Stroke Disability

Stroke can result in many different disabilities, ranging from motor control and urinary incontinence to depression and memory loss. The following are common rehabilitation concerns.

Motor Control Disorders

Motor control (the ability to move muscles in a coordinated manner) is often impaired as a result of a stroke. Strokes usually occur on only one side of the brain, so decreased motor control usually develops on only one side of the body. In fact, one side of the body may be paralyzed (hemiplegia), or muscles on the affected side may be weakened (hemiparesis). Because of the weakness or paralysis in large muscle groups, injuries from falls are common complications of motor control disturbances.

Dysphagia and Pneumonia

Dsyphagia, or difficulty swallowing, occurs when motor control of the mouth, tongue, or throat muscles is impaired. Dysphagia is dangerous because it increases the risk of choking or aspiration of foods or liquids. With aspiration, food is diverted into the trachea instead of the esophagus. When this happens, food particles may actually enter the lungs and cause a serious type of pneumonia called aspiration pneumonia. Stroke patients with dysphagia should report choking incidents to their doctors.

Memory Loss and Dementia Symptoms

Memory loss is another symptom that many patients experience after a stroke. Further, a patient’s attention span tends to be shorter than before the stroke. When combined with memory loss, this condition may be confused with dementia. Stroke can actually cause many symptoms of dementia. When memory loss or dementia symptoms are present, care must be taken to rule out medical causes other than stroke.

Apraxia is a stroke-related condition that also mimics dementia. Apraxia is the inability to make decisions and carry out tasks. Other disabling conditions that stroke victims may suffer from include agnosia (the inability to recognize certain objects), or neglect (the inability to acknowledge one side of the body or anything affecting that side of the visual field).

Sensory Disabilities and Pain

Many stroke victims suffer from sensory losses such as problems with vision, hearing, touch, or pain perception. Patients with paralyzed or weakened limbs may experience paresthesias: pain, numbness, or tingling in the affected limb. Eventually, if the limb is not exercised regularly, it may “freeze” into place, resulting in chronic pain.

Urinary Incontinence

Certain types of sensory damage can lead to urinary incontinence. Urinary incontinence occurs when the brain cannot sense that the bladder is full. People suffering from urinary incontinence are often embarrassed by the problem, making overall recovery more difficult. Feelings of frustration, shame, and anger stemming from incontinence can lead to depression. Successful treatment and management of urinary incontinence is necessary for full recovery.

Language: Aphasia and Dysarthria

Stroke may also affect communication, a condition known as aphasia. Three types of aphasia may occur:

  • Expressive aphasia is the inability to transform thought into speech or writing.
  • Receptive aphasia is the inability to comprehend the spoken or written word (often includes incoherent speech).
  • Global aphasia is the complete disruption of language skills.

Dysarthria is a motor control disorder that affects speech. In this condition, the ability to control the mouth and throat muscles is lost, causing slurred or uncoordinated speech.

Depression and Emotional Disturbances

Given the spectrum of disabilities caused by a stroke, it is no surprise that stroke survivors have high rates of depression. Depression can also seriously impair quality of life and may reduce motivation during rehabilitation. In some cases, depression can even lead to suicide. Symptoms of depression should be treated quickly, especially if suicidal thoughts are present.

Stroke survivors may also suffer personality changes. They may find that they laugh or cry easily. When laughter or crying is uncontrollable, or occurs at inappropriate times, the condition is referred to as emotional lability.

Resources

National Institute on Deafness and Other Communication Disorders. (2002). Dysphagia. Retrieved February 13, 2004, from www.nidcd.nih.gov/health/voice/dysph.asp#1.

U.S. National Library of Medicine. (updated 2003). Eye movements: Uncontrollable. Retrieved February 13, 2004, from www.nlm.nih.gov/medlineplus/ency/article/003037.htm.

U.S. National Library of Medicine. (updated 2002). Horner’s syndrome. Retrieved February 13, 2004, from www.nlm.nih.gov/medlineplus/ency/article/000708.htm.