Summary of the Research: Treatment of Post-stroke Dysphagia with Repetitive Transcranial Magnetic Stimulation

Most exercise is designed for neurorehabilitation, not cardiovascular health, so there is a very different definition for stroke patient exercise, as well as a very different goal set. Because strokes affect each person differently, treatment is also specific to the individual. The literature included in this review focuses on three different methods of exercise, each with very specific goals in mind. Cabanas-Valdés and collegues study was on Core and Trunk stability, Minyoung describes use of Virtual Reality enhanced exercise for treatment, and Tutak introduces the concepts behind Rehabilitation

Aneesh Singhal, MD, author of Recognition and management of stroke in young adults and adolescents, from the Clinical Journal of the American Academy of Neurology states

3000 word essay on patient with left sided stroke with one identified health need/problem: Dysphagia

Brainstem strokes may result in sensory and motor symptoms as well as cranial nerve dysfunction depending on the localization of the lesion (Querol-Pascual, 2010). The 52-year-old woman presented by Bhatnagar (2013) experienced a medullary stroke; therefore, damage to the cranial nerves in the medulla may occur (glossopharyngeal (IX), vagus (X), spinal accessory (XI), and hypoglossal (XII)) (Williams, Perry & Watkins, 2013). However, the symptoms exhibited by the woman indicate that cranial nerves IX, X and XII were damaged. Previous studies have supported Bhatnagar’s claim that the symptoms exhibited by the woman are related to a medullary stroke (Benito-León & Alvarez-Cermeño, 2003; Gupta & Banerjee, 2014; Kim & Han, 2009; Mikushi, Kagaya,

De, D., & Wynn, E. (2014). Preventing muscular contractures through routine stroke patient care. British Journal of Nursing, 23(14), 781-786. doi:10.12968/bjon.2014.23.14.781

Clients suffering from stroke have slow speech loss of memory, speechless one side of their body paralysed which cause restriction to their movement.

The long term effects of a stroke are different from person to person. If the right side of the brain was damaged the left side of the body will be affected and if the right side of the brain is damaged the left side of the body will be affected, also the left side damage to the brain will affect Speech, Balance, Vision and breathing ("Treatment - Stroke - Mayo Clinic," 2015). Extensive therapies are require after a stroke these are physical therapy, occupational therapy and speech therapy. There is also rehabilitation services through in home care, hospitals or skilled nursing facility’s depending on the circumstances. Counseling is available to help cope with the new changes happening to the inside and outside of the body ("Treatment - Stroke - Mayo Clinic," 2015). There are a few alternative treatments available to they are not approves by the food and drug administration ("Stroke Alternative Treatments," 2013). Some of these natural therapies would include aromatherapy, massage therapy and yoga, these help reduce stress and relax the mind and body ("Stroke Alternative Treatments," 2013). Some patients controlled their diet by taking notice of the amount of cholesterol that they were taking in from foods they were eating ("Stroke Alternative Treatments,"

Stroke, or brain attack, is the number four killer of adults in the world. In the United States, 160,000 deaths occur each year. From 1999 to 2009, the death rate from stroke gradually lowered as improvements to medicine and testing developed. Yet, 800,000 Americans continue to have strokes and survive the event. Worldwide, about 15 million experience stroke with 6 million who die and 5 million who become permanently disabled. (Robinson, Richard & Odle, Teresa G. & Frey, Rebecca J. & Odle, Teresa G. , 2011) The statistics in America are better for surviving a stroke because of rapid response and better interpretation of symptoms. Nevertheless, surviving a stroke often brings on dilapidating effects; which means a change in lifestyle and lifelong rehabilitation through physical therapy.

Stroke can be defined as an unexpected and evolving start of neurological symptoms due to a quick and steady blocking of blood stream to the brain. A stroke is a common brain injury that ranks amongst the leading causes of death around the world (Murray and Lopez et al 1997). The symptoms and the harshness of the injury is determined by the area, and the degree of damage it causes to the brain. A common result of a stroke is Hemiparesis, which effects only half of the body. This condition then adversely effects the different systems of the body causing weakness of the muscles and loss of agility. Following a stroke, many patients begin to experience a continuous sensorimotor shortage. This shortage in sensorimotor not only hinders their capacity

Controlled Trial, Looked into hospitals in Perth, Australia that had older adult patients recovering from a recent stroke, causing different levels of dysphagia. This study attempted to see how different intensity treatments would affect a patients ability to return to a pre-stroke diet within 6 months. As well, whether or not it lowered the patients risk of dysphagia related conditions such as malnutrition or death.

Stroke is known as cerebrovascular accident or brain attack. It occurs as a result of sudden impairment of cerebral circulation in one or more blood vessel. This lead to diminish oxygen supply and commonly causes serious damage in the brain tissue (Nettina et al, 2013). Stroke is the second leading cause of death worldwide and the fourth in the UK (Stroke Association, 2015). Yearly, approximately 152000 people in the UK have a stroke, that represent 11% of all deaths in England and Wales (Hutchinson and Wilson, 2013). For the enormous majority of 67% of stroke survivors in the UK, one of the first difficulties on the path to recovery is swallowing dysfunction (Dworzynski, 2013). 50% of stroke survivors experience dysphagia in the acute phase

When DG was first admitted to hospital, the damage from the stroke seemed significantly worse. His speech was unintelligible, the oral stage of his swallow was slow and he was immobile. During the acute stages, DG was very agitated and struggled with fatigue. A combination of early intervention and spontaneous recovery helped DG to progress rapidly. Although his oral transit of food was still slower than pre-stroke, assessment

Brain foundation 2011, A-Z of disorders, Stroke, Brain Foundation, Sydney, viewed 30 June 2011, .

Cognitive impairments, motor impairments, and balance impairments are all characterizations of stroke. Quality of life is diminished and functional dependence may occur from this. Mirror therapy is a reflective illusion meant to trick the brain into thinking movement has occurred without pain in the affected limb. A mirror is placed in the participant’s midsagittal plane. The unaffected limb is put in front of it so the participant can only see the intact limb. This is done to block the affected limb so that the patient can only see the reflection of the unaffected limb. This movement seen from the unaffected limb gives the illusion in which inputs are perceived through the affected limb which is behind the mirror (Myoung-Kwonm et al., 2016)

Also, trouble speaking, confusion, loss of vision, problems with walking and understand. Robert was given Glucocorticoids because it helps with swelling and inflammation. The cause of a Cerebrovascular accident for Robert was numbness in his right hand and unable to speak. Roberts left the side of the brain was involved in CVA because the right hand was numb. Usually, it’s the opposite side of the body is affected. Roberts’s doctor told him that if he doesn’t ability to move then his hand will stay “flaccid”. It means that there will be no movement or muscle flinder in his hand or other body parts. Roberts’s recovery will require teamwork with seeing a physical therapist, occupational therapist, speech therapy and his social workers. A physical therapist will help Robert learn how to walk because after stroke people are usually unstable. Also, position and that’s at the very beginning after the stroke. It helps him with muscle pain, numbness, and stiffness. Occupational therapist will help with daily activities such as dressing, eating, drinking, bathing, writing, and reading. Speech therapist helps with producing and understing to speak. Social worker ill make sure that Robert will go to his therapy, and that he's