Recovery and rehabilitation following stroke


Common causes

There are several risk factors for stroke, including high blood pressure, high cholesterol levels, obesity, having diabetes, having an irregular pulse, and having had ‘mini-strokes’ (transient ischaemic attacks) in the past. If you smoke, eat a diet high in salt and fat, or drink excessive amounts of alcohol you are considered to be at higher risk of having a stroke. Age is also a risk factor; however, about one third of stroke patients are under age 65.

A stroke occurs when the blood supply to the brain is disrupted. This can occur because the arteries supplying blood to the brain are blocked by a blood clot or by fatty deposits (plaques) that have built up on the artery walls. The blood supply can also be disrupted by a bleed in the brain.

Signs of a stroke

The signs of a stroke include*:

  • Weakness, numbness or paralysis in the face, arm or leg – on either or both sides of the body.
  • Difficulty speaking or understanding
  • Dizziness, loss of balance or an unexplained fall
  • Loss of vision, sudden blurred or decreased vision in one or both eyes
  • An unusually severe or abrupt headache, or a change in the pattern of headaches
  • Difficulty in swallowing

If you or someone else is experiencing these signs, seek medical attention immediately.

*Thanks to the National Stroke Foundation for this information.


A stroke can affect movement in part or all of the arm or leg on either side of the body. Because movement, including range and dexterity, may be considerably affected, a person who has had a stroke may feel discouraged about using their stroke-affected limb. However, the only way to regain movement and function is to use the limb.

In constraint-induced movement therapy (CI), the therapist constrains the patient’s unaffected arm in a sling, forcing them to use their affected side repetitively and intensively for two weeks.

Virtual reality therapy, including the use of video gaming consoles, is increasingly being used because patients find it more fun and satisfying, which means they are better able to keep up with their treatment regime.

What we have discovered

We have shown how different levels of the motor pathway are affected after stroke. The brain cannot drive the muscles on the more affected side as well as those in healthy controls and the resulting force is not as steady. This lack of control makes holding objects or carrying items difficult, particularly when patients do not have vision to help control movement.

We have also shown that when patients are distracted, their control of movement on the more affected side becomes worse. This lack of movement control is compounded by the muscle weakness that characterises movement control after stroke.

We have developed a new type of therapy using the Nintendo Wii as a rehabilitation tool after stroke. Because patients have to learn a new skill when playing these games, this results in greater improvements in brain function than strength or endurance training or the repetition of simple movements alone. The Nintendo Wii doesn’t need to be modified and we can tailor the program to each patient.

Our patients significantly improved their movement ability and the range of tasks they could perform in everyday life using their stroke-affected hand and arm after only 2 weeks of therapy. More importantly they were highly satisfied with this form of therapy.

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