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Abstract
The patient's arm affected by hemiplegia is a common problem following a stroke. The term hemiplegia is a limited physiological description of the effects of a stroke on a patient's limb. Any nurse involved in the care of stroke patients must possess essential knowledge on the pathophysiology of hemiplegia and its subsequent treatment and care management programmes. This article reviews the stroke literature for patients with arms affected by hemiplegia. It describes common complications that may arise and subsequent preventive care management strategies that need to be considered. Finally it discusses why success in rehabilitation and recovery programmes need to be considered from the patient's perspective and measured in the context of the patient's experiences and feelings of wellbeing.
Key words: Stroke: rehabilitation * Paralysis * Multidisciplinary teams
The patient's arm affected by hemiplegia is a common problem following a stroke and it has been estimated that 50-80% of stroke patients experience such a problem (Wade et al, 1985). Despite rehabilitation treatments to an affected arm, permanent and persistent disability may result. Care management of a patient with a hmiplgie arm following a stroke is not the prerogative of one specific discipline in one specific specialty. Tb provide effective care for such patients, there is a need to understand the problem in its entirety. This is because the term 'hemiplegia', which is defined in clinical practice as paralysis of one side of the body, is a limited physiological description of the effects of a stroke on a person's limb.
Any nurse involved in the care of a patient who has had a cerebrovascular accident (CVA) must possess essential knowledge of the stages, associated symptoms and impact of hemiplegia. Such knowledge ensures that nursing care addresses all the patient's needs and unnecessary complications may be avoided.
Impaired motor function of an affected arm
A motor impairment to an arm following a stroke may be owing to either:
* Damage to the motor cortex of the brain
* Damage to the descending fibres of the corticospinal tract. If this neurological damage is above motor decussation then the signs and symptoms will be seen in the limb on the opposite side of the body (Carr and Kenny, 1992) (Figure 1).
The direct consequence of such neurological...