You may have experienced changes in the way you walk after a stroke or brain injury. These changes can eventually lead to problems with your feet. However, you can avoid most of these problems by taking a few, very simple steps.
Helpful tips
· Your affected leg is probably thinner and the atrophy (smaller and weaker) is not limited to the muscles. The arteries can also be affected so that you may have developed peripheral arterial disease (PAD, poor circulation) in the effected extremity.
· Exercises can help open up alternative small vessels, and increase blood flow into your leg. Walking 5-10 minutes for 3x week is usually a good start.
· If you have drop-foot, don’t walk around letting your foot slap or flop: it can be injured or you can fall and cause further injury. A drop foot may develop as a result of weakness or paralysis of the muscles which lift the top of the foot. A prosthetic device, called an ankle foot orthoses (AFO) may be necessary to keep the foot and toes from dragging or catching on the ground when walking.
· British researchers analyzed 14 randomized controlled trials with 429 participants evaluating the effects of orthoses in people with stroke and other non-progressive brain lesions. They found that there was a significant and beneficial effect of lower limb orthoses on walking speed, walking step and stride length and weight distribution in standing.
· Check your feet every day for cracks, blisters, sores, swelling or any changes in skin colour. This is especially important if you have circulation problems or reduced feeling in your feet. Any sign of infection, such as redness, swelling, or discharge (oozing), should be examined by your family doctor or your chiropodist (foot specialist).
· Socks and Shoes: The average pair of feet sweat approximately 1/2 pint of fluid per day. That sweat is absorbed mostly by shoes as socks have a limited ability to absorb much moisture. It takes a leather shoe about 30 hours to dry out. So, have at least two pair of shoes and alternate them. If you have really sweaty feet, cotton/wool/polyester blends have traditionally been recommended as old studies show these absorb the most moisture.
· Buy shoes that are wide and deep enough, and fit snugly at the heel. Ideal shoes for stroke patients have low heels, shock absorbing soles, Velcro fasteners, deep, rounded toe boxes, and leather or canvas uppers.
· Shop for shoes at the end of the day when your feet are naturally swollen. Be sure to have both feet measured. If you have any insensitivity in the stroke affected leg make sure that a professional fits your shoes.
· A stroke or brain injuries may cause complete or partial paralysis of the leg or entire side of the body. With partial paralysis or weakness, rehabilitation and physical therapy can increase strength and improve ambulation over time.
· Strokes or brain injuries may also affect balance and coordination, as well as result in a loss of the perception of body position. This means there is a decreased awareness of where different parts are. Understanding body perception is crucial for walking rehabilitation. The foot and ankle and lower leg send numerous signals to the brain about the foot position. The foot can easily adapt to walking on uneven surfaces without an individual looking at their feet. Once this perception of foot and ankle position is lost, it becomes extremely difficult for the brain to know exactly where the foot and leg are. Rehabilitation programs focus on increasing movement and strength, but also on sensory as well as re-educating the brain to identify movements and position.
· Stroke or brain injury rehabilitation may take months or a year and depends on the nature and severity of the stroke-related complications. It is important to have realistic goals and expectations.
· Posture – It is important for everyone and especially after a stroke. While sitting, slouching and curving the spine will cause many other problems. Back and neck issues will occur. While doing exercises and walking, maintain your posture by keep your head up, shoulders back, and the lower part of your back straight.
· Keep a positive attitude! Everyone has bad days, and good days! Stay positive! Every day you take a small step forwards, and after looking back in a month, you will see that you walked a mile!
EXERCISES-
The exercise program is designed to help you improve your strength and endurance to regain your independence. With your exercise program, here are some helpful hints:
- Posture is important!
- Limit the distractions around you while you are exercising. Losing focus can lead to improper mechanics and possibility of falling.
- With any exercise program, stay within your painful range of motion! If it hurts, stop!
- Fatigue – do not exercise to exhaustion. Once you fatigue, stop!
- With most exercises, start having a lot of physical support (ie-table or chair to hold onto). Once the exercise is easy, progress to holding on with little support (ie- one hand holding on the chair) and then completely unsupported. Go at your own pace, don’t perform exercises if you are not ready for them.
Posted via email from Northumberland Physiotherapy and Foot Care Centre's posterous
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