- May 9

Hemiparesis After Stroke

Hemiparesis is a common after-effect of a stroke that causes weakness on one side of your body. This condition affects about 8 out of 10 stroke survivors (1). It is important to know the severity of your stroke and the location of where the stroke occurred to get a better understanding of your hemiparesis. For instance, if you experienced a stroke on the right side of your brain, then you would experience weakness on the left side of your body. Knowing more about your stroke will help you make a successful recovery plan and live an enjoyable life.

One-sided weakness can limit your movement, which can affect your activities of daily living, social participation, work, and even your leisure activities. In this article, you will learn more about symptoms, causes, and how to live with hemiparesis after surviving a stroke.

What is Hemiparesis?

Hemiparesis is defined as partial weakness of one side of the body. This condition may affect the arms, hands, legs, face, neck, and/or your trunk. In some cases, hemiparesis may involve a combination of body parts (1).

Many stroke survivors and care-partners get confused between the term hemiparesis and hemiplegia. Hemiparesis speaks to weakness of one side of the body, while hemiplegia is the paralysis of one side of the body. Both conditions are dependent on where the stroke occurred in the brain.

Causes of Hemiparesis

What might cause hemiparesis? During a stroke, certain parts of your brain do not get enough oxygen due to the disruption of the blood supply, causing brain cells to die. If these cells are associated with body strength, coordination, and movement, then damaging them can cause hemiparesis (4). Each hemisphere of the brain controls movement of the opposite side of the body, which is why hemiparesis will be on the opposite side of the damaged side of the brain when you experience a stroke.

If you have a stroke that occurs in the left side of the brain, the right side of your body will have hemiparesis. You may experience difficulty in talking and understanding (aphasia), in addition to knowing the difference between left and right. If you experienced a stroke that occurred in the right side of the brain, then you will experience hemiparesis on the left side of your body (4). You may experience ataxia (i.e. difficulty in coordinating movement), which will lead to a loss of balance and difficulty in walking. For additional information, visit A Guide to Right vs. Right Strokes.

These conditions can be caused by an ischemic stroke, which is when blood supply is cut off. In the case of a hemorrhagic stroke, the brain experiences bleeding from blood vessels rupturing. Less commonly a stroke survivor may experience a stroke that causes ipsilateral hemiparesis: weakness on the same side as the injury. The location of where the stroke occurred in the brain will determine the location of your weakness. Strokes can also occur outside of the hemispheres of the brain within the cerebral cortex. For more information on these types of strokes, visit our blogs to read more within the following articles: Pontine Strokes, Basal Ganglia Strokes, Cerebellum Strokes.

Symptoms of Hemiparesis

Some symptoms of hemiparesis include (3):

Loss of balance
Difficulty walking
Impaired ability to grab objects
Decrease in movement precision
Muscle fatigue
Lack of coordination

(3)

Life with Hemiparesis

Living with hemiparesis can cause difficulty in performing activities of daily living. Activities of daily living include basic self-care tasks, such as getting dressed, eating, grooming, brushing teeth, toileting, and bathing. Other activities that you may experience difficulty with include working , social participation, functional mobility, and sexual activities. Since hemiparesis causes weakness on one side of the body, your muscles can be too weak to perform even the basic self-care tasks. This may be frustrating and embarrassing, but with the right stroke recovery plan, you can live a successful life (5).

Living with hemiparesis can result in both short and long-term health complications, such as (6):

Respiratory difficulties
Muscle atrophy (loss of muscle tissue)
Muscle spasticity (abnormal increase of muscle tone)
Bowel control difficulties
Urinary retention
Incontinence
Sexual dysfunction

How is Hemiparesis Diagnosed?

There are different assessments that your medical doctor will perform to determine the severity of hemiparesis. Your doctor will conduct a complete evaluation involving your medical history to assess what type of stroke you experienced and the severity of the stroke. Other assessments would include range of motion and muscle strength tests.

Specific imaging tests that your doctor would conduct include (3):

Magnetic resonance imaging (MRI)
Computerized tomography (CT) scan
Electromyography (EMG)

Your doctor may conduct sensation assessments, such as (9):

Ability to localize touch
Discriminating between hot and cold
Sharp and Blunt Discrimination
Two-point Discrimination
Bilateral Simultaneous (Tests sensory neglect)
Joint Position Sense (Tests the direction of the joint moving)

|| Struggling with arm and hand weakness after a stroke? IpsiHand™ is an FDA-approved, non-invasive device for rehabilitation of upper extremity motor function after stroke. Learn more about the IpsiHand.

Therapy for Hemiparesis

During your stroke recovery process, you may undergo many types of rehabilitation programs. In addition to the highlights mentioned below, be sure to visit Blogs at Neurolutions for comprehensive resources related to recovery and rehabilitation if you or your loved one is experiencing hemiparesis after stroke.

Physical Therapy and Occupational Therapy for Hemiparesis

Your medical doctor may recommend physical therapy to prevent muscle spasticity and atrophy, occupational therapy to learn different strategies in completing activities of daily living and to compensate for the weakness of one side of your body, and speech therapy to assist with feeding, swallowing, and language.

Mobility Aids and Adaptive Equipment for Hemiparesis

As a consequence of weakness and coordination impairments after stroke, mobility aids (e.g. walkers, canes, manual or power wheelchairs) are often needed to increase safety and independence in functional mobility. Adaptive equipment is often suggested to make day-to-day tasks easier to perform. Low tech or high tech assistive technology can also help with home and work productivity.

Electrical Stimulation for Hemiparesis

Other treatments may include electrical stimulation therapy. This is when electrical currents are applied to your muscles through pads on your skin. This helps stimulate movement of the weakened side of the body.

Constraint-Induced Movement Therapy (CIMT)

Some therapists may use constraint-induced movement therapy, which is a popular treatment for hemiparesis. This type of treatment involves restraining your unaffected side while exercising your affected side (2). Before trying this on your own, consult with rehabilitation clinics in your area so they can create a customized protocol for you that meets your needs and considers your safety.

Mirror Therapy for Hemiparesis

Mirror therapy may benefit functional movement of the hemiparetic arm or leg. A mirror is placed over the hemiparetic arm or leg. The individual would then practice rehab exercises with the stronger body part while watching the movement in the mirror. The mirror image “tricks” the brain into thinking both body parts are moving. This may help spark neuroplasticity (2).

You can also view a video on the benefits of mirror therapy:

Mental Practice

There are other treatments that do not include movement therapy, such as mental practice therapy (2). This type of therapy involves mentally rehearsing specific activities to improve performance. This is more of a cognitive treatment instead of a physical treatment for hemiparesis. Mental practice helps activate neuroplasticity and triggers cortical changes. Evidence shows that combining mental practice with physical movement therapies such as physical and occupational therapy produces improved results.

For more information on mirror therapy, mental practice, and other motor priming exercises for hemiparesis, refer to 5 Powerful Brain Exercises for Stroke Rehab.

Medication and Hemiparesis

In some cases, your medical doctor may prescribe you medication to help with muscle spasms, muscle spasticity, and pain. For example, your medical doctor may recommend botox to help with spasticity. Botox is a “nerve block” that blocks the signals causing muscle contraction. It is an injectable treatment that may provide relief for about 3 months. During this period in which your muscles are relaxed, you can focus on rehab exercises to help rewire the brain and address the root cause of hemiparesis (2).

Baclofen is a type of medication that helps relax spastic muscles. While it provides a temporary relief of spastic muscles, it can offer a window of opportunity to pursue intense rehab exercises (2).

Hemiparesis Prognosis

Hemiparesis is different for everyone. Every brain is wired differently, and every stroke impacts different neural pathways. In some cases you can have hemiparesis for a few months, a few years, or you may have it chronically. Not knowing how long you may experience hemiparesis can prove challenging in predicting recovery outcomes and timing. However, after a stroke, the brain enters a phase of heightened neuroplasticity as it attempts to rapidly heal from injury. When this phase slows down, the brain enters a “plateau” phase. This plateau often occurs at the 3-month mark. Many stroke survivors make incredible gains during this time, especially while participating in therapy programs. Beyond the 3-month mark, recovery can become contingent. Stroke survivors tend to remain at the same level of ability. However, when rehab is continued even after stopping for months or years, recovery can continue and you can get stronger (2). Visit Recovery Timelines after Stroke and Chronic Stroke Recovery for encouraging education on how to recover throughout all time ines post stroke recovery.

Coping with Hemiparesis

Experiencing hemiparesis may be challenging and frustrating, however there are tools and strategies to assist in living with hemiparesis. Discussing with your care-partner, loved ones, and medical team will help you the right stroke recovery plan for you.There are different coping techniques to help during stressful times in your recovery. For example, mindfulness and meditation can help reduce the anxiety and stress that is involved in your stroke recovery. Moreover, lifestyle changes can help you recover and increase your quality of life.

Lifestyle changes can include (5):

Be active and maintain movement
Strengthen leg muscles and balance through exercises
Wear flat, wide-toed shoes
Use prescribed assistive devices (Do not furniture surf)
Pay close attention while walking

Lastly, home modifications can help reduce anxiety and improve your safety in your home. Home modifications can include (5):

Grab bars
Ramps
Raised toilet seats
Tub bench
Hand-held shower head
Long-handled brushes or washing mitts with pockets for soap
Electric toothbrushes and razors
Plastic adhesive strips on the bottom of the bathtub

Make sure you take your time to complete activities. There is no rush in performing your self-care tasks. Ask for help if you get frustrated or if you feel that it is taking too long to perform your tasks. Living with hemiparesis can impact your activities of daily living; however, asking for help and taking your time will improve your quality of life.

Living with hemiparesis can provide a different outlook on life. You are going to perform activities in a different way than how you used to perform them, and that is okay! Discussing your stroke recovery plan with your medical team and care-partner is very crucial. You are in control of your life and the way you want to live it! It may be different now, but that doesn’t mean you cannot live a successful life. There are many techniques and strategies to help you increase your quality of life. Advocate for yourself and speak up on what you want to accomplish in your life. Be sure to visit Blogs at Neurolutions for educational resources on living with hemiparesis and how to reclaim your life after stroke.

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