Brain Basics

shutterstock_175160774Source: National Institute of Neurological Disorders and Stroke

Introduction

If you’re like most Americans, you plan your future. When you take a job, you examine its benefit plan. When you buy a home, you consider its location and condition so that your investment is safe. Today, more and more Americans are protecting their most important asset—their brain. Are you?

Stroke ranks as the fourth leading killer in the United States. A stroke can be devastating to individuals and their families, robbing them of their independence. It is the most common cause of adult disability. Each year approximately 795,000 Americans have a stroke, with about 160,000 dying from stroke-related causes. Officials at the National Institute of Neurological Disorders and Stroke (NINDS) are committed to reducing that burden through biomedical research.

What is a Stroke?

A stroke, or “brain attack,” occurs when blood circulation to the brain fails. Brain cells can die from decreased blood flow and the resulting lack of oxygen. There are two broad categories of stroke: those caused by a blockage of blood flow and those caused by bleeding into the brain. A blockage of a blood vessel in the brain or neck, called an ischemic stroke, is the most frequent cause of stroke and is responsible for about 80 percent of strokes. These blockages stem from three conditions: the formation of a clot within a blood vessel of the brain or neck, called thrombosis; the movement of a clot from another part of the body such as the heart to the brain, called embolism; or a severe narrowing of an artery in or leading to the brain, called stenosis. Bleeding into the brain or the spaces surrounding the brain causes the second type of stroke, called hemorrhagic stroke.

Two key steps you can take will lower your risk of death or disability from stroke: control stroke’s risk factors and know stroke’s warning signs. Scientific research conducted by the NINDS has identified warning signs and a large number of risk factors.

What are the warning signs of a Stroke?

Warning signs are clues your body sends that your brain is not receiving enough oxygen. If you observe one or more of these signs of a stroke or “brain attack,” don’t wait, call a doctor or 911 right away!

  • Sudden numbness or weakness of face, arm, or leg, especially on one side of the body
  • Sudden confusion, or trouble talking or understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, or loss of balance or coordination
  • Sudden severe headache with no known cause

Other danger signs that may occur include double vision, drowsiness, and nausea or vomiting. Sometimes the warning signs may last only a few moments and then disappear. These brief episodes, known as transient ischemic attacks or TIAs, are sometimes called “mini-strokes.” Although brief, they identify an underlying serious condition that isn’t going away without medical help. Unfortunately, since they clear up, many people ignore them. Don’t. Paying attention to them can save your life.

What are the risk factors for a Stroke?

A risk factor is a condition or behavior that occurs more frequently in those who have, or are at greater risk of getting, a disease than in those who don’t. Having a risk factor for stroke doesn’t mean you’ll have a stroke. On the other hand, not having a risk factor doesn’t mean you’ll avoid a stroke. But your risk of stroke grows as the number and severity of risk factors increases.

Some factors for stroke can’t be modified by medical treatment or lifestyle changes.

  • Age.  Stroke occurs in all age groups.  Studies show the risk of stroke doubles for each decade between the ages of 55 and 85.  But strokes also can occur in childhood or adolescence.  Although stroke is often considered a disease of aging, the risk of stroke in childhood is actually highest during the perinatal period, which encompasses the last few months of fetal life and the first few weeks after birth.
  • Gender.  Men have a higher risk for stroke, but more women die from stroke.  Men generally do not live as long as women, so men are usually younger when they have their strokes and therefore have a higher rate of survival.
  • Race.  People from certain ethnic groups have a higher risk of stroke.  For African Americans, stroke is more common and more deadly—even in young and middle-aged adults—than for any ethnic or other racial group in the United States.  Studies show that the age-adjusted incidence of stroke is about twice as high in African Americans and Hispanic Americans as in Caucasians.  An important risk factor for African-Americans is sickle cell disease, which can cause a narrowing of arteries and disrupt blood flow. The incidence of the various stroke subtypes also varies considerably in different ethnic groups.
  • Family history of stroke.  Stroke seems to run in some families.  Several factors may contribute to familial stroke.  Members of a family might have a genetic tendency for stroke risk factors, such as an inherited predisposition for high blood pressure (hypertension) or diabetes.  The influence of a common lifestyle among family members also could contribute to familial stroke.

What are the treatable factors?

Some of the most important treatable risk factors for stroke are:

  • High blood pressure, or hypertension.
    Hypertension  is by far the most potent risk factor for stroke. Hypertension causes a two-to four-fold increase in the risk of stroke before age 80.  If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to the normal range. Some ways that work: Maintain proper weight. Avoid drugs known to raise blood pressure. Eat right:  cut down on salt and eat fruits and vegetables to increase potassium in your diet. Exercise more. Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.
  • Cigarette smoking. 

    Cigarette smoking causes about a two-fold increase in the risk of ischemic stroke and up to a four-fold increase in the risk of hemorrhagic stroke.  It has been linked to the buildup of fatty substances (atherosclerosis) in the carotid artery, the main neck artery supplying blood to the brain. Blockage of this artery is the leading cause of stroke in Americans. Also, nicotine raises blood pressure; carbon monoxide from smoking reduces the amount of oxygen your blood can carry to the brain; and cigarette smoke makes your blood thicker and more likely to clot. Smoking also promotes aneurysm formation. Your doctor can recommend programs and medications that may help you quit smoking. By quitting, at any age, you also reduce your risk of lung disease, heart disease, and a number of cancers including lung cancer.

  • Heart disease. 

    Common heart disorders such as coronary artery disease, valve defects, irregular heart beat (atrial fibrillation), and enlargement of one of the heart’s chambers can result in blood clots that may break loose and block vessels in or leading to the brain. Atrial fibrillation—which is more prevalent in older people—is responsible for one in four strokes after age 80, and is associated with higher mortality and disability. The most common blood vessel disease is atherosclerosis. Hypertension promotes atherosclerosis and causes mechanical damage to the walls of blood vessels. Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots. Your doctor may recommend surgery to clean out a clogged neck artery if you match a particular risk profile. If you are over 50, NINDS scientists believe you and your doctor should make a decision about aspirin therapy. A doctor can evaluate your risk factors and help you decide if you will benefit from aspirin or other blood-thinning therapy.

  • Warning signs or history of TIA or stroke. 

    If you experience a TIA, get help at once. If you’ve previously had a TIA or stroke, your risk of having a stroke is many times greater than someone who has never had one. Many communities encourage those with stroke’s warning signs to dial 911 for emergency medical assistance. If you have had a stroke in the past, it’s important to reduce your risk of a second stroke. Your brain helps you recover from a stroke by asking the unaffected brain regions to do double duty. That means a second stroke can be twice as bad.

  • Diabetes. 

    In terms of stroke and cardiovascular disease, having diabetes is the equivalent of aging 15 years. You may think this disorder affects only the body’s ability to use sugar, or glucose. But it also causes destructive changes in the blood vessels throughout the body, including the brain. Also, if blood glucose levels are high at the time of a stroke, then brain damage is usually more severe and extensive than when blood glucose is well-controlled. Hypertension is common among diabetics and accounts for much of their increased stroke risk. Treating diabetes can delay the onset of complications that increase the risk of stroke.

  • Cholesterol imbalance.  Low-density lipoprotein cholesterol (LDL) carries cholesterol (a fatty substance) through the blood and delivers it to cells.  Excess LDL can cause cholesterol to build up in blood vessels, leading to atherosclerosis.  Atherosclerosis is the major cause of blood vessel narrowing, leading to both heart attack and stroke.
  • Physical inactivity and obesity.  Obesity and inactivity are associated with hypertension, diabetes, and heart disease.  Waist circumference to hip circumference ratio equal to or above the mid-value for the population increases the risk of ischemic stroke three-fold.

Do you know the risk?

Some of the most important risk factors for stroke can be determined during a physical exam at your doctor’s office. If you are over 55 years old, the worksheet in this pamphlet can help you estimate your risk of stroke and show the benefit of risk factor control.

The worksheet was developed from NINDS-supported work in the well-known Framingham Study. Working with your doctor, you can develop a strategy to lower your risk to average or even below average for your age.

Many risk factors for stroke can be managed, some very successfully. Although risk is never zero at any age, by starting early and controlling your risk factors you can lower your risk of death or disability from stroke. With good control, the risk of stroke in most age groups can be kept below that for accidental injury or death.

Americans have shown that stroke is preventable and treatable. In recent years, a better understanding of the causes of stroke has helped Americans make lifestyle changes that have cut the stroke death rate nearly in half.

Scientists at the NINDS predict that, with continued attention to reducing the risks of stroke and by using currently available therapies and developing new ones, Americans should be able to prevent 80 percent of all strokes.

Score your stroke risk for the next 10 years-MEN

Key:  SBP = systolic blood pressure (score one line only, untreated or treated); ; Diabetes = history of diabetes; Cigarettes = smokes cigarettes; CVD (cardiovascular disease) = history of heart disease; AF = history of atrial fibrillation; LVH  = diagnosis of left ventricular hypertrophy

Points 0 +1 +2 +3 +4 +5 +6 +7 +8 +9 +10
Age 55-56 57-59 60-62 63-65 66-68 69-72 73-75 76-78 79-81 83-84 85
SBP-untrd 97-105 106-115 116-125 126-135 136-145 146-155 156-165 166-175 176-185 186-195 196-205
or SBP-trtd 97-105 106-112 113-117 118-123 124-129 130-135 136-142 143-150 151-161 162-176 177-205
Diabetes No Yes
Cigarettes No Yes
CVD No Yes
AF No Yes
LVH No Yes

 

Your Points 10-Year Probability
1 3%
2 3%
3 4%
4 4%
5 5%
6 5%
7 6%
8 7%
9 8%
10 10%
11 11%
12 13%
13 15%
14 17%
15 20%
16 22%
17 26%
18 29%
19 33%
20 37%
21 42%
22 47%
23 52%
24 57%
25 63%
26 68%
27 74%
28 79%
29 84%
30 88%

 

Compare with Your Age Group Average 10-Year Probability of Stroke
55-59 5.9%
60-64 7.8%
65-69 11.0%
70-74 13.7%
75-79 18.0%
80-84 22.3%

 

Score your stroke risk for the next 10 years-WOMEN

Key:  SBP = systolic blood pressure (score one line only, untreated or treated); ; Diabetes = history of diabetes; Cigarettes = smokes cigarettes; CVD (cardiovascular disease) = history of heart disease; AF = history of atrial fibrillation; LVH  = diagnosis of left ventricular hypertrophy

Points 0 +1 +2 +3 +4 +5 +6 +7 +8 +9 +10
Age 55-56 57-59 60-62 63-64 65-67 68-70 71-73 74-76 77-78 79-81 82-84
SBP-untrd 95-106 107-118 119-130 131-143 144-155 156-167 168-180 181-192 193-204 205-216
or SBP-trtd 95-106 107-113 114-119 120-125 126-131 132-139 140-148 149-160 161-204 205-216
Diabetes No Yes
Cigarettes No Yes
CVD No Yes
AF No Yes
LVH No Yes

 

Your Points 10-Year Probability
1 1%
2 1%
3 2%
4 2%
5 2%
6 3%
7 4%
8 4%
9 5%
10 6%
11 8%
12 9%
13 11%
14 13%
15 16%
16 19%
17 23%
18 27%
19 32%
20 37%
21 43%
22 50%
23 57%
24 64%
25 71%
26 78%
27 84%

 

Compare with Your Age Group

Average 10-Year Probability of Stroke

55-59 3.0%
60-64 4.7%
65-69 7.2%
70-74 10.9%
75-79 15.5%
80-84 23.9%

 

This example helps you assess your risk of stroke. Tally your points to score your
stroke risk over the next 10 years.

Martha, age 65, wanted to determine her risk for having a stroke, so she took this stroke risk profile. This is how she arrived at her 10-year probability risk for having a stroke:

Age 65
SBP – treated, 107-113
Diabetes – No
Cigarettes – Yes
CVD – No
AF – Yes
LVH – No
4 points
2 points
0 points
3 points
0 points
6 points
0 points

TOTAL

15 points

Interpretation:
15 points carries a 16 percent, 10-year probability of having a stroke. If Martha quits smoking she can reduce her points to 12, which carries a 9 percent, 10-year probability of having a stroke.

Her current point total does not mean Martha will have a stroke, but serves as a wake-up call to ways she can lower her risk or even prevent a stroke. A lower percent score doesn’t mean that Martha won’t have a stroke, only that she is at a lower risk of having one.

No matter what your score is, it is important to work on reducing your risk factors as Martha did in this example by quitting smoking.

Source:  D’Agostino, R.B.; Wolf, P.A.; Belanger, A.J.; & Kannel, W.B.  “Stroke Risk Profile:  The Framingham Study.”  Stroke, Vol. 25, No. 1, pp. 40-43, January 1994.

Many risk factors for stroke can be managed, some very successfully. Although risk is never zero at any age, by starting early and controlling your risk factors you can lower your risk of death or disability from stroke. With good control, the risk of stroke in most age groups can be kept below that for accidental injury or death.

Americans have shown that stroke is preventable and treatable. In recent years, a better understanding of the causes of stroke has helped Americans make lifestyle changes that have cut the stroke death rate nearly in half.

Scientists at the NINDS predict that, with continued attention to reducing the risks of stroke and by using currently available therapies and developing new ones, Americans should be able to prevent 80 percent of all strokes.

New Therapy May Help Stroke Survivors Move Hand

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Posted by Dennis Thompson, HealthDay Reporter 

In the experimental therapy, patients use their good hand to help their brain regain control over the paralyzed hand, explained lead researcher Jayme Knutson, an assistant professor of physical medicine and rehabilitation at Case Western Reserve University School of Medicine in Cleveland.

A sensor-laden glove worn on the patient’s good hand sends signals to electric stimulators attached to the paralyzed hand, prompting the muscles in the inert hand to mirror the movements of the functioning hand, Knutson said.

During physical therapy patients think about opening both hands at the same time, as the electrical stimulation forces the paralyzed hand to reflect the movements of the good hand.

“We think we’re training the brain,” Knutson said. “The stimulation coincides with the patients’ attempt to open their hand. That sort of puts the brain back in control, in a roundabout way. The brain is active in attempting to open the hand.”

Electrical stimulation already has been in use as a therapy to help restore movement in a paralyzed hand, but up until now the stimulator has automatically opened and closed the hand at several-second intervals without any input from the patient, Knutson said.

Knutson and his colleagues tested their new approach in a clinical trial involving 80 stroke survivors.
For 12 weeks, half the survivors received electrical stimulation therapy using the new “mirroring” therapy. The other half also used an electrical stimulator, but in standard therapy that mechanically opened and closed the inert hand with no input from the brain.

Both groups used their assigned electrical stimulator on their own at home for 10 hours a week. They also spent three hours a week practicing hand tasks with an occupational therapist in the lab.

Prior to and six months following therapy, all patients were given a standard dexterity test that measured the number of blocks they could pick up, lift over a barrier and release in another area on a table within a 60-second period.

Patients who received the new therapy experienced markedly better improvement than those in the control group. There were able to move an average of 4.6 blocks more than they had prior to therapy, compared with an improvement of 1.8 blocks for those who received standard therapy.

Improvement was greatest for people who received the new therapy less than two years following their stroke, the researchers reported. These patients experienced an improvement of 9.6 blocks on the dexterity test, compared to a 4.1-block improvement in the standard therapy group.

“It’s common to see the earlier you receive therapy after a stroke, the better able the brain is to recover,” Knutson said. If people delay therapy, the brain learns compensatory “bad habits” that become ingrained and are difficult to reverse, he said.

By the end of the treatment, 97 percent of patients who received the new therapy felt they could use their hand better than at the start of the study, researchers report.

Placing the brain somewhat in charge appears to “work on the wiring” of the nervous system, said Daniel Lackland, a professor of translational neuroscience at the Medical University of South Carolina in Charleston.

“This electrical stimulation is supplementing the body’s electrical system at the source of where you want the action to be,” Lackland said. “You’re building up that system. You’re enhancing the electrical system that’s already there.”

Both Knutson and Lackland said larger follow-up trials are needed before the technology can be submitted for U.S. Food and Drug Administration approval. Those trials are in the works, but it will likely be years before the therapy is widely available, Knutson said.

“You don’t want to give people false hope,” said Lackland, a spokesman for the American Stroke Association. “We’re not quite ready. But it is heading in a direction where there’s a therapy that’s relatively easy to use, and it’s going to be helpful for the appropriate type of person.” The findings were published in the October issue of Stroke.

Copyright © 2016 HealthDay. All rights reserved.

Brain Stimulation Could Speed Stroke Recovery

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by Charles Q. Choi, Live Science Contributor

For people who’ve had a stroke, a treatment that involves applying an electric current to the brain may help boost recovery of their mobility, a small clinical trial found

Want to see what having a stroke is like?

shutterstock_388523095Sure…every stroke is different. That’s what EVERYBODY says.  Lotje Sodderland suffered a stroke and you can imagine what is is like. When she recalls her hearing becoming distorted, the film’s soundtrack becomes busy and reverberant; when she describes seeing flashes of colour, the screen explodes into a wash of purple and pink. The result feels more like a series of Snapchat filters and echoing karaoke effects than a cohesive glimpse into another person’s perception.

This new Netflix doc uses gaudy special effects to convey the impact of Lotje Sodderland’s stroke, but her story would have been engaging enough on its own

Certain subjects are hard to keep down in the world of documentary. Year after year they resurface, regardless of whether the world really needs another film about the porn industry, mixed martial arts or Kurt Cobain. Most persistent of all is the Inspirational Recovery Story, in which we follow a buoyant character as they rebuild their life in the wake of a tragic incident, often with the aid of music or some kind of alternative therapy. Premiering yesterday as a highly promoted Netflix Original, My Beautiful Broken Brain is the latest entry in that familiar canon, and its overall structure closely follows the formula established by its predecessors, even as its best moments push beyond the genre’s conventions.

Lotje Sodderland was a digital producer at a hip London creative agency when she suffered a stroke that decimated her language skills and threw her sensory perception into disarray. Together with co-director Sophie Robinson, she began documenting her recovery in hundreds of hours of intimate iPhone videos, footage that would ultimately become the bedrock of My Beautiful Broken Brain.

Click on the following link to preview the show:

Like many other films about impaired cognition, the documentary attempts to simulate Lotje’s experience of the world for the audience, transplanting her peculiar window on existence to the big screen. In theory, film should be the perfect medium for such a task: just as a melody is easier to hum than describe, sensory matters lend themselves to an art form that’s all about the senses. In practice, though, the further the movie goes in attempting to bring her viewpoint to life, the less it succeeds.

For example, where The Possibilities Are Endless – another recent documentary about stroke recovery – conveyed a sensory journey through metaphor and inference, My Beautiful Broken Brain opts for an achingly literal translation of Sodderland’s descriptions. When she recalls her hearing becoming distorted, the film’s soundtrack becomes busy and reverberant; when she describes seeing flashes of colour, the screen explodes into a wash of purple and pink. The result feels more like a series of Snapchat filters and echoing karaoke effects than a cohesive glimpse into another person’s perception, although it does validate Sodderland’s claim that she experiences the world like a “David Lynch movie”, if you take her to mean the gaudy music videos that have made up the bulk of Lynch’s output since he unofficially retired from film-making a decade ago.

My Beautiful Broken Brain works best when it allows its subject-cum-author to talk plainly about her situation; despite her linguistic impairment, Sodderland is an engaging and illuminating video diarist. It’s these quiet, intimate moments, and not the trailer-friendly VFX showcases surrounding them, that lift the film above a crowded field of like-minded docs.

 

Am I getting better now?

shutterstock_309537812When I first started writing my Blog, it took me SO MUCH time…and all I could get out were a few sentences.  Do you remember how that felt?  It was like being 5 years old and trying to explain something. And then when I was done,  I had to read it again, a few hours later, to correct the multiple mistakes!
When I began, I started with 1 posting per week…and No graphics.  It was REALLY hard, but I made sure I fulfilled it each week.  Check it out:

—-

Let’s start the week!

When I first started my Inspiration Speaking business, I was just doing follow up calls on people that I invited to hear me speak.  I had 80 people originally hear the presentation and I was making my follow up calls in between my other job. That was 10 months ago.   Now,  I am meeting people everyday and giving speeches 2-4 times per week!  It’s busy…but I like it that way.

Today, I met a woman who I hope to meet again.  I told her what I was doing and she gave me a few names to call.  She was  fantastic; I can’t wait to call them!  I feel blessed by the people I am meeting. God is looking out for me!

Pretty good, right!  Be honest…I want to get better.  I am open to tips.

Do you speak more than one language? Then that’s good….

A new study conducted by researchers in India has found that individuals who are fluent in more than one language had better protection against cognitive injury as a result of stroke.

After having a stroke, bilingual patients were about twice as likely to have normal brainfunction – 40 percent of bilingual strokepatients had normal brain function, compared to roughly 20 percent of monolingual stroke patients.

Every year, millions of people worldwide suffer from stroke, poor blood flow to the brain resulting in cell death. They also took into account the lifestyle of the participants, including smoking, high blood pressure, diabetes and age. The main risk factor for stroke is hypertension.

Four in 10 bilingual patients made a full recovery following a stroke, compared with just two in 10 among those who spoke only one language, researchers from the University of Edinburgh found.

The study appeared in the American Heart Association journal Stroke.

The authors suggest the protective effect of being bilingual was not because of linguistic skills, but was probably related to “executive functions acquired through a lifelong practice of language switching”.

Both study groups, however, displayed virtually similar rates of aphasia, with monolinguals showing an 11.8 percent frequency for the developing the language disorder and bilinguals showing a 10.5 percent frequency for the condition.

The study, which was published in the journal Stroke, used data from 608 stroke patients in Hyderabad who were assessed, on attention skills and the ability to retrieve and organise information. Bak and Alladi’s earlier research showed that bilingualism may postpone the onset of dementia and improve concentration.

The team previously discovered that people who speak more than one language develop dementia several years than monolinguists.

The findings of the Nizam’s study run contradictory to those suggested in an earlier research carried out by British researchers. Alladi said that bilingualism in Hyderabad may not mirror bilingualism in the United States – fluency in more than one language is common in India, whereas in the United States, it tends to be seen more among recent immigrants and better-educated Americans. “Constantly switching languages is a daily reality for many residents of Hyderabad”, said Suvarna Alladi, lead author of the study, “The cognitive benefit may not be seen in places where the need to function in two or more languages isn’t as extensive”.

However, there was no difference in difficulty with speaking, reading and writing after a stroke.

Interestingly, the researchers found that bilingualism was not associated with better language abilities after a stroke.

It suggests that other activities which boost brain power, such as taking part in night classes, playing chess, doing crosswords, learning an instrument could also prevent the mental decline.

For more information, go to TV News Room

Guess how many people have a stroke…daily…in just one part of the world?

 

ETHealthworld.com

4500 in India!  That is incredible to me!

Stroke / brain attack is now the second commonest killer in the world after heart attack and the first and foremost cause of permanent disability. It is responsible for more deaths annually than those attributed to AIDS, tuberculosis and malaria combined and in India alone, 4,500 people get a stroke every day. However, stroke is eminently treatable and preventable but timely medical attention is critical.

Stroke is a catastrophe, presenting commonly as a sudden onset paralysis of one side of face, or one hand and face or one full half of the body with or without loss of sensations. Loss of ability to speak and understand spoken words is another common feature. Losing vision on one side of visual field or one eye is the other feature. Sudden vertigo or dizziness, vomiting, loss of balance in walking, double vision, difficulty in swallowing etc. are also seen when areas affected are the lower portions of brain called brainstem. Recognition of these symptoms leads to correct diagnosis of stroke in 80% of the cases.

Strokes result most often (80%) from poverty of blood flow to parts of brain which are supplied by a particular artery feeding the brain of oxygenated and glucose rich blood which help brain to derive its energy. An active normal brain consumes more energy than any other tissue in the body. So oxygen and energy deprivation kills brain cells quickly. After a cessation of blood flow to brain, within one second around 32000 nerve cells die and it has been calculated that this may translate also into loss of 9 hours of human lifespan. Hence the most important principle in the care of stroke patients is a fast response.

The need for urgency in rushing a patient with stroke to an acute facility arise from the fact that we now have a very effective treatment using a clot busting drug called tissue plasminogen activator (TPA) which given in an appropriate stroke patient within 4.5 hours from the onset of stroke dissolves the vessel blocking clot and opens up the arteries. This reestablishes blood flow to the starved brain and prevent permanent death and loss of nerve cells which can lead to immediate recovery from paralysis or a minimization of the final severity of stroke. In the meanwhile, stroke prevention strategies have to be reinforced. For primary prevention (prevention of first ever strokes), the effective steps are to a great extent the same as for heart attacks. Most important risk factors are hypertension, diabetes mellitus, high cholesterol, obesity but also includes all forms of heart diseases. Avoidance of tobacco and alcohol and abusive drugs and regular and adequate physical activity and healthy food and sleep habits help prevent stroke.

Once someone develops stroke, it is of paramount importance to prevent further strokes. Stroke rehabilitation is a specialized area and stroke units are perhaps the most effective measures in improving stroke recovery. The role of early mobilization of stroke patients and physiotherapy and occupational therapy are well-established.

Since one of the largest obstacle to emergency treatment is that many people do not know they are having a stroke, it is critical for everyone “to be stroke smart and learn the 3Rs of stroke” which are reduced risk, recognize symptoms, respond by rushing into the nearest hospital. The world stroke organization has popularized this campaign using the acronym FAST – Face, Arm, Speech and Time.

7 Steps To Stroke Recovery

Last year Stroke Recovery Association of British Columbia (SRABC) developed their successful ‘7 Steps to Stroke Recovery’ video, which has been extensively used by stroke survivors and their families. In 2015 SRABC decided, in collaboration with March of Dimes Canada, to create a series covering each step.

Now SRABC is pleased to announce the release of the next video in that series – Step #1: Exercise and Mobility.

The video emphasises important points to help stroke survivors to exercise regularly. It also helps stroke survivors and caregivers to make sure their post-hospital stroke recovery includes enough physical exercise.

Exercise helps us to:

  • Live longer and improve quality of life
  • Be healthier
  • Be in a better mood
  • Reduce stress
  • Have more energy

The most exciting news from the frontiers of brain science is that phys­i­cal exer­cise also trig­gers changes in the brain that can make up for lost function after a stroke. Brain cells surrounding the damaged area change, so they can take on the functions of the damaged cells -and that is really helped by physical exercise. In simple terms exercise trains the brain.

The video is hosted by March of Dimes Canada’s celebrity spokesperson and former TV wrestler Bret ‘The Hitman’ Hart, who is himself a stroke survivor and advocate. The information is presented by physiotherapist and author, Heather Branscombe, who is a member of the SRABC’s Board of Directors and Professional Advisory Committee. Heather is an experienced therapist who has extensive experience of working with stroke survivors.

Stroke is the leading cause of long-term disability in Canada, with 6500 strokes occurring in BC every year. The main question facing stroke survivors after discharge from hospital is “now what?”  Not knowing where to go for help in the community, not knowing what is available and not knowing how to access programs is confusing and frustrating.  As stroke survivors move from hospital to home and adjust to life with a disability, they are at risk for depression, social isolation, as well as physical and cognitive decline. They need relevant education and practical guidance on living life after stroke and SRABC is committed to providing just that.

Video can be viewed here: https://youtu.be/BHfqFGj_tTw

SOURCE:  Stroke Recovery Association of British Columbia

After Stroke, a Former Tech Executive Rowed His Way to Recovery at the Oars

Rowing has always been Sean Maloney’s first passion.
PHOTO: ANGELA DECENZO FOR THE WALL STREET JOURNAL

Mr. Maloney made time to run, row and ski, and he tried to counter high blood pressure with a healthy diet. In February 2010, a blocked artery caused a stroke that paralyzed the right side of his body and impaired his speech.

After six months of intense rehabilitation,Mr. Maloney began to regain speech and movement. Determined to become active and get his strength and fitness back, he started working with a personal trainer. Today, at age 59, Mr. Maloney says he feels healthier than ever. He retired from Intel in 2013 and early this year founded Heart Across America, a cross-country bicycle ride from Palo Alto, Calif., to New York City that raises money and awareness for heart disease and stroke prevention.

Rowing was always his passion, but in February 2015 Mr. Maloney began to channel his energy into cycling. “Rowing and cycling are actually very similar,” he says. “They both require a lot of leg power and a lot of cardiovascular endurance.”

Instead of rowing an hour or two every morning, the way he did before his stroke, he started riding four-plus hours—or 60 to 80 miles—seven days a week. He had his friend, Olympic cyclist George Mount, ride with him every two weeks and critique his technique. “He helped me figure out how to ride uphill with more efficient pedal stroke,” he says.

Mr. Maloney puts the oars in place on a single-skull boat at the Bair Island Aquatic Center in Redwood City, Calif.
Sean Maloney gets out on the water at the Bair Island Aquatic Center in Redwood City, Calif., at least once a week.Sean Maloney with his Carl Douglass specially-built single scull and oars. PHOTO: ANGELA DECENZO FOR THE WALL STREET JOURNAL

He embarked on the cross-country ride March 22 and completed the approximately 5,000-mile journey June 14, despite a crash that left him with a broken left hip and three broken ribs. Mr. Maloney says the accomplishment is proof that we all can succeed if we put our minds to something.

Sean Maloney says since he couldn’t row across country, he took up cycling. There are a lot of similarities between the two sports, he says. .

To train for his cross-country bike ride, Sean Maloney was logging 60 to 80 miles a week on his bike.
PHOTO: ANGELA DECENZO FOR THE WALL STREET JOURNAL

“I still feel like I’m in training mode,” Mr. Maloney says. “Every day should feel like a challenge.” He’s continues to bike and row and plans to participate in another national cycling event organized by the American Heart Association/American Stroke Association next summer.

The Workout

Now that his epic ride is complete, Mr. Maloney divides his time between rowing and cycling. He has a fitness room in his home, and three to four times a week he rows on his Concept 2 rower anywhere from 2,000 to 5,000 meters. “The rowing machine is a brutal workout,” he says.

Mr. Maloney, who rows 2,000 to 5,000 meters three to four times a week on his rowing machine, gets out on the water at least once a week.

He is a member of a Bay Area rowing club and gets out on the water at least once a week. He cycles three to four times a week, even when he travels for work. “I love that cycling allows me to see a different side of cities that I’ve traveled to for years,” he says. On weekends he does challenging climbs on his bike, like tackling 3,848-foot Mount Diablo.

Twice a week his meets his trainer, Kelby Klosterman. He warms up for 10 minutes using a foam roller to massage his muscles. Mr. Klosterman says, “Sean, common to most executives, has limited range of motion in his hips and hamstrings so we spend time doing mobility work on those areas.” Stretching is followed by five minutes of core-activation exercises, including plank, bridge pose where his feet are on the ground and he thrusts his hips into the air, side plank and mountain climbers. He performs each exercise for 30 to 45 seconds. He then does a 30-minute strength and power circuit. The first block of the circuit entails four sets of four reps of barbell dead lifts, and four sets of 15 reps of seated lateral pull downs. He then does elevated push ups where his feet are set up on a bench. He performs a set of 25 reps, 20 reps, 20 reps and 15 reps.

Sean Maloney brings a cable down and across his body to work his oblique muscles.

Sean Maloney uses kettle bells to perform lateral row exercises during his strength training circuits.

He gets a two-minute break to drink water and a protein shake, then begins the second part of the circuit. He starts with fours sets of two-minute weighted sled springs, followed by four sets of 15 reps of lateral row exercises holding kettlebells, and then four sets of 15 reps of standing shoulder presses. He gets another one-minute recovery. Then he does one set of biceps curls to fatigue, one set of triceps press down to fatigue, and five minutes of core conditioning doing 30 to 45 seconds of crunches, bridge pose balanced on one foot, bicycle crunches and leg raises. He ends with five minutes of stretching.

The Diet

After the stroke, Mr. Maloney lost his sense of thirst and so now sets an alarm every hour as a reminder to hydrate throughout the day. Breakfast is eggs, whole grain toast and coffee. He eats a high-protein lunch and dinner, which is most often grilled fish with salads and vegetables. When he goes on long rides, he sustains himself with Clif Bars, chocolate milk and GU Energy Gel. His splurge is a glass or two of Gordon Biersch Czech-style pilsner with dinner.

Cost & Gear

Mr. Maloney rides a Passoni bike that he had custom made in Italy for $15,000. He wears Rapha cycling gear. He spends $150 on each personal training session. His Concept 2 Model E rowing machine costs around $1,100. He pays $1,200 a year in fees for his Bay Area rowing club. He spent $12,000 on his Carl Douglass custom single-skull boat.

The Playlist

“I’m a die-hard Beatles fan and I also love the Who and Pink Floyd.”

Write to Jen Murphy at workout@wsj.com