Stroke alert: Know the signs of a stroke

How to repair a brain
New insights into the capacity of the stroke-damaged brain to repair itself are leading to innovative treatments. After a stroke, the brain is sometimes able to switch functions from damaged to undamaged areas. Also, areas of the brain that appear to be dead may be revivable. The key to making this happen is vigorous rehabilitation. It's a use-it-or-lose-it situation, say rehab researchers.

Milos Popovic designs electrical devices that help replace lost function in limbs so patients can perform a greater range of movement; his research is part of an exciting new discipline known as neuroprosthetic systems. In some cases these devices may even help people regain some permanent normal function by “retraining” the nervous system, says Popovic, who works out of the Toronto Rehabilitation Institute. “Anything that we can do to give stroke survivors a degree of control over daily living would be a priceless gift,” he says.

Integrating survivors back into the workforce
Brain “repair” and rehabilitation are crucial to integrating survivors back into the workforce and helping them lead productive lives, says Dr. Sandra Black, site director of the Heart and Stroke Foundation Centre for Stroke Recovery at Sunnybrook Health Sciences Centre in Toronto. At both Sunnybrook's Centre for Stroke Recovery and the sister site at Baycrest Hospital in Toronto, patients can use virtual reality data gloves to pick up objects on a computer screen, which may help increase the range of motion in a stroke-damaged hand. At the Baycrest site, specially designed computer games and a virtual reality maze are currently being developed to help patients regain hand-eye coordination and navigation skills.

Getting active
Helping stroke patients help themselves by maximizing their physical fitness is another vital part of the new frontier of stroke care and rehabilitation. Janice Eng, a professor of rehabilitation sciences at the G.F. Strong Centre in Vancouver, hands out exercise “prescriptions” to stroke patients. Treatments targeted at improving walking and balance and building strength in damaged muscle and tissue are now commonplace, thanks in large part to her efforts.

“Also, raising stroke patients' fitness through exercise significantly reduces the risk of falls, fracture, heart disease and the occurrence of a second stroke,” says Eng, whose insights are now being applied across Canada.

Most people who survive a stroke will also experience difficulty understanding or speaking (called aphasia). Speech therapy can help recover use of language or develop new ways of communicating, but it can take time, says Holly Sloan, a speech- language pathologist at the Trillium Health Centre in Mississauga, Ont. Sloan says that while some people recover their speech quickly, the amount and timing of recovery is different for everyone.

For more information about stroke rehabilitation, visit these sites:
• Stroke Survivors Association of Ottawa
• Heart and Stroke Foundation
• StrokeEngine
• StrokeEngine Family and Patient Information

Stroke facts
• Stroke is the fourth leading cause of death in Canada.
• It is estimated that 4.1 per cent of Canadians over 65 years of age (approximately 300,000 individuals) currently live with the effects of stroke.
• Fewer than 50 per cent of stroke patients return to work,
leaving families with caregiving responsibilities and the additional burden of lost income.
• Female deaths from stroke outnumber male deaths. In 2003, 8,951 Canadian women and 6,332 males died of stroke. This could be partly because women tend to have their strokes later in life, but additional reasons remain unclear -- systematic, social and biological factors may be involved.

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