A-Z

Stroke

Changes to movement after a stroke

Loss of movement in limbs

Many people experienced partial or complete paralysis of the limbs on one side of the body following their stroke. Usually both the upper and lower limbs were affected, but occasionally only the arm was affected. This sometimes improved spontaneously over a few days or weeks after the stroke, but recovery can continue for much longer. 

A few people recalled suddenly feeling a movement in fingers and toes and others making slow progress over some months. 

 

He had been concentrating on trying to move his toe and suddenly got a twitch which he described...

He had been concentrating on trying to move his toe and suddenly got a twitch which he described...

Age at interview: 60
Sex: Male
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How were you in yourself? Were you able to move about? 

No, I wasn't. I was, my right side was virtually paralysed. I mean, I could move my right arm to a certain extent but, as I said, it had a mind of its own so therefore I was helped to be fed. I, there are televisions in our local hospital and therefore I had a television set pushed in front of my nose, so I was able to watch the cricket. There was a test match on at the time. I was able to watch the cricket and not, because I was able to watch the television, I wasn't, I didn't mope, or didn't worry too much. I mean, there's not much that one can do. You're in bed, you can't move, what's the point in panicking and worrying? You can't do anything about it. I remember although on the last day I was in the, the normal medical ward, I was concentrating on my toe, on big toe of my right leg and I managed to get a twitch out of my toe. I remember calling, shouting out to the nurse, saying, 'Nurse, please come here, have a look at my toe, is that moving or is it my imagination?' She said, 'You've moved your toe' I said 'Wonderful' and of course from moving a toe, once you've moved a toe, you can move your, a few, a few toes. And I think I was well on the way to being, to be well on the, the way to recovery when I got into the stroke unit. 

Lack of use of a limb can quickly lead to wasting of the muscles and several people commented on how weak the limb had become after just a few days or weeks. Limbs, particularly the hand and fingers, could also become stiff. 

Recovery of strength, balance and movement in legs and arms usually required intensive rehabilitation with physiotherapists and occupational therapists (See 'Stroke recovery' Physical aspects and mobility'). 

Balance, coordination and falls

Weakness on one side of the body could affect people's balance, although balance problems could also be caused by the stroke affecting the part of the brain responsible for balance, or by sensory loss (including altered vision) or by the loss of coordination. One man suffered from a lack of balance and coordination due to damage to his brainstem.

 

Suffers from ataxia due to damage to his brainstem this results in lack of coordination and balance.

Suffers from ataxia due to damage to his brainstem this results in lack of coordination and balance.

Age at interview: 62
Sex: Male
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So if you could perhaps then talk about your experiences of trying to explain your symptoms from the stroke?

Husband' Yes. I think when I talk about my stroke, I try to talk to people as if I'm fairly normal and forget what I need to tell them about how things have changed and what I've suffered. And I think very often they tend to assume that stroke means either left or right handed damage and in my case I have all the original muscular strength but I suffer from something called ataxia which basically means lack of co-ordination, so I can stand up and do things but I don't know, as somebody said, he can stand up but you never know next what your feet will do and I think that's quite useful.

Wife' You can only stand up if you're holding on to something.

Husband' Exactly.

Loss of balance affects both ability to stand but also to sit and some people were initially propped up with pillows.

Poor balance and lack of coordination could often result in people falling. To help prevent falls in the first few days people were advised to not move about unless supervised. In the long term falls could still occur and could be quite sudden and dramatic, sometimes resulting in broken bones. Using a stick, holding onto furniture while moving around, being more careful and moving at a slower pace all helped to minimise the risk of falls. 

Coming to terms with loss of physical ability

Coming to term with loss of movement and mobility was extremely hard and some said that they just could not accept it. Although a lack of acceptance could lead to unrealistic expectations for recovery it also helped to spur some people on to get better. 

 

Was initially quite depressed and could not accept that the stroke had affected her physically...

Was initially quite depressed and could not accept that the stroke had affected her physically...

Age at interview: 79
Sex: Female
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It's so blank to me the beginning but I remember when one day I lifted my leg a wee bit and let the doctor see, 'Oh, that's marvellous' and I was saying, 'What's marvellous about that?' I couldn't understand it like I wasn't accepting the fact that I wasn't going to be better, you know but it was several weeks before the physio people came in and started working with me I suppose when I got stronger and they got me out of bed and they were trying to with the, there was the occupational therapists were in trying to make my arms, fingers move, my fingers wouldn't move or anything and they were, they had plasticine and that to help me and I remember one day, day, I said, 'I'm going to try doing a crossword puzzle' and I got, I got the pencil out and had the answer but I couldn't put the letters in the square box for the crossword puzzle and that really got me, you know, I was feeling quite depressed, 'Am I ever going to be able to do things like that again?' and I couldn't even aim it for the box where the letter should go but it gradually came back.

Many wondered how much they would recover and how long it would take. Although many regained at least some movement and mobility over a period of months and years, others were left with limited ability to move their affected limbs and with limited mobility. Most people reflected that recovery of physical ability was a long process and although it might not recover completely they had recovered more function that they originally expected.

 

He had been told by a friend that it could take two years for him to recover physically and that...

He had been told by a friend that it could take two years for him to recover physically and that...

Age at interview: 63
Sex: Male
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I felt alright myself, you know, but it was just, you know, the walking got me, you know. I couldn't walk very far. That's what worried me more than anything. As I say from walking about 4 hours a day continuously and not, not being hardly able to hobble along. it takes me an hour to get up to the Co-op and back which is just up the road which I, which I used to be back in about 10 minutes. Which is, you know, and they said it would take about 2 hours to get, get any sorry, 2 years, sorry, to get better. You won't fully recover, they reckon. You're still suffer a bit from, you'll know you've had a stroke, you know, which is a bit frightening really. But I'm hoping that in about 2 years time I'll be sort of hopefully recovered but I met somebody at the shop, oh, a few weeks ago and he said that his dad had a stroke and it took him 2 years but he said he never fully recovered and I said, 'Oh thanks for cheering me up'. 

 

Although he is not back to normal he stresses that he has achieved more than he originally...

Although he is not back to normal he stresses that he has achieved more than he originally...

Age at interview: 58
Sex: Male
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And I think one of the critical things I'll say is this; there's a time immediately after your illness when you can't imagine that you'll ever be back to normal again. I remember saying to my consultant neurologist, he asked me what my ambition was and I said, 'My ambition is to return to a point when no-one will ever know that I've had a stroke,' and he looked at me slightly gravely and said, 'I think you have to, you may have you reduce your ambition a little.' And I see now what he means. But at the same time it's true to say that, you will find, if you are of the right mind to find it, that there are things that in your immediate, in the immediate aftermath to your illness you could never imagine yourself being able to do. You'll think to yourself, 'Well I might just about walk with a stick but I'll never walk without one,' all you, you have to answer that by thinking back to what you can now do that you once said you would never do. And then think forward from this point and there's no reason why the same distance can't be achieved as between this point and a future point that would be equidistant with the point that you once said you would never reach from a point immediately after your illness.

 

David was told by his doctor that he would never walk again, but in time he has regained some...

David was told by his doctor that he would never walk again, but in time he has regained some...

Age at interview: 62
Sex: Male
Age at diagnosis: 54
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I can remember when my specialist you know said to me, “It’s getting towards the time where you were leaving us.” And he called me into his office and he said, “How do you tell someone that they’re going to spend the rest of their life in a wheelchair?” And I said, “Well if you’ve any sense you don’t tell them.” And he said, “Well I won’t tell you then.” Because when I was released from the hospital I was in a, in a wheel chair. And I thought, “No, too young to be in a wheelchair for the rest of my life.” And I’ve made an effort to... you know I’ve got lots of aids. But I’ve made an effort to walk and walk as much as I can. But you know I still can’t walk very far. But I certainly you know come out of the wheelchair. So you know just keep trying, keep trying. You know. Just remember that when we were born we none us of could walk. You know we had that to learn didn’t we?
 
So... You know just learn it again.

 

Last reviewed June 2017.
Last updated August 2013

 

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