Research Paper on Treatment Methods for Cerebrovascular Accident

Introduction

Cerebrovascular Accident (CVA) is a medical term for a stroke. CVA is a neurological deficit culminating from ischemia or bleeding of the central nervous system. CVA occurs in two types, ischemic stroke, which is the most common and the hemorrhagic stroke, which is caused by rupturing of the blood vessels. Some of the well-known CVA symptoms include difficulties in walking, loss of balance and coordination, dizziness, numbness and paralysis in various parts of the body such as the face, legs, and arms. CVA also causes blurred vision and sudden headaches. After CVA is diagnosed, different treatment methods can be applied, and they include pressure application by sphygmomanometer to reduce spasticity, engaging in underwater exercises to increase mobility in the lower parts of the body, electromyography-triggered electrical stimulation, and swallowing exercises to improve swallowing ability.

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When stroke damages the pyramidal tract and the para-pyramidal fibers, it causes the upper motor neuron syndrome, which causes spasticity. Spasticity is a common problem among stroke patients who require rehabilitation. Various clinical measures have been tried in the treatment of spasticity among patients with CVA, and one of the treatment interventions is the application of pneumatic pressure via the help of a sphygmomanometer to reduce the effects of spasticity (Sheeba, & Richa, 2015). The use of pneumatic pressure through air splints has been found to reduce the excitability of spinal motor neurons after the stroke. Sheeba and Richa (2015) conducted a study to determine the effectiveness of pneumatic pressure on 30 post-stroke patients. The participants were divided into the control group and the direct application of stimuli (DAPS) group. Patients in the DAPS group received pressure through the sphygmomanometer for ten minutes. The research results indicated that spasticity reduced significantly among subjects in the DAPS group than in the control group. The researchers associated tonic pressure reflex as one of the causes that caused the reduction in spasticity. Spasticity also reduced due to the activation of the Golgi tendon organs, which causes autogenic inhibition (Sheeba, & Richa, 2015). The reduction of spasticity was also due to the neutral heat and pressure applications that minimized the excitability of thermal and tactile receptors.

Underwater exercise is another intervention strategy that can be utilized for the treatment of CVA. According to Matsumoto, Uema, Ikeda, Miyara, Nishi, Noma, and Shimodozono (2016), stroke causes hemiparesis, which causes muscular weakness on one side of the body. Hemiparesis is prevalent in one to two patients with stroke. The inability to walk, which is another symptom of stroke is caused by the failure to generate sufficient lower-limb power. Clinicians have designed various strategies to enhance limb-power, but one of the interventions that have received much attention in the recent days is underwater exercises. Underwater therapy is considered as one of the most effective interventions that improve range of motion, enhance balance, walking ability, and reduces fatigue in a significant number of post-stroke patients (Matsumoto et al., 2016). Additionally, evidence suggests that immersion into the water for ten to fifteen minutes inhibits muscle spasticity. The research by Matsumoto et al. (2016) on the effectiveness of underwater physical activities on stroke patients found that repeated underwater exercises improved the quality of life of patients with stroke.

Equally important, electromyography-triggered electrical stimulation is another intervention that can be used for the treatment of shoulder subluxation to persons with stroke. Jeon, Kim, Jung, and Chung (2017) argue that shoulder subluxation causes pain and impedes the upper extremity function. Electromyography-triggered functional electrical stimulation (EMG-triggered FES) induces active self-regulatory muscles. Furthermore, evidence from various studies indicates that EMG-triggered FES can be utilized in task-oriented training, which is a useful strategy for functional recovery. EMG-triggered FES has been discovered as an efficient methodology for the improvement of upper extremity movement. The study by Jeon, Kim, Jung, and Chung (2017) found that when patients in the control group underwent EMG-triggered FES tasks for thirty minutes a day, and five times per week, there was a significant improvement in the level of subluxation, pain, and muscle activation.

CVA patients can also undergo swallowing exercises to enhance their swallowing ability. According to Diana and Rani (2014), the difficulty in swallowing is called dysphagia, which culminates from issues in nerve controls. CVA is one of the leading causes of dysphagia, which is known to paralyze the throat muscles. Adults with CVA undertaking swallowing exercises increase their strength, compensation, and modify food textures to make it easier to swallow (Dian, & Rani, 2014). The authors conducted a study among CVA patients to determine the effectiveness of swallowing exercises before and after treatment. The findings indicated a significant ability difference before the initiation of swallowing training and after the workout. The patients showed an improvement in swallowing function and exhibited other secondary effects such as increased mood state and quality of life.

Conclusion

In conclusion, CVA is a fatal disease that hinders individuals from conducting their daily activities such as walking. However, due to various treatment strategies mentioned above, patients have a chance to improve their quality of life and engage in multiple tasks such as walking.

References

Diana, D. M., & Rani, S. S. J. (2014). A study to assess the Effectiveness of Swallowing exercises on Swallowing Ability among Patients with Cerebrovascular Accident in selected Hospitals. Asian Journal of Nursing Education and Research, 4(4), pp. 429- 435. Retrieved from https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=0&sid=25a0de22-1a89-4862-b946-5adb23eb47d8%40sessionmgr4006

Jeon, S., Kim, Y., Jung, K., & Chung, Y. (2017). The effects of electromyography-triggered electrical stimulation on shoulder subluxation, muscle activation, pain, and function in persons with stroke: A pilot study. NeuroRehabilitation, 40(1), pp. 69-75. Retrieved from https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=0&sid=43b96be3-a0c8-4a73-b374-26b1bf352a5f%40sessionmgr4008

Kauser, S., & Sharma, S. (2015). Effect of Pressure Application by Sphygmomanometer on Spasticity in Post Stroke Hemiplegic Patients. Indian Journal of Physiotherapy and Occupational Therapy-An International Journal, 9(2), pp. 156-160. Retrieved from https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=0&sid=9e9e55e3-ebdc-4acd-ac2e-5ffc7f551457%40sessionmgr4010

Matsumoto, S., Uema, T., Ikeda, K., Miyara, K., Nishi, T., Noma, T., & Shimodozono, M. (2016). Effect of Underwater Exercise on Lower-Extremity Function and Quality of Life in Post-Stroke Patients: A Pilot Controlled Clinical Trial. The Journal of Alternative and Complementary Medicine, 22(8), pp. 635-641. Retrieved from https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=0&sid=7d8e0137-7290-4a8e-b7d0-a2eed16b052c%40sessionmgr4008