Does this posture look familiar? It is typical of contractures of the limbs that can happen after a stroke. Post-stroke contractures happen when post-stroke rehab is ignored. Contractures are recognized by muscular rigidity and tightness on the affected side.

When a stroke goes unrehabilitated, the upper extremity presents with typically a fixed flexed elbow, with the affected shoulder becoming stiff, and the hand clenched.

Contractures may also occur in the affected knee and ankle by an extension/ straightening.
These mobility restrictions almost certainly cause limitations in performing simple day- to- day tasks such as brushing, dressing up etc.


Causes of Contractures After a Stroke


Contractures are a result of spasticity, a condition where the muscles become rigid and tight due to the stroke/brain injury.
Spasticity without due rehabilitation or referral to Physiotherapy likely develops into contractures, causing the affected side of the body to present with the typical symptoms.

Rehabilitation after a stroke

Rehabilitation for contractures involves reestablishing the connection between the brain and the muscles, and retrain how these muscles respond.

Contractures are very reversible if referred early, through the following rehabilitation methods performed by a Physiotherapist.

Stretching: Soft stretching on the affected part can help to use a splint or a ball to prop your hand open. A physiotherapist can teach you routines that may help with your post-stroke spasticity.

Range of Motion Exercises: Regular exercises will help blood flow around the muscles, relieve stiffness and improve range of motion.

Massed Practice: Rewiring the brain happens through a process called neuroplasticity can help to reverse contractures. Neuroplasticity helps stroke patients regain competence and independence. Exercises by your physiotherapist have a way of triggering neurons, and bringing about improvements.
Massed Practice is based on the principle that the more you perform these specific exercises, the more your brain will regain the ability to send correct motor signals to your affected muscles, causing contractures to reverse.

Passive Exercises: Your physiotherapist carries out the routine exercise on patients who suffer from severe spasticity and stiffness. The assisted exercise activates neuroplasticity, and you’ll soon be doing it yourself.

Electrical Stimulation: Your physiotherapist uses an electrical stimulation device around the affected area to release spasticity and tightness. Combining electrical stimulation with rehabilitative exercises produces excellent results when treating contractures.

Orthoses: Your physiotherapist may recommend the use of splints and props to stretch and open the affected muscles. The splints will be adjusted to fit and support the affected part.

Botox: Botox is a nerve blocker that can reduce spasticity and contractures. Although Botox is temporary, as they usually wear off, it provides relief until you can get proper treatment.

Surgery: Surgery is usually the last resort if none of the above treatments don't provide relief from contractures. You may need to undergo surgery if the contracture remains unresolved.


How to Prevent Contractures in People with Stroke

You can prevent contractures from happening by executing the treatment methods above following a stroke. Using splints, stretches, exercise, etc. can help prevent contractures from happening.

Above all, it is essential to see a physiotherapist early after a stroke to address it early on, and prevent contractures and other consequences. Stroke rehab may take a while, and may cost a bit, therefore having a dependable health insurance cover such as Axa Mansard hmo, Hygeia hmo, Reliance hmo, or Bastion Hmo.

Suffering from post stroke contractures? You can contact St. Joseph’s Physiotherapy clinic to begin your stroke rehabilitation. If you need to consult with a Physiotherapist in Lagos, we are located at 21b Christ avenue, off Admiralty Road, Lekki Phase 1, and can be reached via THIS LINK or call 09060960109, the phone lines are open 24/7, with quick responses to your emails