Hemiparesis

Hemiparesis or one-sided (“hemi”) weakness (“paresis”) affects about 8 out of 10 stroke survivors, causing
weakness or the inability to move one side of the body.
One-sided weakness can affect your arms, hands, legs and facial muscles.
If patient have one-sided weakness he may have trouble performing everyday activities such as eating,
dressing, and using the bathroom.
Rehabilitation treatments, exercises at home, and assistive devices can help with your mobility and recovery.
One-sided weakness in arms, hands, face, chest, legs or feet can cause:

 Loss of balance
 Difficulty walking
 Impaired ability to grasp objects
 Decrease in movement precision
 Muscle fatigue
 Lack of coordination

The location in the brain where stroke occurred will determine where in the body patient experience
weakness.
Injury to the left side of the brain, which controls language and speaking, can result in right-sided weakness.
Left-sided weakness results from injury to the right side of the brain, which controls our nonverbal
communication and certain types of behavior.

It is possible for you to increase or regain strength and movement on the affected side with rehabilitation.

Tips to live with hemiparesis

In addition to rehabilitation treatment, exercise at home and assistive aids can help increase mobility.
Repeated practice and regular activity will help increase control and flexibility and re-establish nerve circuitry.
You can learn specific activities to do at home that will help continue recovery after inpatient therapy. Always
consult a healthcare professional before starting these exercises.
Home Modifications

Making home modifications such as the following can improve your safety:

 Grab bars
 Ramps
 Raised toilet seats
 Tub bench
 Hand-held shower head
 Plastic adhesive strips on the bottom of the bathtub
 Long-handled brushes, washing mitts with pockets for soap
 Electric toothbrushes and razors

Lifestyle Changes

Making simple lifestyle changes can help prevent falls and promote a healthier recovery. Some examples
include:

 Remaining active
  Strengthening leg muscles and balance through exercises
 Wearing flat, wide-toed shoes
 Using a prescribed assistive device and not relying on furniture for support while walking
 Taking precautions when taking medications that cause drowsiness
 Paying close attention while walking

https://www.stroke.org/we-can-help/survivors/stroke-recovery/post-stroke conditions/physical/hemiparesis/
 Hemiplegia
Hemiplegia is a paralysis that affects one side of the body. It’s often diagnosed as either the right or left
hemiplegia, depending on which side of the body is affected. According to the National Stroke Association, as
many as “9 out of 10 stroke survivors have some degree of paralysis immediately following a stroke.”
Hemiplegia is caused by an injury to the parts of the brain that control movement, resulting in the inability to
control the voluntary movement of a muscle or a group of muscles. It’s often accompanied by these side
effects:
 Muscle spasticity (weakness in the muscles)
 Muscle atrophy (loss of muscle strength)
 Seizures
 Pain

Hemiparesis
Hemiparesis occurs when one side of the body is weakened, and it typically impacts your limbs and facial
muscles. It affects about 8 out of every 10 stroke survivors. Patients may experience limited movement in their
arms, hands, legs, or facial muscles, which can lead to increased difficulty performing everyday activities.
Experiencing a one-sided weakness in your arms, hands, face, chest, legs, or feet can cause the following in
patients:
 Loss of balance
 Difficulty walking
 Difficulty grasping objects
 Loss of spatial recognition and a decrease in movement precision
 Muscle fatigue
 Lack of coordination
Right-sided hemiparesis involves injury to the left side of the brain, which controls language and
speaking. People who have this type of hemiparesis may also have problems talking and/or
understanding what people say. They also may have trouble determining left from right.
Left-sided hemiparesis involves injury to the right side of the brain, which controls the process of
how we learn, non-verbal communication and certain types of behavior. Damage to this area of the
brain can also cause people to talk excessively, have memory problems and short attention spans.
Treating Hemiplegia and Hemiparesis

Although hemiplegia and hemiparesis are serious handicaps, physical and occupational therapy and
rehabilitation can help improve movement in those areas. Here are some of the techniques that aid in
recovery.
Range-of-Motion Exercises
Range-of-motion exercises can help to prevent muscle stiffness and contractures by moving the weakened or
paralyzed limb. Depending on whether the limb can voluntarily move or has to be moved by someone else,
range-of-motion exercises can be passive (where someone else moves the limb for you), active-assistive
(where you perform as much of the movement as possible with the help of someone else to complete the
movement), or active (where you complete the movement).
Flexibility Training
After a stroke, your therapist will work with you to design a stretching program that will best suit your
needs. Flexibility training improves blood circulation and can help you regain the balance and coordination
that can be lost after a stroke. When paired with strength training, flexibility training can lead to improved
posture and ability.
Flexibility training is important if you have limited mobility on your non-dominant side. Often, the muscles on
your dominant side of your body will be more flexible, so working to keep your dominant side as flexible as
possible can help to increase mobility on your non-dominant side.
Motor Imagery (MI)
During motor-imagery exercises, you will be asked to imagine yourself using a certain part of your body. As you
imagine these body parts moving, certain areas of your brain and muscles may be active as if you were actually
doing the activity. This mental practice has been shown to improve arm movement in patients with
hemiparesis, and research suggests that motor-imagery exercises may be useful in helping patients walk.
Assistive Devices
Assistive devices, such as braces, canes, walkers, and wheelchairs, can increase strength and movement in
patients with weakened or paralyzed limbs.
Your physical therapist will recommend a device that best fits your needs; however, it’s important to be
trained in the safety procedures and proper use of orthotics—including making sure the device is properly
fitted and learning how to maintain it.
 Difference between hemiplegia & hemparesis
Both hemiparesis and hemiplegia sound very similar, but each of them refers to different things. The use
of these two words is often quite confusing because many professionals use the words interchangeably.
There are even instances when a healthcare professional may start explaining your child's condition
using one word and then suddenly switch to the other. So, when you compare hemiplegia and
hemiparesis,what exactly is the difference?

Comparing Hemiplegia vs. Hemiparesis to Know the Difference

Hemiplegia

The word "hemi" means one side of the body, whereas the word "plegia" stands for severe weakness.
Together, "hemiplegia" means complete paralysis or loss of function of one-half of the body, including
one leg and arm. You can develop hemiplegia because of an injury or disease in the motor centers of the
brain.
You usually develop a left-sided hemiplegia if you sustain an injury to the right side of your brain, while a
right-sided hemiplegia is the outcome of an injury to the left side of your brain. Injury may well be a
reason behind the development of hemiplegia, but stroke remains the commonest cause of hemiplegia.
There is loss of brain function when your brain cells do not receive enough blood. You may get a stroke
because of one of the following factors:
 A thrombus, which means a clot forms within the blood vessel and blocks the supply of blood.
 An embolus, which means a thrombus or clot breaks away from its original site and blocks blood
supply somewhere else in the body.
 A hemorrhage, which means a blood vessel that supplies the blood to the brain ruptures and bleed.
Symptoms
The symptoms you experience after getting hemiplegia largely depends on the part of the brain affected.
And when comparing hemiplegia vs. hemiparesis, you may find some very similar symptoms. The most
common symptoms are difficulty in swallowing, difficulty in walking, problem maintaining balance,
speech difficulties, depression, and numbness with loss of sensations on the affected side of the body.
Some people have blurred vision as well as loss of control over bladder and bowel movements. You may
no longer be able to perform tasks like tying laces, holding objects, buttoning, dressing yourself, etc.
Moreover, your memory may become poor with you becoming unable to recall past events concerning
places, people, and activities.
 Hemiparesis
The word "paresis" may sound like paralysis, but it actually refers to "partial loss of movement". It
means that instead of affecting one-half of your body, the condition affects particular muscles only. In
other words, the less severe form of hemiplegia is hemiparesis. Research shows that hemiparesis affects
every 8 in 10 stroke survivors, and make it difficult for the person to move one side of the body.
Symptoms
What you experience usually depends on the affected part of the brain. If you sustain an injury to the left
side of the brain, you may have right-sided weakness. This part of the brain controls language and
speaking. Similarly, any injury to the right side of the brain, which controls nonverbal communication,
may result in left-sided weakness.
You may have weakness in your hands, arms, legs, and even facial muscles. With one-sided weakness, it
becomes difficult to perform certain activities, such as dressing, eating, and using the bathroom.
Difficulty walking, muscle fatigue, lack of coordination,impaired ability to hold objects and decrease in
movement precision are also common symptoms of hemiparesis. Exercises at home, rehabilitation
treatments, and assistive devices help improve mobility and accelerate recovery.

Hemiplegia vs. Hemiparesis: Management

The comparison between hemiplegia and hemiparesis makes it easy to understand the difference
between the two, but it is equally important to understand how to manage both conditions properly.
Here are some ways to achieve this.

1.Range of Motion
You need to move the weak or paralyzed limb to help prevent muscle contractures and stiffness. Range
of motion can be active or passive, active-assistive depending on the severity of the problem.

2. Orthotics
You may benefit from wearing a wrist and hand orthoses, ankle foot orthoses, or elbow brace to keep
your joint in the right position and provide support to weak or paralyzed muscles.

3. Slings
You may benefit from arm slings when subluxation is a problem. It occurs when the head of the upper
arm bone drops out of the shoulder socket. This usually happens due to wakened ligaments.

4. Positioning
You need to learn how to position your weak leg or arm properly. You can use a pillow, tray, or lapboard
to support your weak arm when sitting. If you are using a tray or pillow, you need to ensure that the
height is not too much to push your shoulder up. Be sure to position your leg comfortable while sitting
and avoid too much rotation at the hip. Knee should be facing forward and foot should be flat on the
floor. Place a pillow by your side while lying on your back. Similarly, when lying on your unaffected side,
keep a pillow in front of your body to support your affected side.

5. Strengthening
It is important to perform some strengthening exercises to accelerate recovery. Your doctor will teach
you certain exercises while considering hemiplegia vs. hemiparesis. You may not be able to perform
 certain exercises when you have hemiplegia or complete paralysis of one side. Electrical stimulation may
also help strengthen and activate your weak muscles.

6. Compensatory Techniques
You may have to make use of compensatory techniques to deal with problems caused by hemiplegia. It
is easy to find adaptive equipment that improves mobility and makes ADLs easier. The most common
examples of adaptive equipment are bathroom transfer benches, hemi-walkers, dressing aids, raised
toilets, and more. It is now also possible to find adaptive clothing that stroke patients can use for easy
fastening and removal.

Therapeutic Ball Exercises for Hand Recovery After Stroke

Exercise #1: Ball Grip

Hold ball tightly in palm of hand. Squeeze the ball, hold, and relax. Repeat ten times, for two sets.

Place ball between bent thumb and extended two fingers of same hand. Extend and straighten the thumb to roll
the ball. Repeat ten times, for two sets

Hold ball between thumb and index and middlefingers. Squeeze together, hold and relax. Repeat ten times, for
two sets.

Place ball between any two fingers. Squeeze the two fingers together, hold and relax. Repeat ten times, for two
sets.
Place the affected arm on the table and place a water bottle in the affected hand. Keep the
affected hand and fingers relaxed. Curl the fingers in and grasp the water bottle then release.
Repeat ten times, for two sets.

Place a pen to the side of the table and then gently grip it with the affected fingers. Slide the pen across the
table, and then release. Repeat ten times, for two sets.

https://www.youtube.com/watch?v=Vlre_SCXK7Q Amresh dev

 Mild cognitive impairment (MCI)
Mild cognitive impairment (MCI) is a condition in which someone has minor problems with cognition - their
mental abilities such as memory or thinking.

Symptoms of mild cognitive impairment

The term MCI describes a set of symptoms, rather than a specific disease. A person with MCI has
mild problems with one or more of the following:

 memory - for example, forgetting recent events or repeating the same question
 reasoning, planning or problem-solving - for example, struggling with thinking things through
 attention - for example, being very easily distracted
 language - for example, taking much longer than usual to find the right word for something
 visual depth perception - for example, struggling to interpret an object in three dimensions,
judge distances or navigate stairs.

Top tips on managing mild cognitive impairment

There is a lot you can do to help reduce your chances of MCI progressing to dementia. There are also
many ways to deal with memory problems that will allow you to live well with MCI.

 Take medication (for example for blood pressure) as prescribed by the doctor, even if you
feel fine. It will help keep underlying health conditions in check.
 If you do smoke, now is a good time to stop. If you drink, check you are well within the
recommended limits.
 Try not to become stressed or anxious as this can make memory or thinking problems worse.
 Having a regular routine can help to minimise memory problems, though make sure to have
some variety in your days or you may get bored. Similarly, try to always keep things in the
same place as it will make them easier to find.
 Use calendars and diaries, or reminders on electronic devices, to help you remember
appointments and important events.
 Get regular physical exercise - you could go for a brisk walk or a swim, or do some more
energetic tasks in the garden or around the house. Try to do this for at least 30 minutes, five
times a week.
 Try to break tasks down into small steps if you are struggling, then focus on just one step at
a time. For example, while cooking focus on one step of the recipe in turn.
 Eat a healthy balanced diet with plenty of fruit and vegetables, lots of starchy foods (like
potatoes and rice), regular fish and some meat, but not too much saturated fat or dairy
products (like butter and cheese).
 Keep your brain active with puzzles, quizzes, reading or anything else you enjoy that
stimulates your mind.
 Make time to relax - you might enjoying listening to music or sitting in the garden. You could
also find out about how to practise breathing exercises by taking out a book about relaxation
and breathing at your local library or looking online for tips.
 Try to sleep well - avoid stimulants like tea or coffee, or having alcohol, before bed.
 Stay socially active - make an effort to keep going out to see friends and family. If you attend
a place of worship, continue to go regularly.
 Ask your doctor about memory support groups for people with MCI in your area.