What is a stroke?

A stroke (also known as apoplexy or cerebral infarction) involves an acute disruption of blood flow to the arteries that supply the brain with blood. Globally, strokes are considered the second leading cause of death. The causes are diverse, with the main risk factors including high blood pressure, atrial fibrillation, diabetes mellitus, obesity, and smoking. The risk of having a stroke significantly increases with age, and men are generally affected more often than women.

There are two types of strokes:

The ischemic stroke: This is the most common type of stroke. A circulatory disorder causes under-supply to certain areas of the brain. This leads to cell death and subsequent tissue destruction.

The hemorrhagic stroke: This type involves an acute cerebral hemorrhage. The most common cause is long-term high blood pressure, which leads to changes in the arterial walls in the brain and thus to bursting or tearing. The escaping blood increases brain pressure, and the tissue is not adequately supplied with oxygen.

What are the symptoms of a stroke?

The symptoms are diverse, depending on the affected supply area of an artery in the brain, they can vary in severity. A hallmark of a stroke is that it involves sudden onset neurological deficits. These include, for example, hemiplegia, numbness, speech disorders, word-finding difficulties, visual disturbances, consciousness disturbances, gait and balance disorders, and states of confusion. However, less specific symptoms such as severe headaches, dizziness, epileptic seizures, and vomiting can also be signs of a stroke.

Welche Symptome hat ein Schlaganfall?

How is a stroke treated?

A stroke is a medical emergency and must be treated immediately. Since brain tissue is sensitive, treatment options are limited to a few hours after the onset of symptoms. A computed tomography scan helps to distinguish between an ischemic and a hemorrhagic stroke. The goal then is to prevent the progression of tissue destruction in the brain. The blood clot blocking a vessel can be either dissolved by medication or mechanically removed with a catheter. Brain hemorrhages must sometimes be operated on and/or monitored in an intensive care unit.

What are the consequences of a stroke?

Depending on the severity and timing of the treatment, symptoms may recede or remain permanent. The spectrum of lasting impairments ranges from minor fine motor disorders to complete paralysis of the legs and/or arms. For those affected and their relatives, a stroke is a life-changing event, often leading to a complete change in lifestyle. To restore physical functions such as balance, standing, and walking as well as movement sequences as effectively as possible, early rehabilitation is required. Through this, patients are either to relearn lost functions or find ways to cope with existing limitations. In addition to regular physiotherapy and occupational therapy, orthoses are used to improve gait and thus prevent falls and misalignments.

Why is an orthosis useful after a stroke?

Orthoses are regularly used in patients who have had a stroke with lasting impairments. Often, a condition known as foot drop occurs, which is the inability to lift the tip of the foot towards the body. However, this movement is crucial for a safe and fluid gait. Affected individuals often get caught with their toe and stumble. To compensate for the paralysis and completely lift the leg, a compensatory movement is made in the hip. As a result, malpositions occur, which lead to back pain and further discomfort.

The use of an orthosis helps affected individuals to train walking and standing, thus regaining more independence and mobility. It is advantageous to use the orthosis as early as possible to prevent subsequent damage and misalignments in time.

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Conclusion: An orthosis improves gait after a stroke

A custom-made orthosis helps individuals feel more secure on their feet after a stroke. This is crucial to prevent falls and to rebuild self-confidence.

Especially in combination with consistent physiotherapy, it is often possible to walk and stand safely again after a stroke. Greater security provided by wearing an orthosis helps individuals feel more confident in everyday life.

Therapists, doctors, and orthopedic technicians are the right contacts to select the appropriate aids. After all, it is an individual situation that requires tailored solutions. The goal is for walking to be less strenuous because the entire focus is no longer needed on each individual step.

How does an orthosis work?

An orthosis is professionally adjusted and tailored to the individual needs of the affected person. In addition to continuous physiotherapy, it supports people who have suffered a stroke and have difficulties walking and standing.

This type of orthosis particularly involves the ankle and foot and works on multiple levels:

  • The paralyzed calf muscle is actively supported to gain more security while standing and walking
  • The paralyzed tibialis anterior muscle is actively supported to prevent falls due to tripping
  • Various spring units help to support and stabilize balance
  • Walking becomes less strenuous as the focus is no longer on each individual step

Whether an orthosis is sensible is discussed in a detailed consultation. Therapists, doctors, and orthopedic technicians are the appropriate contacts to select the right aids and work out individual solutions.

  • Bibliography

    [1] Daryabor, A., Arazpour, M., Aminian, G., 2018. Effect of different designs of ankle-foot orthoses on gait in patients with stroke: A systematic review. Gait Posture 62, 268–279. https://doi.org/10.1016/j.gaitpost.2018.03.026

    [2] de Paula, G.V., da Silva, T.R., de Souza, J.T., Luvizutto, G.J., Bazan, S.G.Z., Modolo, G.P., Winckler, F.C., de Oliveira Antunes, L.C., Martin, L.C., da Costa, R.D.M., Bazan, R., 2019. Effect of ankle-foot orthosis on functional mobility and dynamic balance of patients after stroke. Medicine (Baltimore) 98, e17317. https://doi.org/10.1097/MD.0000000000017317

    [3] Katan, M., Luft, A., 2018. Global Burden of Stroke. Semin Neurol 38, 208–211. https://doi.org/10.1055/s-0038-1649503

    [4] Saini, V., Guada, L., Yavagal, D.R., 2021. Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions. Neurology 97, S6–S16. https://doi.org/10.1212/WNL.0000000000012781

    [5] Unnithan, A.K.A., M Das, J., Mehta, P., 2022. Hemorrhagic Stroke, in: StatPearls. StatPearls Publishing, Treasure Island (FL).

    [6] Winstein, C.J., Stein, J., Arena, R., Bates, B., Cherney, L.R., Cramer, S.C., Deruyter, F., Eng, J.J., Fisher, B., Harvey, R.L., Lang, C.E., MacKay-Lyons, M., Ottenbacher, K.J., Pugh, S., Reeves, M.J., Richards, L.G., Stiers, W., Zorowitz, R.D., American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research, 2016. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 47, e98–e169. https://doi.org/10.1161/STR.0000000000000098

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For a standard model, expect a statutory co-payment between €5 and a maximum of €10 per fitting. Additional costs may apply for premium fittings, depending on the model.

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