Is it safe to treat ?

[charlize29]

Hi,

Just want to confirm whether it is safe to treat a patient for a stroke rehab.with a dx of a 3-week old stroke (L) MCA infarct, Paroxysmal AF, rate controlled with digoxin, uncontrolled HPN and an underlying Type 2 DM. Getting up on the bed from supine already produces high BP at 138/114mmHg, breathlessness and dizziness.

Regards,
Charlize

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[physiosanskrati]

Yes you can start with positioning , bridging , breathing ex , ankle toe mov etc . Try improving his endurance as well as exercise tollerance by making him ex. in bed only. Nex time when you write any question plz avoid using abbreviations.
Regards.

[hoopoe]

please your Abbreviations is not clear to me
can you more explane

[charlize29]

He's a 3 week old stroke, Left Middle cerrebral artery infarct,with paroxsysmal Atrial fibirllation which is controlled with digoxin, has an uncontrolled Hypertension and Type 2 Diabetes Mellitus. Blood pressure shoots sky high with minimal activity..Sorry guys...

[sjsrikanth]

Dear friend
rather than knowing what to do in this situation i think we should concentrate on what should not be done.
1.Breathholding during any active exercise should be avoided.
2.combined Isometrics (local isometrics are ok), and even small movts like a straight leg raise can cause fluctuation in blood pressure.
3.positioning or turning should not involve sudden movemnts of the head.

mild free movements with above caution can help

[Aisha_kb]

Hey Charlize,
Just wondering, is his medical condition under control and are the doctors giving the appropriate treatment to deal with the symptoms you have described?
Its very important that his Blood pressure and diabetes is regulated and controlled, that helps in easing the symptoms and providing for better recovery.
Otherwise, I would just concentrate on positioning, and maintaining muscle integrity...
Keep a close link with the doctors and an eye on his charts, when you notice some stability in the above symptoms then you can attempt further management.

Atleast that is what i do in such scenarios....

[sdkashif]

Generally physiotherapy is started after 72 hours post stroke when the vital signs are stable and patient medical condition is controlled. So if you find if some of the vital signs is not controlled, you may make your physiotherapy approach from more active to passive. Among traditional physioitherapy measures which are positioning,ROM, mobilization, strengthening and compensatory techniques, you may chose the passive measures to follow for physiotherapy.