Covid -19 affects not only the disease it causes, but also the entire flow of life due to the measures taken to slow down and stop the spread of the virus.
During the pandemic period, everyone tries to stay at home as much as possible, and even neglects other health problems with coronavirus concerns. In particular, stroke patients are in the group that should be considered primarily, as they carry many of the coronavirus risk factors. When the physical therapy and rehabilitation processes are added to this situation, permanent disabilities can be inevitable. Head of Physical Therapy and Rehabilitation Department at Memorial Şişli Hospital Prof. Dr. Engin Çakar made important suggestions for stroke and stroke patients.
Stroke - stroke patients are more at risk
Stroke is a brain damage that develops as a result of the sudden deterioration of the blood circulation of the brain, and in our society it is also known as the word paralysis, which is actually the result of the disease. It occurs due to reasons such as stroke, cerebral hemorrhage, cerebral vascular occlusion, and clotting in the brain. It can cause symptoms and findings in many different areas such as movement, balance, sensation, emotion, speech, and thinking. It causes significant physical and psychological restrictions in a person's life. It usually requires a long and determined physical therapy and rehabilitation process to overcome these obstacles. People who have had a stroke become more at risk for severe problems such as pneumonia if they get coronavirus. In this respect, the pandemic can create double stress on stroke - stroke patients.
It is very important to comply with protective measures
The coronavirus can affect people of all ages. However, some risk factors cause the new coronavirus disease to be caught more easily and the disease to progress more severely.
Among these risk factors;
- Older age (65 years and older are particularly risky)
- Heart diseases
- Lung diseases (such as COPD)
- There are chronic diseases that weaken the immune system.
Stroke patients usually carry one or more of these risk factors. Stroke and diseases that cause stroke weaken the body and reduce the reserve capacity needed to overcome the disease. A similar situation is observed in the influenza virus "influenza". Therefore, it is recommended that people at risk get seasonal influenza vaccines. Vaccination studies for the new coronavirus are still ongoing. Therefore, it is very important for high-risk people to follow protective measures in order not to get sick.
Coronavirus (Covid-19) can increase stroke risk
Preliminary data suggest that the coronavirus increases the risk of stroke, but its rate is not yet known. Generally, this relationship was seen in more severe infections. According to the data announced by China, 19% of the people hospitalized due to Covid-6 had stroke and 15% had other severe neurological symptoms (confusion, delirium, coma). This may be due to having severe pneumonia, or it may be specific to Covid-19, it is not yet clear. Coronavirus can rarely cause brain tissue inflammation (encephalitis). In the literature, a case of acute hemorrhagic necrotizing encephalitis (inflammation with edema and bleeding in the brain tissue) has been reported in association with Covid-19.
Be very careful at home
People at high risk of having a severe coronavirus disease and other people in the house must follow the distance and hygiene rules at home. People caring for a stroke-paralyzed patient with physical or mental function limitation should also strictly and seriously comply with the precautions.
- If the house is crowded, a distance of at least 2 meters from other people should be left and a medical mask should be worn.
- If possible, the companion should stay in a separate room, if this is not possible, attention should be paid to the ventilation of the room.
- Stroke patients and their caregivers or relatives should have limited movement in the home.
- If available, use of separate toilet and bathroom is recommended.
- Items such as cups, plates, towels should not be shared.
- Visitors should not be accepted to the house.
Physical therapy and rehabilitation should continue at home
The first weeks and months of stroke treatment are gold for physical therapy and rehabilitation. Inpatient physical therapy for physical therapy in early stroke patients is important in terms of providing less contact with the patient and applying a more intense program. Robotic physical therapy can also contribute to recovery during this period. Regular exercise at home may be preferred during the pandemic process in patients who have come a long way in the treatment of stroke. Thus, fewer people are touched. At this point, it may be an option to continue the stroke physical therapy of the patients with online physical therapy called telerehabilitation.
What is online physical therapy in stroke treatment?
Since hospitalization of patients in the risky group for rehabilitation purposes or daily tide may cause them to encounter infection, inpatient or outpatient physical therapy decisions can be postponed. This decision is a matter for the patient, his family and the follow-up physical therapist. It may not be correct to postpone stroke treatment when absolutely necessary. If the patient does not come to the hospital within the scope of the pandemic measures taken due to coronavirus or it is decided to come to the hospital less frequently, the needs of the patients such as physical therapy, occupational therapy and speech therapy do not disappear. In cases where the patient does not have to come to the hospital, online physical therapy methods called telemedicine or telerehabilitation come into play for compensation. In online physical therapy, it takes place in the form of a video call with the patient's physician and physiotherapist or occupational therapist. In this meeting, the exercises that the patient should do are done with the participation of the patient and the help of his caregiver. Telerehabilitation can be applied as online physical therapy every day or as a normal physical therapy and robotic physical therapy program in the clinic for 3 days a week, and as a hybrid as online physical therapy by connecting to the internet at home for the other 3 days. Thus, the patient can continue his treatment without interruption.