Yogic Management of Stroke and Paralysis

Stroke

Stroke is a serious medical emergency which is characterised by episodes of focal brain dysfunction due to disturbance in blood supply to brain due to ischemia or heamorrhage. It is the third most common cause of death is developed world.

Symptoms

The important symptoms of stroke can be remembered with the word

FAST : Face-Arms-Speech-Time

• Face - The face may have dropped on one side and the person may not be able to smile or their mouth or eye may have drooped.
• Arms - The person suspected with stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness.
• Speech - Speech of the stroke suspected person may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.
• Time - It is time to call ambulance immediately if any of these signs or symptoms are present.

It is important for everyone to be aware of these signs and symptoms. Symptoms in the FAST test identify about nine out of 10 strokes.

Other signs and symptoms may include :

• Numbness or weakness resulting in complete paralysis of one side of the body.
• Sudden loss of vision
• Dizziness
• Communication problems, difficulty talking and understanding what others are saying
• Problems with balance and coordination
• Difficulty swallowing
• Sudden and severe headache, unlike any the person has had before, especially if associated with neck stiffness
• Blacking out (in severe cases) 

Etiological classification : (Etiology-Causes)

• Ischemic - Ischemia is due to interruption of the blood supply. 80% of strokes are due to ischemia;
• Hemorrhage - Hemorrhage is due to rupture of a blood vessel or an abnormal vascular structre. 20% of strokes are due to hemorrhage.

Clinical Classification

• Transient ischemic attack (TIA) - In this type of stroke symptoms resolve within 24 hours.
• Progressive Stroke - This describes a stroke in which the focal neurological deficit worsens after the patients first presents the problem. It may be due to increasing volume of infraction or hemorrhage.
• Completed Stroke - This describes a stroke in which the focal deficit persists and is not progressing.

Risk factors

• Advanced age
• Gender
• Heredity
• Previous Vascular Event (e.g. stroke, peripheral embolism)

Modifiable risk factors

• Hypertension (high blood pressure)
• Diabetes
• High cholesterol
• Smoking
• Excessive Alchohol Consumption
• Heart disease (atrial fibrillation, heart failure, endocarditis)

Paralysis

Paralysis is loss of the ability to move one or more muscles. It may be associated with loss of feeling and other bodily functions. Paralysis is most often caused by damage to the nervous system or brain, especially the spinal cord. Major causes are stroke, trauma, poliomyelitis, amytrophic lateral sclerosis (ALS), botulism, spina bifida, multiple sclerosis and Guillain-Barré Syndrome. Temporary paralysis occurs during REM (Rapid Eye Movement) sleep and deregulation of this system can lead to episodes of waking paralysis. Drugs that interfere with nerve function, such as curare, can also cause paralysis.

Various types of paralysis

• Monoplegia is the paralysis of one limb.
• Hemiplegia is a paralysis of one arm and one leg on either side of the body.
• Paraplegia is impairment in motor and/or sensory function of the lower extremities. The area of the spinal canal which is affected in paraplegia is either the thoracic, lumbar or sacral regions.
• Quadriplegia also known as tetraplegia, in which a person experience paralysis affecting all four limbs, although not necessarily total paralysis or loss of function.

Causes

• Vascular :
  • Uncontrolled Hypertension
  • Occlusion of middle cerebral and internal carotid artery through thrombosis and embolism.
• Infections : Encephalitis, meningitis and tuberculosis.
• Space occupying lesion : Cerebral tumor, cerebral abscess.
• Trauma : Hemorrhage, Depressed fracture.
• Others : Multiple sclerosis, post-epileptic paralysis, congenital sclerosis and cerebral agenesis.

Management

The management of stroke and paralysis is aimed at minimizing irreversible damage to brain and preventing complications. Such as chest infection, painful shoulder, pressure sores, Urinary tract infection, Epileptic seizures and reducing the patients disability and reducing the risk of recurrence.

Modern medicine Management

• Medicinal management : Anticoagulant therapy in case of thrombosis and antibiotics in case of infections.
• Surgical treatment : In case of hemorrhage and haematoma
• Other management : Includes Physiotherapy, Acupuncture etc.

Dietary Management

A poor diet is a major risk factor for a stroke. High-fat foods can lead to the build-up of fatty plaques in the arteries and being overweight can lead to high blood pressure. A low-fat, high-fibre diet is recommended, including plenty of fresh fruit and vegetables and whole grains. The amount of salt used to eat should be reduced to no more than 6g a day because too much salt will increases the blood pressure. Six grams of salt is about one teaspoon.

A balanced diet should include a small amount of unsaturated fat, which will help reduce the cholesterol levels. Avoid food containing saturated fats because these will increase the cholesterol levels. The foods high in saturated fats are:

• Butter
• Ghee - a type of butter often used in Indian cooking
• Cream
• Hard cheese
• Cakes and biscuits
• Foods that contain coconut or palm oil

Yogic Management

The practices which are helpful in the management of Stroke and Paralysis are as under :

• Kriyas : Jalneti, Sutra neti
• Sukshma Vyayama : Vyayama Ucharanashaktitathavishuddhi, Chakrashuddhikriya, Buddhitathadhritishaktivikasakakriya, Smaranshaktivikasakakriya, Medhashaktivikasakakriya, Grivashaktivikasakakriya (II), Bhujavallishaktivikasakakriya
• Sthula Vyayama : Sarvangapushti
• Yogasanas : Uttanapadasana, Pavanamuktasana, Vajrasana, Vakrasana/Ardhamatsyendrasana, Gomukhasana, Mandukasana, Ushtrasana, Bhujangasana, Tadasana, Urdhwahastottanasana, Katichakrasana, Shavasana.
• Pranayama : Nadishuddi, Sitali, Ujjayi, Bhramari.
• Bandhas : Jalandharabandha
• Meditation : Breath awareness, Om Meditation or guided meditation focusing on the affected part.
• Yogic diet (Mitahara) : Alkaline foods with less oil, salt and spice.
• Note : Since practicing Yogasanas will be a difficult task for a paralytic patient, assistive, modified movements will be of much helpful.

Prevention of Stroke

• Control the blood pressure : Go for regular check up of blood pressure and, if needed, take measures to lower it. Lowering high blood pressure reduces the risk for both stroke and heart disease.
• Stop smoking : Cigarette smoking is linked to increased risk for a stroke. Research indicates that the risk of stroke for people who have quit smoking for 2-5 years is lower than people who still smoke.
• Exercise regularly : Common sense dictates that moderate exercise makes the heart stronger and improves circulation. It also helps to control weight. Being overweight increases the chance of high blood pressure, atherosclerosis, heart disease and adult- onset (type 2) diabetes. Moderate physical activities like walking, cycling, yoga, swimming and gardening work lower the risk of both stroke and heart disease.
• Eat a healing diet : Eat a variety of fruits and vegetables. Juicing is an excellent and delicious way to include raw foods in diet. If diabetic, control the diabetes: If left untreated, diabetes can damage the blood vessels throughout the body and lead to atherosclerosis.
• If diabetic, control the diabetes : If left untreated, diabetes can damage the blood vessels throughout the body and lead to atherosclerosis.

Yogic Practices for the Management of Stroke & Paralysis

Source : Morarji Desai National Institute of Yoga