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Stroke is a health problem that occurs from blockade of blood flow to a specific area of the brain. The National Stroke Association [NSA] (2011), asserts that stroke develops when a “clot of blood barricades an artery or a when an artery ruptures, thereby impeding blood flow to an area of the brain served by that vessel.” This situation leads to brain cells’ necrosis and subsequent damage to the brain.
Necrosis of the brain cells caused by stroke results in loss of the body functions associated by the part(s) of the brain involved. Such abilities involve memory, motion, and speech. The impact of stroke is proportional to the region of the brain affected and the magnitude of the damage. The subsequent paragraph describes some conditions that can arise due to stroke, including their interventions.
Spasticity and orthotic intervention
Spasticity refers to an increased barrier to the reflex movement of a joint due to hypertonus (high muscle tone). There are various interventions to this condition, including orthotic intervention. Tone reducing orthotics is useful to enhance gait patterns and alleviate reflexive muscle stimulation in patients with spasticity.
In addition, the practitioner can use adjustable orthosis to manage muscle impairment of the left hand. This method is comparable to casting since it facilitates prolonged stretching of an elbow flexion contracture. The technique is easy to adjust and can be removed for short time intervals on daily basis.
Ankle-Foot Orthosis (AFO)
Ankle-foot orthosis is essentially designed to compensate for drop-foot (weakness of dorsiflexor). In absence of AFO, drop foot causes gait alterations leading to increased energy use from compensatory movements including excessive hip and knee flexion or hip hiking to enable foot clearance during swing stage. Spastic plantar flexors typically necessitate a strong AFO designed to sustain a 90-degree position of ankle dorsiflexion. Nevertheless, without spasticity, a spring-aided dorsiflexion is commonly used. “Spring-aided dorsiflexor can be integrated into double metal upright AFO and Plastic designs to enable partial ankle movement –from perpendicular to complete ankle dorsiflexion” (DeLisa, Gans & Walsh, 2005, p.165). The ankle in an AFO is unable to plantar-flex past the 90-degrees, thereby maintaining the GRF line behind the knee, causing a knee flexion instant from first contact through midstance.
Nevertheless, from midstance through terminal stance, a rigid AFO does not enable the tibia to articulate progressively forward through dorsiflexion, facilitating rather early heel ascent from knee flexion. Importantly, sustaining foot capacity though in limited range is important during initial and mid-swing stages (DeLisa, Gans & Walsh, 2005, p. 165). The aforementioned AFO makes prevent toe drag by constraining plantar flexion.
Equinus
Equinus is a health condition that involves a limitation of an upward bending articulation of the ankle joint. A person with equinus lacks the plasticity to flex the foot anterior of the leg. The orthotic intervention for this condition, include arch supports that are convention orthotic devices, which fit inside the shoe to sustain proper weight distribution and to help manage muscle/tendon imbalance (American College of Foot and Ankle surgeon, 2009).
Hearing and Speech problems
Certain communication problems associated with stroke may pose challenge to orthotist. Thus, the orthostis should take the following factors in consideration.
- The amputee may have problem in putting thoughts together to narrate an event.
- Patient changes topics without warning.
- Problem taking turns during conversation.
- Problem using a proper voice tone during communication.
- Challenge interpreting the detail of conversation.
- The patient has tendency to inappropriate reaction.
- The patient may exhibit minimal or zero self-consciousness of her or his improper behaviors.
Reference list
American College of Foot and Ankle Surgeon. (2009). Equinus. Chicago: ACFAS. Web.
DeLisa, J. A., Gans, B. M., & Walsh, N. E. (2005). Physical medicine and Rehabilitation principles and practice. Philadelphia: Lippincott Williams & Wilkins.
National Stroke Association. (2011). what is stroke? Englewood, Colorado: National Stroke Association. Web.
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