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Aphasia from 3 points of view: Patient, Family Member and Therapist. “The problem of right hemiplegia with aphasia is that it is really complex to manage from all points of view.” The patient finds himself from one day to the next without his ability to move on the right side of the body, on a hospital bed, with health professionals around him who speak to him and without him fully understanding the meaning of their words, like suddenly finding himself in a foreign country and in a strange “body” Added to these terrifying moments, there is the impossibility of describing his own condition and asking doctors and family members for information about what happened and about his future recovery. When he tries to speak, the words often do not come out, but they seem to be in his head and the result is babbling or nonsense words, which for those who listen to him do not make any sense. Sometimes the aphasic patient speaks through incomprehensible language with correct intonation and the certainty that he has said the sentence properly and faces the stunned faces of relatives who are struggling to understand. It is evident how this type of pressure is very dramatic for the patient but also from the point of view of the relatives, the situation is unpleasant. They are dealing with a situation that any day...

  The evaluation of the population health status has been based on simple estimators such as general mortality rates or by age groups, incidence rates, prevalence or lethality, these estimators present limitations to measure the health-disease phenomenon. Stroke of both ischemic and hemorrhagic origin has many similar risk factors that are classified into two categories: modifiable and non-modifiable. Among the non-modifiable risk factors are age, sex, family history of stroke, having a previous episode, and black race. Multiple studies and clinical practice guidelines indicate that the risk of stroke increases significantly after 60 years of age. On the other hand, generally, up to the age of 60, there is a greater risk in men than in women, although mortality is always higher in women. After these ages, the risks are comparable. Strokes are the leading cause of serious long-term disability in several developed countries such as the United States. It is one of the 18 main diseases that causes loss of healthy life years and years of life lived with disability during 2010. In Colombia, stroke was the third leading cause of death, after violence and coronary heart disease, during 2010; it is one of the main determinants of loss of healthy life years due to disability and premature death. Regarding the prevalence, differences have been found in reports according to the period and the place. Local studies were...

Dysphagia is when difficulties occur in the swallowing process. This symptom can be present in the first days after the stroke, manifesting itself with levels of severity, ranging from the difficulty of swallowing only some types of food, to the total impossibility of feeding or hydrating through the mouth, reaching the most serious cases, the difficulty of handling one’s own saliva. Going through a clinical and / or instrumental evaluation, the presence-absence of dysphagia, and the eventual magnitude of the disturbance, is correct. Screening procedures are generally carried out by professional nurses, if dysphagia is suspected, a specific clinical evaluation is requested, completed by instrumental investigations such as Fibroendoscopy (FESS), swallowing tests of different types of food, or videofluoroscopy (VFSS).   Are phoniatrician and speech therapists equivalent in the treatment of dysphagia? The phoniatrician or the otolaryngologist are doctors who take care of the clinical and instrumental evaluation, thus giving a diagnosis of dysphagia. The speech therapist, after having carried out his language assessment, deals with the treatment of post-stroke dysphagia.   How to behave if the structure does not have the right staff to recover from dysphagia? Dysphagia after a stroke is a disorder that can have serious consequences; therefore, it must be evaluated and treated quickly, requesting specific professional advice. What are the side effects of PEG? When mouth feeding is not safe enough, the nutritional need...

In the pages of this site, we almost exclusively refer to the most common strokes, and until now, we have never discussed the topic of cerebellar stroke and what is the cerebellum. This is a particularly complex issue, on one hand due to the complexity of the functions that the cerebellum performs, on the other because it is a rarer injury compared to those caused to the cerebral hemispheres (approximately 2-3% of strokes). Despite this, the treatment of the cerebellar patient is an issue that must be addressed, because the patient who survives an injury of this level, often presents problems that are quite incapacitating that limit him, sometimes even in the acts of minimal autonomy, also the mere fact of standing is impossible. Only by studying in depth, the role of the cerebellum in relation to movement we can expect to be able to process the rehabilitation therapy that best suits the patient’s needs with cerebellar injury. As we will see later in the course of this article, the cerebellum has undergone a long process of reinterpretation by researchers in the last century, and it is time to transfer this interpretive evolution to our operational field of physiotherapy, strictly reconsidering our work in the gym.   Objectives A common and widespread custom is to think of the cerebellum as a structure of our central nervous system, member of...

When we hear this phrase said by the operators of a rehabilitation clinic or hospital: ¨the patient does not cooperate¨ our world falls apart. We have just passed the most critical stage where we did not even know if our relative would survive the stroke and now we find ourselves in a moment where we are doing everything in our might to reorganize the whole family’s life. We have decided and want to get to the top of the hill, even though some inconveniences that have not really mattered. But when the physiotherapist tells us that our relative unfortunately does not cooperate and does not actively participate in the physiotherapy, we feel that is going to be more difficult to reach the objective. In other words as if now we have to fight another enemy. Let me advice you that it is not another enemy, it is the same enemy that we have had since the stroke, but that now requires specific therapeutic attention. WHAT PATIENTS ARE USUALLY TOLD THAT ARE UNCOOPERATIVE? Typically there are two types of patients who are tagged like that. ● Patients with right hemiplegia, aphasia, and apraxia. ● Left hemiplegic patient with consciousness and attention disorders. These two types of patients represent a great amount of the total who have suffered a stroke, therefore the phrase ¨the patient does not cooperate” affects dozens of...