Cerebrovascular accident (CVA) is the number one cause of disability in adults. The damaged brain, motor skills, memory and language may be affected depending on the intensity, location and type of stroke (hemorrhagic or ischemic). Supported as soon as possible, these sequelae are not not a fatality. The recovery of speech or motor skills is possible. Various treatments can be offered when you return home, such as care with a physiotherapist, a speech therapist or in a hospital department specializing in physical medicine and rehabilitation. In a report published on July 4, 2022, the High Authority for Health (HAS) takes stock of the most effective techniques (Source 1).
The brain is able to create new neural circuits with the aim of overcoming the deficiencies (difficulty walking, speaking, etc.) which are the consequences of the stroke. Professor Alexis Schnitzler describes this phenomenon of plasticity : “During a stroke, part of the brain is deprived of oxygen and sugar. Some cells are then put to sleep, others destroyed. Sleeping cells will be able to wake up within 3 to 6 months, provided they are stimulated. Rehabilitation serves to optimize this natural process. »
Walking, universal treatment
L’hemiplegiais the main sequelae of the AVC and results in a more or less severe paralysis on one side of the body. At the same time, patients often have cognitive impairment of memory and attentionas well as difficulty speaking (aphasia).
Walking – and physical activity in general – improves all these parameters, not just motor skills. Alexis Schnitzler explains why: “when we walk, the neurological structures dedicated to motor skills are mobilized and, at the same time, neurotransmitters are secreted. This means that the transmission of messages between neurons is improved and the brain receives more oxygen and sugar. This process facilitates its plasticity and therefore the recovery of motor skills and stroke on a global level. »
To be efficient,you should walk or engage in physical activity at least 45 minutes a week. The more we move, the more we increase the chances of recovering motor skills.
Virtual reality wins its stripes
Video games, augmented reality headset… new technologies have a side playful on which rehabilitation specialists rely. The goal? Motivate their patients following a stroke.
Post stroke,some people have difficulties in organizing themselves in their daily activities. They can therefore practice shopping in a virtual store. The helmet can also make them feel like they are walking in the forest, which is more pleasant than a treadmill in a rehabilitation room.
“Virtual reality is not magic, but it is one more string to our bow”
A new technology to re-educate language in case of aphasia
The sessions ofspeech therapybased on diction and articulation exercises, provide valuable assistance to aphasic patients. In its latest report, the HAS points out that the transcranial magnetic stimulation (rTMS) can complement this classic method of treating this language disorder and improve chances of recovery. The goal of rTMS is to stimulate a cerebral hemisphere by exposing the patient to a magnetic field. “With this technique, the brain would be more conducive to work in speech therapy. But you should know that the rTMS is not accessible everywhere in France”, observes the specialist.
Which doesn’t work. Balneotherapy, acupuncture, music therapy… The High Health Authority considers that these techniques have not shown effective results in the treatment or post-stroke rehabilitation.
Questions – answers with the expert
3 questions to Professor Alexis Schnitzler,head of the physical medicine and rehabilitation hospitalization unit at the Lariboisière-Fernand-Widal hospital (Paris)
After how long does it take to start rehabilitation to recover? How to stimulate a person after a stroke?
Current recommendations are to start treatment within 48 hours of stroke motor and cognitive stimulationwith the help of a medical team made up of a physiotherapist and a Speech Therapist. Rehabilitation must be done at a reasonable pace so as not to tire the patient.
What is the duration of support?
The greatest recovery progress is made in the first 6 months. Beyond that, the benefit of rehabilitation with a physiotherapist or a liberal speech therapist is less obvious. The important message is to take care of your body and practice regular physical activity.
What consequences can we expect after a stroke? What can be the sequelae and consequences?
- a third of patients are cured ;
- a third maintains a moderate disability;
- a third have a severe disability.
It is useful to take stock at least once a year with a specialist in physical medicine and rehabilitation.
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