Tuesday, 27 October 2009

Back in the water and back on track

After an abortive week last week, which saw Jo’s hydrotherapy session cancelled in midstream because a second person did not appear to satisfy health and safety requirements and her physiotherapy session cancelled because her physiotherapist took some more annual leave, we finally got back on track with a hydrotherapy session today.

This went very well with Jo getting better and better at kicking her left leg from the knee whilst floating on her back and saw her increasing the use of her left leg to stand from a semi-sitting position in the water.

She seems to be moving from stage 4 to 5 of Brunnstrom’s 7 stages of neurological recovery, where spasticity begins to decrease and movement patterns are not dictated solely by limb synergies.

It was interesting to read, in a Wikipedia entry on spasticity, that “multi-tasking, such as walking while talking, or doing several physical activities simultaneously, can also trigger an increase in spasticity, especially if one or several of those activities makes the person nervous”.

This describes exactly what is happening during Jo’s walking exercises, with anxiety about turning corners leading to an increase in muscle spasticity and thus pain.

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Different strokes...

It has been nearly seven years since Jo suffered a "controlled" stroke whilst undergoing brain surgery to clip the blood vessel that had caused a subarachnoid haemorrhage in 2000. Sadly two successive coilings did not occlude the bleed and so Jo had a craniotomy in August 2008. During surgery the surgeon discovered the coiling had penetrated the rear of the aneurysm, occasioning emergency repair procedures. Consequentially they spent one and a half hours longer in surgery than expected, leading to the right half of Jo's brain forgetting it has to look after the left side of her world.