case studies and clinical considerations. Top Stroke Rehabil. 2007;14(5):56–64.
Kumar S, Selim MH, Caplan LR. Medical complications after stroke. Lancet Neurol. 2010;9(1):105–18.
Law YM, Feng LF, Liang Q, Meng LJ, Shen P, Yu SJ, et al. Effect of exercise on physical recovery of people with locked-in syndrome after stroke: what do we know from the current evidence? A systematic review Cerebrovasc Dis Extra. 2018;8(2):90–5.
Li S, Francisco GE. New insights into the pathophysiology of post-stroke spasticity. Front Hum Neurosci. 2015;9:192.
Li S, Francisco GE, Zhou P. Post-stroke Hemiplegic Gait: New Perspective and Insights. Front Physiol. 2018;9:1021. https://doi.org/10.3389/fphys.2018.01021.
Lubetzky-Vilnai A, Kartin D. The effect of balance training on balance performance in individuals poststroke: a systematic review. J Neurol Phys Ther. 2010;34:127–37.
Macko RF, Ivey FM, Forrester LW, Hanley D, Sorkin JD, Katzel LI, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke. 2005;36(10):2206–11.
Mancall EL, Brock DG, editors. Gray’s clinical neuroanatomy: the anatomic basis for clinical neuroscience. Philadelphia: Elsevier Saunders; 2011.
Mohr JP, Albers GW, Amarenco P, Babikian VL, Biller J, Brey RL, et al. Etiology of stroke. Stroke. 1997;28:1501–6.
Musuka TD, Wilton SB, Traboulsi M, Hill MD. Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ. 2015;187(12):887–93.
Na EH, Yoon TS, Han SJ. Improvement of quiet standing balance in patients with wallenberg syndrome after rehabilitation. Ann Rehabil Med. 2011;35(6):791–7.
Odier C, Michel P. Common stroke syndromes. In: Brainin M, Heiss WD, editors. Textbook of stroke medicine. second Cambridge: Cambridge University Press; 2014 155–68.
Ojaghihaghighi S, Vahdati SS, Mikaeilpour A, Ramouz A. Comparison of neurological clinical manifestation in patients with hemorrhagic and ischemic stroke. World J Emerg Med. 2017;8(1):34–8.
O'Sullivan SB, Schmitz TJ, Fulk GD, sixth ed. Physical rehabilitation. Philadelphia: FA Davis Co; 2014.
Parent A, editor. Carpenter’s human neuroanatomy. ninth Baltimore: Williams & Wilkins; 1996.
Patestas MA, Gartner LP. A textbook of neuroanatomy. Oxford: Blackwell Publishing; 2006.
Pedersen PM, Wandel A, Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS. Ipsilateral pushing in stroke: incidence, relation to neuropsychological symptoms, and impact on rehabilitation. The copenhagen stroke study. Arch Phys Med Rehabil. 1996;77(1):25–8.
Ropper AH, Samuels MA, Klein JP, Prasad S, editors. Adams and Victor’s Principles of neurology. tenth New York: McGraw Hill Education; 2014.
Saleem S, Yousuf I, Gul A, Gupta S, Verma S. Hyponatremia in stroke. Ann Indian Acad Neurol. 2014;17(1):55–7. Available from: https://doi.org/10.4103/0972-2327.128554.
Schott M, Dachi L, Cassol MC, Brondani JE, Colpo E. Risk of pressure ulcer in hospitalized patients after stroke:relation of nutritional factors and of morbidity. Clin Pract. 2018;15(1):424–32.
States RA, Salem Y, Pappas E. Overground gait training for individuals with chronic stroke: a Cochrane systematic review. J Neurol Phys Ther. 2009;33(4):179–86.
Stewart KC, Cauraugh JH, Summers JJ. Bilateral movement training and stroke rehabilitation: a systematic review and meta-analysis. J Neurol Sci. 2006;244:89–95.
Teasell R, Foley N, Doherty T, Finestone H. Clinical characteristics of patients with brainstem strokes admitted to a rehabilitation unit. Arch Phys Med Rehabil. 2002;83(7):1013–6.
Tenny S, Thorell W. Cerebral salt wasting syndrome. Treasure Island (FL): StatPearls Publishing; 2019.
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986 Feb;34(2):119–26.
Truelsen T, Begg S, Mathers C. The global burden of cerebrovascular disease. WHO Discussion Paper. Geneva, Switzerland: World Health Organization; 2006.
Wasner G, Schattschneider J, Binder A, Baron R. Complex regional pain syndrome-diagnostic, mechanisms, CNS involvement and therapy. Spinal Cord. 2003;41(2):61–75.
Yang YR, Wang RY, Lin KH, Chu MY, Chan RC. Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke. Clin Rehabil. 2006;20(10):860–70.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Joshua, A.M., Misri, Z., Rai, S., Harigovindan Nampoothiri, V. (2022). Stroke. In: Joshua, A.M. (eds) Physiotherapy for Adult Neurological Conditions. Springer, Singapore. https://doi.org/10.1007/978-981-19-0209-3_3
Download citation
DOI: https://doi.org/10.1007/978-981-19-0209-3_3
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-19-0208-6
Online ISBN: 978-981-19-0209-3
eBook Packages: MedicineMedicine (R0)