What is Stroke Stroke or brain attack is

What is Stroke? Stroke or brain attack is a sudden problem affecting the blood vessels of the brain. There are mainly two types of stroke: Ischemic Stroke In ischemic stroke, which occurs in approximately 8590% of strokes, a blood vessel becomes occluded and the blood supply to part of the brain is totally or partially blocked Hemorrhagic A hemorrhagic stroke, or cerebral hemorrhage, is a form of stroke that occurs when a blood vessel in the brain Stroke ruptures or bleeds

What are the symptoms? If stroke effect CNS pathways, symptoms may include: • muscle weakness (Hemiplegia) • numbness • reduction in sensory or vibratory sensation If stroke effect the brainstem, symptoms may include: • altered smell, taste, hearing, or vision (total or partial) • drooping of eyelid and weakness of ocular muscles • decreased reflexes: gag, swallow, pupil reactivity to light • decreased sensation and muscle weakness of the face • balance problems • altered breathing and heart rate • weakness in sternocleidomastoid muscle (SCM) with inability to turn head to one side • weakness in tongue (inability to protrude and/or move from side to side) If the cerebral cortex is involved, symptoms may include: • aphasia (inability to speak or understand language from involvement of Broca's or Wernicke's area) • apraxia (altered voluntary movements) • visual field cut(involvement of occipital lobe) • memory deficits (involvement of temporal lobe) • hemineglect (involvement of parietal lobe) • disorganized thinking, confusion, hypersexual gestures (with involvement of frontal lobe) If the cerebellum is involved, symptoms may include: • trouble walking • altered movement coordination • vertigo and or disequilibrium

Survey Study Who: Students in three classes in adaptive learning Division in program for poststroke in Foothill college Number of People who joined survey: 19 Their situation: 1 to 20 years post stroke

Survey Results Number of people who have problems with arm/hand after stroke 18 VS VS Number of people who don’t have problems with arm/hand after stroke 1

Survey Results • Do they still have touch sensation after stroke on the attacked side? YES*: Not a normal one: 7 out of 19 5 out of 19 7 out of 19 36. 8% 26. 4% 36. 8% (Note*: Some patient don’t know whether they have normal sensation or not)

Survey Results • Hours people spent on therapy exercise: Number of People 68. 4% people do exercise less than 1 hour/day 15. 8% people do not do exercise at all Many people spend most of their time to do walking exercise

Survey Results • How do you think the importance for you to recover your arm/hand’s function? A. Important 89. 5% B. Not that important 10. 5% C. I can do all the jobs using my other hand/arm 15. 8%

Survey Results • Were there any arm/hand exercises that you cannot perform on your own after leaving hospital? Yes: No: 89. 5% 10. 5%

Survey Results What are the exercises that you cannot perform? • • • Hold & release a ball Push a bar down do rubber band stretch Cannot grip at all lifting my arm opening hand grasping object

Survey Results What is the most frustrating problem with your hand/arm that occurred after your stroke? 1. Eat with attacked hand 2. hard to move arm to reach a goal 3. Cannot grasp something 4. hard to use some tools 5. Fine motor control: Typing. Eating, grooming. 6. too hard to get results 7. Lack of movement of arm, 8. complete dressing with putting on pants, inserting shirt in pants, etc 9. No rapid progress, but slow, steady improvement 10. not being able to do things: cleaning closets, organize my home 11. Laziness ………………. .

Survey Results What is the most frustrating problem? Objective: Hard to move arm to reach a goal Can not grasp something not being able to do things: cleaning closets, organize my home Eat with attacked hand Subjective: too hard to get results No rapid progress, but slow, steady improvement Laziness

Survey Results Motivation 1. Hard to move arm to reach a goal 2. Can not grasp something 3. not being able to do things: cleaning 4. closets, organize my home 5. Eat with attacked hand Number of People 89. 5% people think it is really important for them to have their hand/arm function back 1. Laziness 2. too hard to get results 3. No rapid progress, but slow, steady improvement

Observations • People do much more exercise on their leg/foot than on arm/hand • It is really hard to recover the full function of their arm/hand. However, a semi-functional arm/hand is also very helpful for them in everyday life • No fine motor exercise is taught in class (exercise with a rod in both hand). Majority of them don’t have the ability to open their attacked hand • Lot of exercise is used to maintain the muscle’s natural tone. • Lack of Motivation is a big obstacle for them to do exercise. Shoulder pain is another important obstacle for them to get back their arm/hand motion.

Survey Results Ideas from people who had stroke for designing rehab device: 1. A mechanical exerciser you can hold. It will strengthen your arm 2. A device to achieve hand functions. Help getting in and out of bed.